Strategies for chronic pain: three mind-body techniques to cope with ongoing agony from headaches, backaches and sports injuries - Health

Pain is the most primal of human experiences; the rude shock of being born is our first encounter with intense discomfort. Yet pain -- especially pain that doesn't let up -- remains largely a medical mystery. We know the basic outline: When we twist an ankle, for example, signals shoot through our central nervous system to our brain, which in turn lets us know we've experienced an injury and we should respond. But one person's experience of the same pain stimulus can be completely different from another's, and medical experts aren't sure why. And when it comes to chronic pain -- defined as persistent hurting that lasts six or more months -- doctors often find successful treatment elusive.

Chronic pain is big business: More than 86 million Americans suffer from it, costing upward of $90 billion annually in lost workdays, legal expenses, drugs and medical procedures. The most common forms of chronic pain are headaches, backaches, arthritis and residual sports- or car-accident injuries.

The gender divide in pain experience is a particular problem in a medical culture that often treats women less proactively for pain than men. Studies show that many health-care providers believe women have a higher pain tolerance than men, resulting in boys and men getting more effective doses of painkillers. Also, women are more likely to be diagnosed with histrionic disorder -- suggesting that women's pain is less "real," and only in the sufferer's mind.

In truth, from what understanding there is of the pain experience, all pain is in the mind. "We don't necessarily know where pain comes from, but we do know it can amplify in the central nervous system -- and it's not always representative of tissue damage," says James N. Dillard, M.D., D.C., author of The Chronic Pain Solution (Bantam, 2002). Doctors have long recognized that someone who has had a limb amputated can still feel phantom pain in the missing appendage. A case of the brain and central nervous system misfiring, this phenomenon may be similar to what happens when pain becomes chronic.

However, the good news is that even chronic pain is treatable. "Because the process is so complex, we can attack it from many directions," Dillard says. So, while you may worry you have no choice but to stay on pain medication, there are affordable, effective ways to manage and decrease your pain yourself. Here are a few of these alternatives:

Self-hypnosis

Hypnosis has proven to be a medically solid method for alleviating pain. A recent Beth Israel Deaconess Medical Center/Harvard Medical School study of 241 patients undergoing minor surgery found that those who used self-hypnosis needed less pain medication and left the recovery room faster than those who did not. Even the National Institutes of Health has issued a report noting that hypnosis can be effective in treating chronic cancer pain. According to Bruce Eimer, Ph.D., a Philadelphia-based psychologist, hypnotherapist and author of Hypnotize Yourself Out of Pain Now! (New Harbinger Publications, 2002), pain operates through the unconscious mind -- where your body signals your brain with no help from you -- so it's best to treat pain directly through the subconscious.

Here's how self-hypnosis works: The patient enters a trancelike state, in which pain-reducing suggestions can penetrate without the interference of the conscious brain. (Because you're not quite sleeping, you can awake from the trance simply by opening your eyes.)

Elmer suggests going to a certified hypnotherapist first for a lesson in self-hypnosis. (Visit the American Society of Clinical Hypnosis online at asch.net for a referral.)

You try it

Sit in a comfortable chair with your feet on the floor. Tell yourself, "I can interrupt unpleasant feelings by breathing slowly and deeply." Recite the sentence over and over. It will percolate while you're hypnotized. Then focus on a nearby object and tell yourself that your eyelids are getting heavy and that when they close, you'll be in a state of self-hypnosis. As you focus on your breathing, you go deeper into a state of relaxation. When you want to come out, count from one to five and "wake up."

Mindfulness meditation

While hypnosis helps guide your conscious mind away from your pain, mindfulness meditation actually directs your awareness to it -- and helps you manage it from that point of focus. "It makes you more grounded in the present moment, which puts pain in its proper perspective because you're paying attention to the full range of stimulation in your environment," says Patrick D. Randolph, Ph.D., a meditation instructor and psychologist in Lubbock, Texas. When Randolph was director of the Pain Management Center at Texas Tech University Health Sciences Center, he conducted a study wherein 78 chronic-pain sufferers meditated six days a week for eight weeks. A full 80 percent reported an increase in their ability to deal with pain, and 79 percent said they had a decrease in the depression and anxiety that frequently accompany chronic pain.