Sunday, June 05, 2011

Guest Post: Ways to Increase Pain Tolerance by Allison Gamble

Allison Gamble, who writes for Psychology Degree, describes herself as a curious student of psychology whose studies have led her to writing, editing, and Internet marketing. She requested the opportunity to submit a guest post to this blog dealing with some psychological factors that may modulate pain tolerance.

Guest Post: Ways to Increase Pain Tolerance

Allison Gamble

Far from being a simple manifestation of discomfort, pain is a complex occurrence related to psychological and physiological factors. While science has eagerly embraced physiological treatments for both chronic and acute pain, it has only been recently that the psychological mechanisms of pain have begun to be unraveled. This has led to improved treatments for pain and a new understanding of how one’s pain tolerance might be increased. Luckily a person doesn’t need a psychology degree to better understand these mechanisms. However it is essential that one not only identify ways of increasing their pain threshold, but also to understand the types pain that exist and how the brain and body interact to generate the sensation of pain.

Types of Pain

Currently, science recognizes two broad categories of pain: chronic pain and acute pain. While a patient’s symptomatic response to chronic pain and acute pain may be similar, the causes of these pain types are not.

Chronic pain generally lasts for an extended period of time (1), while acute pain is of brief duration. Both types of pain may be caused by an injury or illness, but chronic pain is typically related to residual effects of an injury that has resulted in nerve damage or an illness of sustained duration.

Additionally, it has been proven that depression is more common in individuals suffering from chronic pain and may actually add to the pain symptoms of the individual. Most people who suffer from chronic pain also experience episodes of breakthrough pain in which medications cease to be of benefit. This can be due to the body’s increased tolerance to a medication or due to an action that triggers a pain episode.

The source of most people’s pain generally falls into one of three categories: pain from tissue damage, pain from nerve damage and pain from psychological distress. As its name implies, pain from tissue damage is generally due to an injury. However, tissue damage may also encompass pain related to internal organs, arthritis and even cancer.

Nerve damage is more complex and is best understood by discussing a faulty electrical circuit. Just as a circuit is supposed to communicate a pre-set signal via electrical impulses, so do nerves. When nerves misfire, the results can lead to over-sensitivity and pain, just as a misfiring circuit can cause a shock. Injuries, strokes, diabetes, HIV and a variety of other ailments can cause damage to the body’s nerves.

Psychological factors that contribute to pain, also called psychogenic pain, generally have a physical cause. However, living with the pain results in feelings of anxiety, depression or stress that actually amplify the feelings of pain.

Pain Threshold and Pain Tolerance

A person’s pain threshold is the “least experience of pain” an individual can perceive (2). By contrast, pain tolerance refers to the “greatest level of pain” an individual is able to accept. Each of these definitions is subjective to the experience of the individual. It is important when defining an individual’s pain threshold and pain tolerance to understand that, as both are subjective, they are also subject to fluctuations. Therefore, it is possible to get many individuals to raise pain threshold and pain tolerance over time. Generally, this is accomplished through the use of a number of cognitive and behavioral techniques that encourage them to adapt to higher levels of pain.

Increasing Pain Tolerance

A number of techniques have proven to be successful in increasing an individual’s pain tolerance. These have, as mentioned above, encompassed a wide range of cognitive and behavioral techniques. Among the more successful are breathing techniques — similar to those used during labor, meditation and self-talk.

Before investigating the reasons why these particular methods seem to increase pain tolerance, it is important to dispel a myth that has persisted since Rocky first ran up the steps of the Philadelphia Library. Repeated exposure to pain does not increase pain tolerance. In fact, it often does just the opposite. Repeated exposure to pain can cause the area that is being exposed to pain to become more sensitive, a process known as secondary hyperalgesia (3). To increase one’s tolerance to pain, meditation, breathing exercises and self-talk are more likely be of assistance.

Breathing exercises typically involve slow deep breathing, though some individuals have reported that shallow breathing, when slow and controlled, is equally helpful. In almost all cases breathing has been shown to successfully reduce pain, which indicates an elevated pain tolerance level. Experiments in which participants reported increased pain tolerance when focusing on deep breathing during childbirth reveals that breathing can be used to increase tolerance to sharp, stabbing pains (4).

Positive self-talk has also been shown to increase pain tolerance during episodes of acute pain. For instance, athletes who were given positive coaching statements to internalize during training sessions were better able to cope with pain than those who did not learn to internalize positive statements (5).

While breathing techniques and self-talk often generate only short-term benefits related to pain tolerance, meditation has been shown to be effective at increasing tolerance for extended periods. Meditation appears to be particularly effective in the management of chronic pain. In some instances, only four 20-minute meditation sessions resulted in a marked reduction in pain perception. Participants in one experiment received identical thermal stimuli applied to their calves both before and after receiving meditation instruction. After the instruction, they perceived on average 40 percent less pain and found it to be 57 percent more tolerable (6). Although the long-term benefits of meditating to increase pain tolerance are still being studied, researchers hope that continued meditative practice can increase tolerance of chronic pain and not only acute discomfort.

While each individual’s pain tolerance level is susceptible to change on a daily basis, it is often possible to increase pain tolerance to both acute and chronic pain. Increased tolerance to pain can improve athletic performance, help individuals cope with injury, and increase the quality of life for those who must deal with chronic pain. Ongoing research continues to investigate new methods of increasing pain tolerance, but basic existing techniques offer an excellent start for individuals who seek to increase their pain tolerance.

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