Working through pain may actually reduce it

Many people who cope with chronic pain know that going to work (if the pain is bearable) and keeping busy can help keep their minds off the pain and actually reduce it. At the same time, they know that staying home with nothing to do but think about the pain can make it worse.

Now, a new study has shown just how distraction reduces pain—and it’s not purely psychological. The study, published in the June issue of Current Biology, found that distraction causes a physiological cascade of events that work not just on the brain but on the spinal cord.

German researchers used spinal functional MRIs to view the spinal cords of 20 men as they were exposed to painful levels of heat to their arms. At the same time, the study participants had to complete either a hard or an easy memory task.

When the men were given a hard memory task, they perceived less pain than when they were given an easier task. Moreover, the MRIs detected less activity in the spinal cord during a hard mental task. What that means is that fewer pain signals were being relayed to the brain.

Distraction may release natural opioids, which play a key role in pain relief, the authors wrote in their study.

In fact, when the researchers repeated the study, but gave participants a drug that blocks the effects of opioids, distraction was much less effective at reducing the pain, suggesting that distraction does its pain-reducing magic partly through opioids.

"The results demonstrate that this phenomenon is not just a psychological phenomenon, but an active neuronal mechanism reducing the amount of pain signals ascending from the spinal cord to higher-order brain regions," said lead researcher Christian Sprenger of the University Medical Center Hamburg-Eppendorf.

A number of past studies have shown that distraction (or attention) is highly effective in altering our experience of pain.  Some studies showed that distraction interferes with pain perception while other studies show that pain increases when it is the focus of our attention.

Distraction techniques, such as guided imagery and trying to be active, are a staple of cognitive behavioral therapy, an effective treatment for chronic pain.  These approaches also have the potential to prevent pain from becoming chronic by altering the underlying neurological signals in the spinal cord, the researchers said.