If you are one of the more than 100 million Americans suffering with chronic pain, you know how desperate you can get searching for relief. For constant or chronic pain, sometimes knowing that you can only get temporary relief from medications sits at the back of your brain and sets up pain anticipation. Shouldn’t there be a better way, an approach or approaches that don’t rely on pharmaceutical drugs to combat pain? According to new research, there are some new pain relief methods that look very promising to do just that.
TREATMENT FROM STRANGERS MAY PROVIDE UNEXPECTED PAIN RELIEF
It may seem counter-intuitive, yet a study conducted by researchers from the University of Würzburg, Amsterdam and Zurich found that participants treated for pain by strangers (medical professionals from a different social group) experienced stronger pain relief than when they received pain treatment by someone from their own social group. Participants rated their pain “less intense” after being treated by strangers, and the reactions were reductions in both subjective and pain-related activation areas of the brain corresponding to the pain. Researchers call this “prediction error learning,” otherwise known as the analgesic effect of surprise. Patients didn’t expect to experience pain relief from strangers, and the less they expected to receive pain relief, the greater their surprise and the more pronounced their actual pain relief afterward.
HIGHER MINDFULNESS MAY LESSEN PAIN
Long suspected to play a role in providing pain relief, mindfulness now gets a thumbs-up in a study just published in the journal Pain. In the study, supported by the National Center for Complementary and Integrative Health (NCCIH), researchers from Wake Forest University and some other collaborating institutions looked at how participants with no prior experience with meditation fared after completing the Freiburg Mindfulness Inventory and then two testing sessions with a magnetic resonance imaging scanner (MRI) and thermal probe and the delivery of minor lower-leg heat stimuli (sometimes uncomfortable). Results showed that those with higher innate mindfulness reported feeling less pain. Their responses to the pain stimuli (heat) showed up in areas of the brain (the precuneus/posterior cingulate cortex) involved in attention and subjective emotional responses to sensations. In other words, this brain area is thought to have a role in how you react to experiences. Researchers point to the study’s usefulness moving forward with nonpharmacological approaches to pain management that, in addition to mindfulness, may include biofeedback and behavioral therapies targeting increasing mindfulness and reductions in this brain region.
A meta-analysis of mindfulness meditation’s effectiveness in reducing migraine pain found that it may reduce the intensity of pain from migraine and shows promise as a viable, complementary treatment option for patients with primary headache. The 2018 study was published in the Chinese Medical Journal.
PROMISING DUAL-TARGET PAIN RELIEVER WITHOUT OPIOID SIDE EFFECTS
First, the bad news: it’s not available yet. Second, the good news: scientists are working to develop a dual-targeting painkiller that is an effective analgesic without any opioid painkiller side effects. Opioids have long been known for their effective pain relief and work by activating the mu opioid peptide (MOP) receptor. Yet, MOP side effects can be severe: dependence, tolerance, respiratory depression, hyperalgesia, and even lead to addiction. Researchers have developed a bifunctional nociceptin and mu opioid receptor agonist called AT-121 that reportedly provides potent pain relief in primates without causing dependence, hyperalgesia or respiratory depression. The hope is that AT-121 may prove to be a safe and effective prescription pain reliever to treat humans suffering chronic pain.
HOME-BASED VIDEO GAME EXERCISES FOR CHRONIC LOW-BACK PAIN
It turns out there’s another target group who can benefit from playing video games: older adults with chronic low-back pain. That’s according to 2018 research from the University of Sydney published in Physical Therapy. This is a first-of-its-kind study looking at how effective home-based video game exercises benefit pain reduction in people over the age of 55 using a Nintendo Wii-Fit-U. Results showed participants had 27 percent reduction in chronic low back pain and the exercises gave them 23 percent increase in function. The 8-week self-managed program consisted of 60-minute exercise sessions of aerobic, strengthening and flexibility three days a week. The results were comparable to exercise completed in a physiotherapist-monitored exercise program. The video game exercise program offers older adults with chronic low back pain a cost-effective solution that doesn’t require them to travel outside the home – and helps them to self-manage their pain and continue daily life activities despite having pain.
OTHER PAIN RELIEF STAND-BYS THAT WORK
While research continues on novel methods to effectively treat pain, including some that may be years off in reaching the marketplace, there are some therapies that have loyal adherents and are backed by research to provide non-opioid relief from pain. They may not work for everyone in every instance of chronic pain, but the fact that they do work for a significant number of individuals seeking pain relief at least offers pain sufferers viable alternatives to taking potentially-addicting painkillers.
MINDFULNESS BASED STRESS REDUCTION AND COGNITIVE-BEHAVIORAL THERAPY
Results of a study funded by the National Center for Complementary and Integrative Health (NCCIH), part of the National Institutes of Health found that the combination of mindfulness based stress reduction (MBSR) and cognitive-behavioral therapy (CBT) may prove “more effective than usual treatment in alleviate chronic low back pain.” MBSR combines elements of mindfulness meditation and yoga. CBT, on the other hand, trains individuals to modify specific beliefs and thoughts relative to pain. Researchers studied participants who used MBSR and CBT or usual treatment for one year. At 26 and 52 weeks, participants using both mind-body approaches experienced better functioning and less back pain than the usual care group. Both groups (mind-body and usual care) received relief in terms of pain intensity and some mental health measurements, those using CBT didn’t see continuing improvement after 26 weeks. The MBSR group, however, did continue to see improvement. Researchers suggested that MBSR may be an “effective” form of treatment for people suffering chronic low back pain.
A form of psychotherapy, cognitive-behavioral therapy (CBT) has proven helpful to individuals struggling with chronic pain. By utilizing several methods, CBT helps pain sufferers to cope more effectively with chronic pain, better manage it, change their pain response behaviors, and boost their self-confidence that they can be an active participant in reducing their pain – and do so successfully. CBT is considered the psychological gold standard of treatment for a wide variety of pain. Systematic reviews and meta-analyses have shown the efficacy of CBT in reducing pain distress, pain interference with daily activities, distress, and disability.
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This article was originally published on Psych Central.
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