The Mind-Body Connection: Reducing Chronic Pain

An interesting article that highlights the importance of mind-body connection.
— Dr. Dale

From The Mind-Body Connection: Reducing Chronic Pain 

Researchers at the National Institutes of Health say that 50 per cent of older adults who live independently, and 75-85 per cent of those in assisted living facilities, have chronic pain.

Chronic pain can affect our sleep, appetite, mobility, mental health and our ability to live on our own. Unfortunately, it's so common that many patients and physicians consider chronic pain a normal part of aging.

According to American Pain Society, more than half of persistent pain sufferers have been living with their pain for more than five years, and experience their pain almost six days a week. However, a growing body of research indicates that chronic pain, such as fibromyalgia, sciatic nerve pain and lower back pain, is not something we should take for granted, and that it may be connected to non-age-related issues like loneliness, chronic stress and anxiety. In other words, there may be a stronger mind-body connection than we think.

Placebos and Nocebos

Lissa Rankin, MD, author of the best-selling book, Mind Over Medicine - Scientific Proof That You Can Heal Yourself (find it here), is both a physician and patient who radically changed her life and healed her own body. She believes the mind-body connection deserves more credit than traditional medicine gives it. In an interview with Lifetime Daily, Dr. Rankin explains why.

"Chronic pain is the body's way of calling for help," said Rankin. "The placebo effect (where a fake medical treatment improves a patient's symptoms or cures their condition) is proof of the mind's ability to impact our health. "When patients believe they've received a treatment that will heal them, even if it's only a placebo, they often experience relief from their symptoms, and healing."

Similarly, when patients experience negative outcomes from fake medical treatments, or negative suggestions made by medical staff, they experience a "nocebo" effect. While some view this as medical quackery, Rankin disagrees. "The nocebo effect shows that our ability to develop and recover from disease and chronic pain depends in large part on what we think and believe, how we live and who we surround ourselves with."

Ted J. Kaptchuk is Professor of Medicine and Professor of Global Health and Social Medicine at Harvard Medical School and Director of the Harvard-wide Program in Placebo Studies and the Therapeutic Encounter (PiPS) at Beth Israel Deaconess Medical Center in Boston, Mass. According to Kaptchuk, a host of studies show just how powerful placebos and nocebos can be.

"The placebo effect includes everything that surrounds the health care experience that can influence patient outcomes -- from a positive doctor-patient interaction to the power of imagination, hope, trust, persuasion and compassion," said Kaptchuk. "Placebos can stimulate an array of physiological responses, including changes in the brain's chemical activity, that alleviate pain, depression, anxiety, and fatigue.

"Other studies have shown that placebos address symptoms of illnesses like Parkinson's disease, asthma, irritable bowel disease, and benign prostatic hyperplasia," Kaptchuk continued. "Placebos have also been proven to augment the effectiveness of existing medicines and procedures, making them more powerful."

What Makes a Body Healthy? 

Rankin says that a healthy body is the product of a healthy life filled with strong and supportive relationships, fulfilling work, a sense of purpose, healthy outlets for creativity, spirituality and sexuality, a safe living environment, stable finances and solid mental health, all lived within a framework of love, service, gratitude and pleasure.

When one or more of those elements is out of whack, as they are for many older adults, it creates imbalances that impact the rest of your life and ultimately your health.

"Countless studies confirm that among older patients, psychosocial determinants like the presence of strong social ties and supportive friendships, along with feelings of control and purpose, are inextricably linked not only with health but also with life expectancy," Rankin said. "In fact, they may be even more important than more traditional health determinants like a healthy diet, exercise and health care.

"In countries where people live the longest, older adults have strong family and community bonds, active social lives and rich spiritual experiences," she added. "They enjoy greater longevity even if they drink alcohol, smoke cigarettes and eat foods that are deemed to be 'unhealthy.'"

What Makes a Body Unhealthy?

Rankin suggests that the body creates symptoms and illnesses as motivators for change. "The body starts communicating via whispers -- subtle physical symptoms like a headache or lower back pain," she said. "If we ignore these whispers, the body begins to yell and that's when you face serious illness."

Life lived out of balance creates stress, which causes the adrenal glands to release cortisol (the stress hormone). Under normal conditions, stress hormones are only released at times of danger and they return to normal levels when danger is over.

But many people live with so much stress that cortisol levels remain abnormally high. That raises prolactin levels, which increases the body's sensitivity to pain. When nerve endings, bones and muscle fibers are chronically bathed in stress hormones, they become hypersensitive to the point where even minor pain can feel excruciating. Autoimmune functions deteriorate, inflammation occurs and chronic pain develops.

The good news, Rankin says, is that a "mind over medicine" approach to chronic painis highly effective. "When people work on improving their relationships, creative outlets, spirituality, sex life, environment and finances, they change their thoughts, beliefs and feelings," she explained. "They dial down stress responses and shift the nervous system into relaxation responses. Cortisol levels drop. Endorphins, the body's natural pain relievers, are released."

How to Cultivate a Healthier Mind-Body Connection

Rankin developed a diagnostic and treatment wellness model she calls the Whole Health Cairn. A cairn is a stack of balanced stones that stands as a memorial or landmark. In Mind Over Medicine she writes, "Like a cairn, the body is awe-inspiringly strong and resilient, and at the same time, fragile and easy to tip out of balance. If whole health is a stack of balanced stones, the body is the stone on top, the most precarious, the most likely to tumble if other stones shift."

Rankin recommends taking a good look at your life to diagnose the root causes of your stress responses. She also recommends that you practice what she calls "radical self care." Get support, believe you can heal, and seek out appropriate medical care to address your body's health needs as a whole.