How Nostalgia Can Help Ease Chronic Pain

April 15, 2022 / Thomas Cohn, MD

Nostalgic feelings and thoughts can bring us back to a happier time, but according to new research, it could also help to reduce pain perception in patients with chronic pain.

New research published in Frontiers in Psychology sought to understand how embracing nostalgia would impact the perception of pain intensity for those dealing with a chronic pain condition. Previous work has found that nostalgia has been linked to psychological, emotional and social benefits, but two new studies wanted to see its effects on pain perceptions.

The first study used a writing task to to evoke feelings of nostalgia, while the second study examined how a patient’s pain tolerance varied following thoughts of nostalgia. In both studies, those individuals who were classified in the nostalgia group had higher pain tolerances than those in the control group. These results fall in line with previous studies that found that participants who were put through pain simulations while focusing on childhood photos reported lower feelings of pain compared to those who looked at random images.

Why Nostalgia May Affect Pain Perception

Researchers stopped short of saying exactly why feelings of nostalgia could impact a person’s perception of pain, but previous work on the effects of nostalgia may shine a light on the idea. One study found that nostalgic reflection increases thoughts of self-esteem, optimism, and perceived social support, and other studies have found that those same variables can reduce a person’s pain experience.

Another study found that nostalgia may act as a motivational component, leading people to believe they can achieve specific goals when reminiscing about the past, perhaps allowing them to re-frame their current chronic pain situation.

So while the answers to why nostalgia may decrease our perception of chronic pain are still theories and ideas, there does appear to be a clear connection between nostalgia and an increased pain perception. Future studies should continue to examine this link and see if there are ways to harness this connection.

And while you probably won’t be able to rid yourself of your chronic pain condition by thinking about years gone by, it’s fascinating how researchers are always looking for new ways to help patients gain control over their chronic pain condition. That’s the same philosophy that Dr. Cohn and his team have when it comes to your pain. We won’t stop until we find a solution that works for you, and we know that what works for one person may not work for another. Let us help you get back to a life free from pain. For more information, or for help with your pain condition, reach out to Dr. Cohn’s office today at (952) 738-4580.

Psychiatric Disorders and Pain Perception

June 27, 2018 / Thomas Cohn, MD

Chronic pain clearly isn’t just in your head, but according to a new study, psychiatric disorders or mental health issues may lead to an uptick in perceived conditions.

For their study, researchers in Brazil examined more than 200 individuals who believed they were suffering from Gastroesophageal Reflux Disease, or GERD. GERD is very similar to chronic acid reflux, where patients suffer a burning sensation when stomach acid makes its way back through the esophageal sphincter and into their lower esophagus. All individuals received a comprehensive medical exam and were asked to complete a 14-question survey that analyzed their mental health for signs of depression or anxiety.

Anxiety, Depression and Pain Perception

After completing the medical exams and reviewing the survey results, researchers came to an interesting conclusion. Nearly half of the patients who reported having anxiety or depression had normal acidic pH values in their esophagus, suggesting that they most like did not have GERD. However, this doesn’t mean that patients are crying wolf about their perceived symptoms.

“Patients with anxiety and depression or other mental health issues display a ‘hypervigilance’ or ‘hypersensitivity’ to pain sensations,” said lead researcher Dr. Fernando Herbella.

Moreover, researchers uncovered an inverse relationship between anxiety levels and esophageal pH; the more anxious a patient was, the less damage they had in their esophageal lining.

Dr. Vic Velanovich, a co-author on the study, offered a neurological explanation for the link between mental disorders and pain perception.

“It’s called the ‘pain modulation network.’ Pain is converted to electrical signals that travel to the brain. It’s interpreted there by the frontal cortex. So anything happening in the frontal cortex, including mental disorders, makes pain perception worse.”

The subject matter is near and dear to Dr. Velanovich, who worked on a similar study back in 2011. In that study, Dr. Velanovich studied patient satisfaction after GERD surgery. Most notably, surgery satisfied 93.5 percent of patients without psychiatric disorders, but only 11.1 percent of patients with a disorder.

“It was a classic ‘nocebo’ effect,” Velanovich says. “For both groups of patients the GERD pain was greatly relieved. But only anxious patients found the aftereffects of the surgery intolerable. Which tells me that there’s something else going on.”

