Pain and Fear

I believe that for most of us pain and fear are closely linked. Are they locked together? All recent attempts by scientists to define pain include reference to emotion. Imaging studies of the brain have shown a very close anatomical connection between parts of the brain activated by fear and those by pain. Fear and […]

Fear and Pain

As a child I had no fear of going to the dentist until I had a tooth pulled without local anesthetic. Afterward it took years before I stopped flinching at the mere thought of going to the dentist. Getting me to go, even for a check up, became a trial. The point of telling you […]

Weakening the Bond

If we accept that pain and fear interact with each other in a vicious cycle, each magnifying the other, it follows that whatever may reduce one may also reduce the other. One might even say that it is the very strength of their bond that allows us to weaken it. This is not so paradoxical […]

Increasing Performance

Increasing Performance (#4-Pain and Fear) Repeated practice of imagining oneself successfully performing a task leads to improvement in task performance. Mental rehearsal of physical movements alone can actually increase strength. Combined with repeated physical practice of performing the same task, mental rehearsal may greatly enhance an individual’s ability. For best results, training to improve strength, […]

Multi-modal Treatment

Drugs, injections and even surgery can be used to directly attack the pain side of the pain-fear equation and should therefore not be ignored despite their potential for short or long term side effects. In fact any treatment that can provide sustained pain relief may be useful if it facilitates reducing the fear of pain. […]

Non-organic Pain

In our pain group sessions there are sometimes people who can barely participate or who say they cannot sit or stand with biomechanically correct posture because of pain. Although the postures we teach are those that put the least amount of stress on the neck, back and other parts of the body, these individuals persist […]

Practice Makes Better

Let me summarize this series: the neurological and physiological changes caused by pain and fear bond them together. Fear and pain magnify each other. The fear of pain leads to avoidance of activity that is self-reinforcing. So-called pain behavior and non-organic signs, common in chronic pain patients, are indicators of significant distress associated with pain. […]

Claims and Pain

Not all information is equally useful and not all perspectives are equally valid. Everyone is entitled to an opinion but some opinions are worth more than others. In a rational discussion, any claim about the effectiveness of a pain treatment should be backed up by evidence and the nature of the evidence be made transparent. […]

Decisions, Decisions

Every intervention for pain may carry some risks and benefits. They key in deciding whether to try some new therapy is having knowledge of your chances of getting relief vs. your chance of having a bad reaction. Given that there is no such thing as perfect knowledge or certainty, you’ll have to take at least […]

Consolation for Chronic Pain

“I cried when I had no shoes until I met a man who had no feet.” Some of my patients have told me that knowing others have worse problems than their own helps them put their pain into perspective and offers at least some consolation. I think that taking this attitude is a good strategy […]