Is Pain All In The Mind??

Is pain all in the mind?
New research shows why some people are better at coping with pain than others
By Vivienne Parry
Times Online (UK)

Pain is a simple enough concept to grasp. You stub your toe, shout, perhaps utter a few expletives, rub it better and it eventually fades. But neuroscientists are realising that pain is much more complex than anyone thought possible, comprising not just physical sensations, but emotional ones too. Pioneering studies are providing insights into why some people experience debilitating chronic pain long after an injury has healed, as well as why some are more prone to pain than others, and why certain people never recover from bereavement.

"Pain is much more than mere sensation. The psychological component is at least as important as the physiological processes giving rise to it," says Dr Jonathan Brooks, a scientist at the Centre for Functional Magnetic Resonance Imaging of the Brain, at Oxford University. His research centre scans the brains of people with chronic pain and compares them with those of healthy people.

While most pain goes away as an injury gets better, sometimes it remains for months or even years, long outlasting its original purpose. Chronic physical pain is debilitating and can cause disability, depression and post-traumatic stress disorder. It is also very common. A group from the University of Washington reported in the journal Archives of Surgery earlier this year that 63 per cent of patients who had sustained serious trauma still had injury-related pain a year later. It was most common in the 35-44 age group and in women, and least common in those with a college education.

Other chronic pain conditions include arthritis and lower back pain. In the latter, a physical source can be identified in only about 10 per cent of cases. No one really knows why some people experience chronic pain and others do not, but recent imaging studies at Northwestern University, Chicago, have found a series of abnormalities in the brains of chronic pain sufferers in which the part linked to decision-making (the prefrontal cortex) is reduced, while an area of the prefrontal cortex linked to emotion is hyperactive. What is known for certain is that the brain changes in those with chronic pain so that they experience pain differently from the way they did before.

We all have a system for suppressing pain when necessary so that we can flee attackers even when injured. Those who suffer from chronic pain appear unable to access this and cannot use distraction as a means of suppressing pain; their brains seem to amplify pain signals rather than inhibit them.

Treatment for the condition comprises both physical and psychological interventions, says Dr Michael Platt, the lead clinician for pain services at St Mary's Hospital, London, part of Imperial College Healthcare NHS Trust, where he holds weekly pain clinics. "Most physicians realise that you have to heal the mind as much as the body. For example, if you have pain, then depression is worse, and if you have depression, then pain is worse." He adds that gaining a better indication of which parts of the brain are involved in pain sensations may lead to better treatments for patients.

We all respond to pain differently

Scientists are increasingly realising that everyone responds to pain differently. "There are many physiological and psychological factors that determine how much pain you feel," says Dr Brooks. "Personality, how worried a person is, and, in the case of women, the time in the menstrual cycle, can all have an effect."

He adds that our genes can also influence our sensitivity to pain. This was first brought to the attention of scientists by the "ginger-whinger" syndrome. Anaesthetists reported that redheaded women complain of pain more than other patients, and consequently need more pain relief. Why? Not because redheads are wimps; it was later discovered that their genetic make-up makes them less sensitive to certain types of pain medication.

Neuroscience is also revealing a host of similarities between emotional and physical pain. In the same way that in some people injury can cause long-lasting chronic pain, science reveals why some will never get over heartbreak.

Professor David Alexander, the director of the Aberdeen Centre for Trauma Research, has been involved in many disasters: the 2004 tsunami; Iraq; and the recent earthquake in Pakistan. He is not surprised about the link between physical and emotional pain. "If you listen to people who are damaged emotionally, they will often translate their pain into physical similes: 'my head is bursting, my guts are aching', and so on. The parallel is very strong."

It is only in the past few years, however, that scientists have begun to investigate what is going on in the brain during an episode of emotional pain. The neuroscientist Mary Frances O'Connor, of the University of California, Los Angeles (UCLA), is one of the scientists who has propelled emotional pain up the research agenda. "We're at a very new time when we can use technologies to look at the brain and the heart." Naomi Eisenberger, one of her colleagues at UCLA, has shown which parts of the brain are active when we feel emotional pain. She devised a computer game in which participants were made to feel left out.

Simultaneous brain scanning revealed that the pain of being socially rejected was processed in much the same way in the brain as physical pain, and in the same area, the anterior cingulate cortex, which is located towards the front of the brain, roughly at the height of the temples.

Eisenberger theorises as to why this should be so. Pain is often interpreted as a warning, so that you take your hand away from a hot surface. Social relationships are crucial to our survival as a species. In dangerous situations, a lone human being is in peril, whereas a group may survive. "The social attachment system piggybacked on to the physical pain system to make sure that we stay connected to close others," Eisenberger says. Being wrenched from another or rejected by a group is painful, so we learn to avoid it.

