How Our Perception of Pain Influences the Way We Manage It

“Dr. C seems better these days, don’t you think?” Neo asks Mrs. Dr. C. Neo is the inner part of Dr. C’s brain that shares his insights on Parkinson’s disease, science, and general well-being.

Mrs. Dr. C agrees. “Since we moved to where winter snow doesn’t linger into April, he’s out gardening more. We do our walks in the yard and love discovering new blooms. He is excited about writing a new book. His sleep ritual has improved, and meditating twice a day, morning and night, has decreased pain levels. It also helps that our stress levels are a lot lower.”

“I’ve noticed that his eating habits have changed. Do you think that’s made a difference?” Neo frowns at his extra winter weight.

“I’m sure it has,” says Mrs. Dr. C. She knows the biggest change has been eliminating foods with a high refined sugar content, such as candy, cookies, and ice cream. “To ease the cravings, he eats small amounts of 80% cacao dark chocolate. He said that this dietary change has improved his sleep, meditation, and pain management.”

“I’d like to know more,” Neo says with eager enthusiasm.

“He describes pain management to me as incremental,” Mrs. Dr. C. replies. “The practice involves a series of small things done every day. Not eating high-sugar foods drops the pain perception by 10%.

“Gardening, along with muscle relaxation, drops it by 10%. Meditating twice a day manages 10%. Writing columns and working on the new book reduces another 10%. Stress management, especially physical rest, and threshold management drops the pain by 10%. And he says having me around helps another 10% — even after almost 50 years!”

Neo calculates the numbers. “If I’m doing the math, then even after all that, he still has nearly half of his pain to deal with.”

“That’s true,” Mrs. Dr. C acknowledges. “He tells me half of that remaining pain is perceptual and the other half we learn to live with.”

“You mean to tell me he’s just making it all up in his head?” Neo isn’t sold on the idea that pain is somehow make-believe.

Mrs. Dr. C clarifies. “Not exactly, Neo. We all perceive pain as real. The problem is that due to his disease and the difficulties of conductor training, the pain signals are exaggerated. It’s a hard thing to convince your brain that it is not telling you the whole truth. If you can, turn this idea of exaggerated pain into reducing your perception of the pain severity. This shift in perception along with meditative practice makes a big difference in pain management.

“One of the problems with pain is that it demands so much attention from us. Dr. C says he lives with a dozen pain focal points in his body. He calls this familiar pain, and it responds well to pain management strategies. Familiar pain does not need as much attention as it seeks. It is like a 2-year-old throwing a temper tantrum. The more attention it gets, the more the problem escalates. New pain is different. New pain requires attention because it signals that something new is malfunctioning. New pain needs to be rigorously evaluated before it can become familiar pain.”

“So how I perceive pain and how much attention I give it will affect its perceived intensity.” Neo senses that it can be a vicious cycle. “The more I pay attention to the pain, the worse it gets. As the pain gets louder, the more it demands I pay attention. Sounds terrible! This must be why people use so much pain medication.”

“I think people don’t know how to sit with their own pain long enough to understand the difference between familiar pain and new pain,” says Mrs. Dr. C. “We want to escape or fight against it. We reach out for nurturing. But we don’t take the time to really understand our pain and suffering.”

Pain is part of the human condition. According to a study in the Journal of Clinical Neuroscience, many people with Parkinson’s disease report pain as a major contributor to decreased quality of life. Our culture often falls short in treating our pain. Add to this the devastating outcomes often portrayed to people with Parkinson’s disease, and we easily end up down a dead-end alley encountering our own self-fulfilled prophecy.

Dr. C has written about the complications and mental health dangers associated with damage to the second dopamine center, the insular cortex. Learning how to adjust to this brain damage, using a shift in perception, and building new pathways limits the exaggerated effects on pain perception. It is an important part of helping people live better with this disease.

Sometimes the best pharmacy we can go to is the one between our ears.

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Note: Parkinson’s News Today is strictly a news and information website about the disease. It does not provide medical advice, diagnosis or treatment. This content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or another qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read on this website. The opinions expressed in this column are not those of Parkinson’s News Today or its parent company, Bionews, and are intended to spark discussion about issues pertaining to Parkinson’s disease.