What is it? Re-framing means changing words and attitudes about pain to make living with pain easier, and safer too.
Why does that work? The Gate Control theory of Pain Reduction, states that pain perception depends on the balance of large and small diameter nerve activity. Elevated large nerve fibers can "close the gate" to information traveling to the brain, including pain signals.
The Gate Theory of Pain has been experienced by all of us.You may have had a headache, but when you stubbed your toe, you forgot all about your head. You can use this principle to help you hurt less.
How?
Be honest to yourself. You may be really angry that you cannot do what you want to do because of pain, or maybe just really depressed. Pain stands in your way, looming over you. You may be going from doctor to doctor to find a cure. Or maybe you have just given up.
In order to feel better your first step is to reframe the image of your pain. You need to let go of the anger toward your previous employer, if injured on the job. You need to stop right now reviewing the events of the accident or injury that you cannot undo no matter how hard you think. You must stop blaming your parents for the diseases they passed on to you. You must stop blaming yourself!
Stop feeling guilt for being less than you want to be. Stop grieving over the person you used to be. Honestly consider the person you are now.
Concentrate on your good qualities, e.g. kindness, good with animals, a whiz at cards, etc. Concentrate on what you have left: eyes, ears, speech—whatever still works. Focus on what you can still do. Make what you can still do important. Talk with friends on the phone, or get the phone number of a lonely patient in one of the local nursing homes and call her just to cheer her up. Offer to help a child with reading or math. You can do these things right in your home, if necessary.
The Pain Scale commonly used
Pain Assessment
The second part of honesty is to accurately assess your pain.In my opinion, numbered pain scale, has been over-used. It is too easy to say pain is a ten. What does that mean? Is my 10 the same as your 10? Doctors struggle with their chronic pain patients a lot. There are two schools of thought. The older school of thought is that chronic pain is really a mental disorder and that patients with chronic pain are really just people seeking prescription drugs to take to satisfy a drug habit, or to sell, to make more money than they could working. The second school of thought is that pain is real and that we should accept our patients’ description and severity of pain as valid and attempt to eliminate pain.
Doctors who believe this live in fear, much of the time. We fear we may lose our license as a result of prescribing too many narcotics.We fear most of all that we will get a phone call that someone overdosed or died on the medication that we prescribed them.I have seen patients who have had real pain that took pain pills in spite of slurred speech or drowsiness or low oxygen who could have killed themselves, or did. You need to critically evaluate the medication that you are taking. If your pain score does not improve after a dose of medication, stop taking it, (after talking to your doctor, of course). Many people come to me stating that their pain medications do not work, but are reluctant to quit taking them.You need to evaluate each of your medicines honestly so that we doctors do not continue to subject you to side-effects, and even danger, from pills that are not working.
You will find that your doctor will be more willing and more relaxed about giving you pain medications that do work, if you are willing to streamline your list of pills.
The honest truth is that no medication is going to relieve your pain. Your goal must be to lessen your pain. A reasonable goal is to keep your pain below level 5.
Mind over Matter: Reframing the Pain
There are really only a few examples of mental or brain disorders causing pain. A stroke damaging the pain center in the brain is one example. It is a fact, however, that mental disorders can and do make your perception of pain worse. That is why many patients with chronic pain are taking antidepressants. The brain plays an important role in your perception of pain. There are several waysyou can use your brain to lessen your pain with or without pain medications.These could be placed in the category of mind over matter. These are listed as follows:
Sensitization:
Be accurate in your assessment of your pain.Sometimes it helps to focus on what the feeling is exactly.For example: A dull aching; a full feeling; tightness, prickly sensations; burning from here to here.By actually studying the feeling, you distract your brain from the feeling; by replacing the word "Pain" with more precise terms you can awaken your psyche to other sensations around you. Our bodies and our brains have been desensitized ordinary things around us. The pleasure of the feeling well worn denim or soft cotton is an example of this. By intentionally focusing on those small pleasures that we were previously desensitized to, you can change your focus from pain to perception of other more pleasant things. Distraction: Your pain seems worse at night or when you sit down to rest. Is it really worse?In most cases it isn’t; you are just not distracted by housework or bill paying or television watching. In other words the busier you are, the less aware you are of your pain.If you can find something that you are really passionate about, your pain will bother you less! Research a subject on the internet or start your own blog or web page. Start a kitchen herb garden, or sew a quilt. If you can think of nothing else to do, write a short story or novel about a person in pain. Perspective: The big picture is chronic pain, but the little things inside the big picture can actually help you refocus your mind to diminish its perception of that pain, in addition to, or sometimes even without medicine. Have you ever noticed that when you hear or see a severely ill person, a double amputee, a mentally disabled child, you have the flashing thought, “Oh, I am not as bad off as they are!” My minister, during a recent sermon, said, "What is the significance of 10, 20, even 40 years of pain compared to all eternity?" I hope this has helped you. Alda L Knight MD