A related issue is "complicated grief", which O'Connor estimates occurs in about 10 per cent of people, who fail to adapt to bereavement over time. Her imaging work shows that this sort of grief activates neurons in the reward centre of the brain, giving addictive-like properties to memories of the lost one. There is a strong suspicion, as yet unproven, that sufferers might also be among those who experience the greatest levels of chronic physical pain. This is an area that deserves urgent research because of its terrible emotional and physical toll.

How to deal with pain

Exercise

Prolonged exercise lifts the spirits and reduces pain, as evidenced by the "runners' high", which is driven by the naturally produced painkillers, endorphins.

Don't bottle it up

Talking about your emotions helps - one reason why women are less at risk from illness after a bereavement.

Don't self-medicate

Dulling pain with alcohol, recreational drugs or too many prescription painkillers can turn recoverable trauma into lifelong dependency or addiction.

Don't get overtired

Tiredness exacerbates pain, especially in women. Fatigue is often reported with chronic pain, though less so in men, whose higher testosterone levels make their muscles more resistant to fatigue.

Try mindfulness meditation

By concentrating on your moment-to-moment experience, you can - through repeated practice - achieve a greater sense of control and enhanced emotional wellbeing.

Case study

For the chronic pain patients who arrive at the pain management centre at St Mary's Hospital, in Paddington, West London, this clinic is their last resort.

One such patient is Ursula Madden, who lives in London with her 12-year-old son. Madden works as a radiographer at St Mary's, but her chronic pain turned her from employee to patient. She initially dismissed her painful feet as a side-effect of her busy job. But when she to lie down every night after work because of an unbearable burning sensation across the tops of her feet, she decided it was time to see her doctor.

Getting a diagnosis was not easy. It took two years, with long spells off work because she couldn't walk, and Madden became very depressed.

"None of the doctors was accepting the fact that I was in agony," she says. Madden was eventually referred to the pain clinic where it was discovered that the pain in her feet was caused by a combination of arthritis and faulty nerves sending pain signals to the brain. The diagnosis made a big impact. "When you have something that people can't see, unlike, say, a broken arm, recognition is a very big part of it."

The doctors at the clinic use a variety of approaches, from psychological intervention such as counseling and life coaching, to more physical treatments, such as pain killers, acupuncture and super-hot chili pepper cream. The latter works to desensitize the nerves.
"The first time I used the cream I was jumping around with pain, but it worked brilliantly," says Madden, who believes that attending the clinic has helped her enormously, both physically and psychologically.

While visiting her sister in Ireland recently she managed to go on a four-mile walk along the coast that she wouldn't have been able to do two years ago. "I was thinking, 'Sod the pain; I'm going to put on my boots and do it'. Yes, it was painful. But I still really enjoyed it; it was wonderful."

UPDATE: Ignorance on Autism continues....

WorldNetDaily Exclusive
MEDIA MATTERS
Savage defends criticism of autism 'racket'
Stands by assertion false diagnoses creating national panic
Posted: July 22, 2008
3:00 am Eastern

© 2008 WorldNetDaily


Michael Savage (San Francisco Chronicle)
Standing by his criticism of the autism "racket," nationally syndicated radio host Michael Savage devoted his entire three-hour show yesterday to the topic, allowing experts and callers to weigh in on the controversy sparked by a left-leaning media watchdog's campaign against him.

The Web-based Media Matters – which describes its task as "correcting conservative misinformation" – urged people to call their local radio stations to hold Savage "accountable" for his comments during a July 16 broadcast of the Savage Nation, the country's third most popular talk show, with more than 8 million weekly listeners on 350 stations.

Savage explained in a statement on his website that his assertion autism is a "fraud" and "a racket" was "meant to boldly awaken parents and children to the medical community's attempt to label too many children or adults as 'autistic.'"

During his July 16 show, Savage said, "I'll tell you what autism is. In 99 percent of the cases, it's a brat who hasn't been told to cut the act out. That's what autism is."

Savage said, "They don't have a father around to tell them, 'Don't act like a moron, you'll get nowhere in life. ... Straighten up. Act like a man. Don't sit there crying and screaming, idiot."

Savage explained to the New York Times his use of the figure 99 percent was hyperbole.

He told WND that Media Matters itself is as much a part of the story as autism. Acting like the HIV virus, he said, "they invade the body politic and mimic the defense cells until they poison the entire organism."

Summing up the controversy, he said: "I spend my entire life championing helpless children, because of the tragedy of my brother Jerome. I attack falsely diagnosed cases, the misdiagnosed and the outright fraud artists through a bold parody, and Media Matters rips the parody out of context, stirs up the autism community against me, and here we are!"

During his broadcast yesterday, Savage urged his critics not to rush to judgment, "because the truly autistic child needs as much help as he or she can get, the truly autistic child needs the funding."

