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Pain is all in the mind

Is pain, like sex, all in the mind? Yes, reported The Journal of Neuroscience this week, confirming what yogis on beds-of-nails and firewalkers have insisted on all along — it is possible to convince the mind to feel no pain.

health and fitness Updated: Aug 28, 2010 23:07 IST

Is pain, like sex, all in the mind? Yes, reported The Journal of Neuroscience this week, confirming what yogis on beds-of-nails and firewalkers have insisted on all along — it is possible to convince the mind to feel no pain.

The anticipation of pain makes it hurt more, even days later, reported German researchers, who hope to use this new-found understanding to develop therapies to lower anxiety and stress. On the flip side, it also opens up the grim possibility of torture — and even death — by suggestion is possible in the world beyond Haitian voodoo-land.

How it works is simple: you put the thought of pain in someone’s mind and sit back and watch them writhe. In medicalese, it’s called the ‘nocebo effect’ — the placebo effect’s evil twin — and is used to describe putting negative thoughts in someone’s mind to adversely affect their health and well being.

The study found that if a doctor tells the patient that a surgery will be very painful, the patient will experience more pain than usual. However, if he plays down the pain of a surgery, the patient would actually end up feeling less pain. It’s effect is not just psychosomatic. The stress created by the nocebo effect can have a long-lasting impact on the heart, at times serious enough to cause a heart attack.

There is more to pain that what meets the eye. Biologically, the perception of pain shows wide variation in different people in complexity and sensitivity as compared with other sensory systems. It’s often not proportionate to the intensity of the stimulus. A poke in the ribs may be very painful for some but cause no pain in others. What’s more, the difference in pain perceived by the same person can also vary, depending on the state of mind.

Then there is the gender difference. Women, for example, are not just more sensitive and susceptible to pain but also process it very differently from men. Women are more sensitive to acute painful stimuli — short-term pain causing events — compared to men.

They, however, can cope better with pain over the long term — a quality, experts say, evolved because women have to bear the trauma of childbirth.

Clinical evidence also suggests that pain sensitivity is inherited and your response depends on your genetic make-up. In women, genetic predisposition accounts for 39-58 per cent of migraines and 55 per cent for menstrual pain. Simply put, genetic variations can partly explain the differences in pain perception. Sex hormones such as oestrogen, progesterone and testosterone play a role, with sensitivity to pain varying cyclically each month through a woman’s reproductive life.

Women also suffer from a larger number of painful conditions, such as headaches, and auto immune disorder-related pains and facial pains. In women, anxiety and depression also alters duration and response to treatment, with a woman who is depressed and in pain suffering for longer and not responding as well to treatment as men in a similar state of mind.

Until personalised gender-specific prescriptions are available to help you cope with the pain, pop a painkiller and tell yourself you don’t feel a thing. There may be some ups and downs as you cope, but whatever you do, avoid the endless doses of well-intended advice. Everyone has suffered pain, and nearly everyone will tell you it was worse than anything you ever experienced. Don’t listen to them. Let your mind do the coping and you’ll do all right.