Strategies to Control Pain

Pain specialists use a variety of techniques to control pain, including hypnosis and painkilling drugs. We’ll discuss both of these topics in the next chapter. Two other pain-relieving strategies are biofeedback and acupuncture.

Biofeedback is a process of learning voluntary control over largely automatic body functions, such as heart rate, blood pressure, blood flow, and muscle tension. Using sensitive equipment that signals subtle changes in a specific bodily function, people can learn to become more aware of their body’s internal state. With the auditory or visual feedback provided by the biofeedback instrument, the person learns how to exercise conscious control over a particular bodily process.

For example, an individual who experiences chronic tension headaches might use biofeedback to learn to relax shoulder, neck, and facial muscles. Numerous studies have shown that biofeedback is effective in helping people who experience tension headaches, migraine headaches, jaw pain, and back pain (deCharms & others, 2005; Nestoriuc & Martin, 2007).

Acupuncture is a pain-relieving technique that has been used in traditional Chinese medicine for thousands of years. In the United States, acupuncture has been practiced for about 200 years. Currently, about 3 million Americans each year seek acupuncture treatment for various types of pain (National Center for Complementary and Alternative Medicine, 2011c).

Acupuncture involves inserting tiny, sterile needles at specific points in the body. The needles are then twirled, heated, or stimulated with a mild electrical current. Exactly how this stimulation diminishes pain signals or the perception of pain has yet to be completely explained (Moffet, 2008, 2009). Some research has shown that acupuncture stimulates the release of endorphins in the brain and may also inhibit the production of substance P (Field, 2009; Lee & others, 2009). However, evidence suggests that psychological factors also play a significant role in the pain-relieving effects of acupuncture. Some early clinical studies found that true acupuncture was only slightly more effective than sham acupuncture in relieving pain (Madsen & others, 2009; Moffet, 2009). However, a new meta-analysis of dozens of studies found that acupuncture was significantly more effective than sham acupuncture or usual-care treatment in relieving pain associated with chronic headaches, arthritis, and chronic back, neck, and shoulder pain (Avins, 2012; Vickers & others, 2012).

Along with pain relief, acupuncture is being scientifically evaluated as a treatment for other conditions, including menstrual pain, osteoarthritis of the knee, nausea associated with cancer chemotherapy, and infertility (Domar & others, 2009; Huang & others, 2009; Lee & Fan, 2009; National Cancer Institute, 2008).

But what about everyday pain, such as the pain that accompanies a sprained ankle or a trip to the dentist? There are several simple techniques that you can use to help cope with minor pain.

Self-Administered Strategies

1. Distraction

By actively focusing your attention on some nonpainful task, you can often reduce pain (Edwards & others, 2009). For example, you can mentally count backward by sevens from 901, multiply pairs of two-digit numbers, draw different geometric figures in your mind, or count ceiling tiles. You can also focus on the details of a picture or other object.

Or try our favorite technique, which we’ll dub the “iPod pain relief strategy.” Intently listening to music, especially calming music, can reduce discomfort (Loewy & Spintge, 2011; North & Hargreaves, 2009).

2. Imagery

Creating a vivid mental image can help control pain (Pincus & Sheikh, 2009). Usually people create a pleasant and progressive scenario, such as walking along the beach or hiking in the mountains. Try to imagine all the different sensations involved, including the sights, sounds, aromas, touches, and tastes. The goal is to become so absorbed in your fantasy that you distract yourself from sensations of pain.

3. Relaxation and meditation

Deep relaxation can be a very effective strategy for deterring pain sensations (Edwards & others, 2009; Turk & Winter, 2006). One simple relaxation strategy is deep breathing: Inhale deeply, then exhale very slowly and completely, releasing tension throughout your body. As you exhale, consciously note the feelings of relaxation and warmth you’ve produced in your body.

Several studies have shown that practicing meditation is an effective way to minimize pain (see Brown & Jones, 2010; Grant & others, 2011). Meditation may reduce the subjective experience of pain through multiple pathways, including relaxation, distraction, and inducing a sense of detachment from the painful experience. Apparently, you do not need to be an expert or long-term meditator to benefit from meditation’s pain-relieving effects. Fadel Zeidan and his colleagues (2011) found that after just four 20-minute training sessions in a simple meditation technique, participants’ ratings of the unpleasantness of a painful stimulus dropped by 57% and ratings of its intensity dropped by 40%. (We’ll discuss meditation in more detail in the next chapter.)

4. Positive self-talk and reappraisal

This strategy involves making positive coping statements, either silently or out loud, during a painful episode or procedure. Examples of positive self-talk include statements such as, “It hurts, but I’m okay, I’m in control” and “I’m uncomfortable, but I can handle it.”

Self-talk can also include reappraising or redefining the pain (Edwards & others, 2009). Substituting realistic and constructive thoughts about the pain experience for threatening or helpless thoughts can significantly reduce pain. For example, an athlete in training might say, “The pain means my muscles are getting stronger.” Or consider the Marine Corps slogan: “Pain is weakness leaving the body.”

Can Magnets Relieve Pain?

Our students frequently ask us about different complementary and alternative medicines (CAM). Complementary and alternative medicines are a diverse group of health care systems, practices, or products that are not presently considered to be part of conventional medicine. Scientific evidence exists for some CAM therapies, such as the benefits of massage (Moyer & others, 2004). Therapies that are scientifically proven to be safe and effective usually become adopted by the mainstream health care system. However, the effectiveness and safety of many CAMs have not been proven by well-designed scientific studies.

Magnets are one popular CAM that have been used for many centuries to treat pain. But can magnets relieve pain? To date, there is no evidence supporting the idea that magnets relieve pain (National Standard Monograph, 2009). The pain relief that some people experience could be due to a placebo effect or expectations that pain will decrease. Or the relief could come from whatever holds the magnet in place, such as a warm bandage or the cushioned insole (Weintraub & others, 2003).

One final note: The techniques described here are not a substitute for seeking appropriate medical attention, especially when pain is severe, recurring, or of unknown origin. If pain persists, seek medical attention.