"It is the falsely diagnosed, the misdiagnosed and the outright fakers who want the benefits, who must be found out and must be turned out, so that the money can go to the truly needy in this particular field," he said.

Savage explained that argument "was the essence of my conversation last week."

"Why would I have chosen to attack defenseless children when I've never done so in my entire life?" he asked. "Think about that. What would I have gained by doing it? Nothing. I didn't do it. The fact of the matter is the enemies of the truth did it, using you, the parents of the injured child to turn on me, the defender of the child."

In the statement on his website, Savage explained that just as drug companies "have overdiagnosed 'ADD' and 'ADHD' to peddle dangerous speed-like drugs to children as young as 4 years of age, this cartel of doctors and drug companies is now creating a national panic by overdiagnosing "autism, for which there is no definitive medical diagnosis!"

In its "Call to Action" against Savage, Media Matters said, "Your voice is critical in holding Savage accountable for his comments. Autism is not a fraud – asthma is not a money racket. I hope you take the time to call and tell those running the station exactly what you think of Michael Savage."

In New York City yesterday, a coalition of groups that advocate for children with autism responded, staging a protest outside the studios of radio station WOR, which carries Savage's program.

Savage commented that "some in New York found it odd that the protesters were almost all men, they had neatly printed signs and there were no children. They suspect it was a staged protest by the Stalinist Savage-haters."


By the way, if you would like to contact Mr. Savage's employer to voice your opinion on his "star" commentators remarks, here is how you can do just that:

Talk Radio Network
P.O. Box 3755
Central Point, Oregon 97502

Phone: 541-664-8827
Fax: 541-664-6250
Email: info@talkradionetwork.com

Irritating Ignorance....

Until recently I was blissfully unaware that there was an infestation of the airwaves known as Michael Savage. Apparently his radio show is widely syndicated, and he recently addressed the autism epidemic:

SAVAGE: Now, you want me to tell you my opinion on autism, since I’m not talking about autism? A fraud, a racket. For a long while, we were hearing that every minority child had asthma. Why did they sudden ⎯ why was there an asthma epidemic amongst minority children? Because I’ll tell you why: The children got extra welfare if they were disabled, and they got extra help in school. It was a money racket. Everyone went in and was told [fake cough], “When the nurse looks at you, you go [fake cough], ‘I don’t know, the dust got me.’ ” See, everyone had asthma from the minority community. That was number one.
Now, the illness du jour is autism. You know what autism is? I’ll tell you what autism is. In 99 percent of the cases, it's a brat who hasn't been told to cut the act out. That’s what autism is.
What do you mean they scream and they’re silent? They don't have a father around to tell them, “Don’t act like a moron. You'll get nowhere in life. Stop acting like a putz. Straighten up. Act like a man. Don’t sit there crying and screaming, idiot.”
Autism ⎯ everybody has an illness. If I behaved like a fool, my father called me a fool. And he said to me, “Don’t behave like a fool.” The worst thing he said ⎯ “Don't behave like a fool. Don’t be anybody’s dummy. Don’t sound like an idiot. Don’t act like a girl. Don’t cry.” That’s what I was raised with. That's what you should raise your children with. Stop with the sensitivity training. You’re turning your son into a girl, and you’re turning your nation into a nation of losers and beaten men. That’s why we have the politicians we have.

Mr. Savage apparently didn’t take his father’s advice. He’s behaving like a fool. Mr. Savage is an idiot. No, that gives idiots everywhere a bad name. There really is not a good adjective to describe him. Does he really think that families all over the world are going through this for all the perks that come with having an autistic child? Does he really think that the stimming, the sensory problems, the communication problems, the gut issues, and the rest of the laundry list of symptoms you can add in here are voluntary?

Mr. Savage, stop acting like a putz!

Now, if you’ll excuse me, I’m off to find out if one of my local radio stations carries this A-Hole’s show. If so, I’ve got to make sure the buttons in my car radio don’t include that station.

UPDATE:

NAA has asked for an apology and retraction from Savage, as well as time on his show to educate this buffoon. It's a nice thought, but I won't hold my breath.

Listen to the recording below and decide for yourself if an apology is required and a retraction necessary, I bet you will say "YES, both are definitely very much needed, and soon!!

