Published December 13, 2005
There may be a high-tech way to teach people to handle chronic pain, scientists report.
They’re not talking about a sophisticated device that erases pain. Instead, they used medical technology to help patients learn how to develop mental coping devices that would allow them to train their brains to cope with, and reduce their experience of pain.
The strategy is in its early days, so it’s not ready for widespread use. Thorough tests are needed, the researchers note.
They describe their work in Proceedings of the National Academy of Sciences.
Coping With Pain
The study included 36 healthy students from Stanford University and 12 people in their 30s with chronic pain.
The pain patients had largely had little relief from other pain treatments (including painkillers and counseling).
Those who didn’t have chronic pain received pain exposure through heat applied to the palm of their left hand during the experiment.
The Golden Rules of Processing Pain
First, everyone got four written rules about coping with pain. Those rules were:
—Shift attention away from the pain to a painless part of the body
—View pain as a neutral sensation, not something hurtful, frightening, or overwhelming
—Regard pain as being of low or high intensity
—Stay in control of the experience of pain
Next, participants were told they would get real-time brain scans using functional magnetic resonance imaging (fMRI) while they used those rules to cope with pain.
For comparison, four pain patients were taught another way to deal with their pain, without getting any brain scans. That method involved biofeedback, in which people learn to consciously control automatic body processes through watching monitors of their body functions such as heart rate and respiration.
The Brain on Pain
Patients saw their brain scans in real time. That is, they could see how their brains behaved during pain.
The scans focused on a brain area known to be involved in sensing and regulating pain.
Over time, patients were able to cut down on their pain levels. The real-time brain scans let them see their brains’ pain perceptions.
The Real Thing?
The researchers — who included Sean Mackey, MD, PhD, a Stanford assistant professor of anesthesia — tricked some of the participants.
They secretly gave fake brain scans to some of the healthy patients. Their results were compared with participants who got the real brain scans.
Patients who got the fake scans didn’t do as well at learning to handle pain. Neither did a comparison group who learned biofeedback without getting any scans.
In a news release, Mackey says he and his colleagues believe the patients who got real-time brain scans “really learned to control their brain, and, through that, their pain."
“Pain has a huge impact on individual patients, their families, and society,” Mackey says. “I got incredibly jazzed by the results [of the imaging study]. We could change people’s lives.
“However, significantly more science and testing must be done before this can be considered a treatment for chronic pain,” Mackey says.
For instance, it’s not known if some pain patients might respond better to the technique, or if the strategy works for long-term pain.
The NIH-funded study included a scientist from Omneuron, Inc., a Menlo Park, Calif., company that is developing the technology.
By Miranda Hitti, reviewed by Louise Chang, MD
SOURCES: deCharms, R. Proceedings of the National Academy of Sciences, Dec. 20, 2005; vol 102: pp 18626-18631. News release, Stanford University Medical Center.