Why is it that when some people are in pain, the experience is so extreme that they can’t think of anything else, while others can turn their minds somewhere else and feel better?

Karen Davis, a neuroscientist at the University of Toronto’s Centre for the Study of Pain wondered why prescription painkillers like Vicodin don’t work for everyone, and alternative treatments like meditation or cognitive behavioral therapy work for some people, but not all.

Davis found herself in severe pain from a pinched nerve in her neck. “I tried a lot of painkillers, and it didn’t do much,” Davis said. Yet, when she focused on her work, the pain didn’t bother her as much.

Aaron Kucyi, a graduate student at Davis’s lab decided to recreate Davis’s painful experience by applying electric shocks to volunteer’s wrists. After each zap the subjects were asked how they felt, and what they were thinking about. Some people’s thoughts wandered from the pain, while others stayed focused on the pain. The subjects were also given cognitive tests while being zapped. The mind-wanderers did well, while the people focused on the pain felt more pain.

Davis says this is not basic daydreaming however. “Mind-wandering away from pain is different than daydreaming in general.”

The researchers put 32 of the participants in an MRI scanner. They found that people who were better able at letting their minds wander away from pain had more nerve connections to a brain region that produces painkilling substances. The brain made that connection using a system called the default-mode network, which people normally use for thinking internal thoughts. And, they found that the mind-wanderers were more flexible in responding to pain.

Most people in the study fell in the middle, some focusing on pain, and some doing mind-wandering. Davis believes that for most people there is a range of pain management techniques that could work.

“People who mind-wander, they might be more able to vary their response to pain on their own. They also might be more adept at learning pain control methods like yoga, meditation, or cognitive behavioral therapy. And non-wanderers may need different forms of help.”

The viewpoint from this study is that a one-size-fits all approach to pain management may not be the optimal way to connect people with treatments that can help them…..     npr shots    10/29/13



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