Currently Recruiting: Dystonia and CRPS Study

**Seeking Clinical Research Volunteers** Dystonia and CRPS Study The NIH/NINDS is sponsoring an outpatient research study assessing patients with Focal Dystonia (FD). FD is a condition where specific movements of the hand trigger acute overactivity in muscles involved in the intended task and activity spreads to adjacent muscles that were supposed to be relaxed. We think the underlying reason of this condition is a lack of suppression of the unwanted muscle activity in the brain. In complex regional pain syndrome (CRPS) without obvious nerve damage, dystonia-like muscle spasms can occur. In a series of tests including transcranial magnetic stimulation (TMS), electromyography (EMG) and electroencephalography (EEG), individuals with FD, CRPS and both conditions in the upper or lower limb will be compared. Our goal is to find out more about the underlying mechanisms of both conditions. Studies are conducted at the NIH Clinical Center in Bethesda, Maryland. Inclusion criteria - patients Presence of FD/CRPS/CRPS and FD in one limb (upper or lower limb) Age 18 years or older Exclusion criteria Any serious medical, surgical, neurological or psychiatric conditions Medications such as the following: antidepressants, anxiolytics, anticonvulsants, antipsychotics, antiparkinsonians, hypnotics, stimulants, and antihistamines (please tell the research doctor what you take, if anything) Presence of pacemaker, implanted medical pump, metal plate or metal object in skull or eye History of seizure disorder Known history of hearing loss. Pregnancy Use of blood thinners other than a daily aspirin There is no cost for participation. You will be compensated for research-related travel expenses. Time commitment consists of 5 visits. For more information, call (301) 496 6388, Sandra C Beck, MD. This study is carried out in compliance with testing and safety standards of the U.S. Department of Health and Human Services.

Pain doesn't sideline determined animal lover

Pain doesn't sideline determined animal lover By Pamela Mcloughlin Staff New Haven Register

BETHANY - Judy Rettig's name has long been synonymous with animal rescue and care, first as animal control officer in West Haven, then for the Bethany, Orange and Woodbridge animal control district. But these days, although she still helps animals any way she can, Rettig's name has been attached to something less cheerful - a nerve disease that causes such debilitating pain its sufferers can lose the will to live. Rettig developed reflex sympathetic dystrophy, a chronic neurological syndrome which often appears after an injury or surgery, after she slipped on ice and broke a leg at the animal shelter. The strongest painkillers available do little to dull the pain. Rettig wears a special boot on her affected leg because even a bed sheet brushing across it is excruciating. The vibrations from a loud sound can send her reeling. "This disease is very complicated," Rettig said. "Every minute of my life, it's like my leg just broke. ...You learn to make friends with your pain." At one point Rettig became so discouraged, she considered giving up the fight. But the same determination that made her crawl into sewer pipes to free trapped dogs or carry a 90-pound Labrador retriever down a rescue ladder kicked in, and she went into fighting mode. On June 22, she joined the RSD team as part of the sixth annual Achilles Hope and Possibility 5-mile run/walk in New York City's Central Park. The event raises money for the Reflex Sympathethic Dystrophy Syndrome Association, headquartered in Milford. Unable to walk, Rettig made the journey in a wheelchair, pushed by her partner of 30 years, Christine Santoro, and other friends. They named Rettig's group, "Team Monk," after television's fictional detective, Adrian Monk. Monk's character has obsessive compulsive disorder, which acts as both a curse and a blessing, because while it creates barriers, it also helps him solve cases. Rettig is very organized, clean and particular, qualities revealed in the immaculate way she kept the shelters she managed, and her house at a time when she had more than a dozen dogs there. "It was really wonderful," Rettig said of the walk, noting that many participants were Iraq War vets with missing limbs. The event also included groups raising money for other causes. "When I look at life around me, I still feel very lucky," she said. James W. Broatch, executive director of RSDSA, said they had more participants than ever in this year's walk. Although the total has not yet been tallied, and donations are still coming in, Broatch said he hopes it raised at least $60,000, 90 percent of which will go directly to research. Participants, including RSD sufferers and their family and friends, came from as far away as Colorado and Florida. "It was a day filled with hope," Broatch said. Hope is what gets many people through RSD, an "under recognized disease," Broatch said. RSD affects between 200,000 and 1.2 million Americans. Rettig was replaced as animal control officer because there was no sign of her recovery, although RSD can go into remission. Because there is no cure for the disease, remission is her only hope. The disease or pain can travel to other limbs, and did in Rettig's case. Still young and driven to help animals as well as people, Rettig hopes someday to get a version of her old life back. There's nothing she'd rather be doing than chasing dogs and cats or helping rebuild areas of the nation affected by hurricanes, floods or other natural disasters, Rettig said. Donations for RSD research in Rettig's name can be sent to: RSDSA, P.O. Box 502, Milford, CT. 06460 or made by visiting the website, www.RSDS.org.

Believe in Yourself

Believe in yourself -- in the power you have
to control your own life, day by day,

Believe in the strength that you have deep inside,
and your faith will help show you the way.

Believe in tomorrow and what it will bring --
let a hopeful heart carry you through,

For things will work out if you trust and believe
there's no limit to what you can do.

~Emily Matthews