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Mr. Moseley has made the brain’s role in pain part of his life’s work. “The longer pain persists, the more sensitive the pain system becomes,” he said. “That’s what the nervous system does: It learns. Understanding this complex relationship, along with re-engaging the body, is the first step toward loosening pain’s grip.”
It’s not a cure all. We can’t think away all pain. For one, we don’t fully control our thoughts. Just as you can’t relax when told “to just relax,” you can’t become pain free just by telling yourself your brain is exacerbating your pain. Even the happiest, calmest optimists experience pain. For another, many people experiencing chronic pain are also experiencing other stressors that cause them to feel less safe and secure — feelings that exacerbate pain.
“Most people with chronic pain aren’t just a little stressed, they are a lot stressed,” said Paul Ingraham, who has made a career explaining the science of chronic pain and injury rehab. “They’re stressed by the pain itself and also by major life challenges and socioeconomic problems that no one could solve with anything less than years of effort and maybe a miracle or two.” Some stressors that exacerbate pain, as well as contribute to other health problems, are not so easily removed. For many, anxiety is an unavoidable feature of life, and it makes pain worse.
This points to the importance of addressing mental health alongside physical health. A recent systematic review of 202 clinical trials of nonpharmacological pain treatments found that those with evidence of effectiveness included approaches that addressed the mind, not just the body. According to the report, published by the Agency for Healthcare Research and Quality, these were “consistently associated with durable slight to moderate improvements in function and pain,” at least for some conditions.
Some stress reduction and promotion of feelings of safety can be achieved relatively easily. For example, deep breathing or listening to or playing music are relatively simple and inexpensive, and without harmful side effects. Others, like improving your social life or leaving a stressful job, take more work and can be more disruptive. Some might consider consulting professionals specializing in cognitive behavioral therapy and other mindfulness techniques aimed at addressing the brain-pain relationship.
Although all these can be of some help, they won’t eliminate all pain in all people, and in many cases they can only offer short-term relief. Perhaps because I find it calming, I feel much better after playing the trumpet, but I can count on pain’s return in some form another day.