These two studies highlight the importance of getting a comprehensive medical diagnosis by a pain care provider who knows all the signs to watch for. Unless all the underlying issues are treated, you’re not going to acheive full relief. To learn more about the association between mental health and the perception of chronic pain, or to talk to a specialist about another issue, reach out to Dr. Cohn today.

Can Genetic Switches Turn Off Pain?

February 12, 2014June 24, 2014 / Thomas Cohn, MD

A recent article published in Forbes this month describes research in England that found a connection between DNA and perceived pain levels.

The Study

The study tested perceptions of pain across 1,000 identical twins. Researchers attached a heat source to each twin’s arm and began to increase the heat, telling each participant to press a button when the heat became too much to handle.

The results of the study showed that many of the twins did not have identical perceptions of pain. Researchers then took blood samples from a select group of twins in which the differences in pain perception were highest. From these blood samples, researchers found several segments of DNA that appeared to be different between the twins.

As most studies go, this is interesting but it’s a relatively weak finding, all things considered. Pain is far more complex than this study makes it out to be. As a result, this study really does not show anything useful.

Pain Perception is based on Emotional Experiences

Pain is an emotional response to perceived sensory changes. Identical twins have the same genetic make-up, but they do not have the same life or emotional experiences and therefore will likely have different perceptions of pain. Analyzing the differences in genetics between two twins and postulating that these contribute to differences in perceived pain is highly unlikely. The most likely explanation of the difference in pain perception is the difference in life experiences. There clearly was no control of these variables and this is well known to have a significant effect in pain perception.

Unfortunately, this is only an interesting side light of a story on pain. When the most important variables that impact pain perception have no control, no conclusion can possibly be accurate beyond the wildest of guesses for the results. Bottom line, this makes for an interesting story and nothing more.

Do Women Feel More Pain than Men?

September 11, 2013September 27, 2016 / Thomas Cohn, MD

Over the past few years, some studies have contended that women report more pain intensity than men. But there is no definitive answer to the question of whether or not women feel more pain than men.

Women may report more pain than men, but women are also generally more likely to go to the doctor for medical problems. For many men there is a stigma attached to seeing a doctor for pain – many would prefer to “tough it out.” One of the most common reasons people go to the doctor is pain. Since women tend to report their problems more than men, it’s easy to assert that women feel more pain than men.

Everyone Feels Pain Differently

However, this connection may be correlation, not causation. In practice, pain is very subjective, and every person describes his or her pain differently. By definition, pain is an unpleasant sensory or emotional experience associated with actual or potential tissue damage. The regions of the brain responsible for perception of pain are right next to critical emotional areas of the brain. For any painful condition, every person will report a different experience. As a result, it is impossible to compare men to women in their perception of pain.

To make sense of this oft-debated topic, we can make a few general statements about men, women, and how they feel pain:

Women go to the doctor more often than men,
Women tend to report their emotions more readily than men.

Since pain is subjective, each situation is unique and different and cannot be compared. Some people tend to hide their pain and emotions, while others want everyone to know their problems.

Do Men Feel More Pain than Women?

While some believe women feel more pain than men, others assert that women are much tougher than men, since no man has ever given birth. Again, the truth is that some people are tough and just grin and bear it while others scream every time they stub a toe. Men may be slightly more stoic at times, but once they have pain, they are usually no different than women.

How the Body Feels Pain

July 8, 2013September 27, 2016 / Thomas Cohn, MD

Pain is a complex issue. Acute pain is usually related to one of the following:

Tissue damage
Perceived damage
Injury

Chronic pain can be associated with chronic damage or a short circuit in the transmission of pain signals. Treatment of pain depends on the cause. In acute pain, if you treat the cause the pain will normally go away. However when pain becomes chronic, treatment often does not take away all the symptoms.

Pain Signals & Sensory Stimuli

Chronic pain is generally defined as pain lasting longer than 3 to 6 months. Often, it outlasts the initial injury. In some ways it becomes independent of the initial stimulus or cause. Damage may be ongoing, and there may be a chronic inflammatory response, all causing ongoing sensory stimuli, which are subsequently linked in the spine and brain, to the perception of pain. Often, non-painful sensory signals then become linked to nerves that previously transmitted pain signals. Normal signals then become perceived as pain.

All sensory signals are processed in the brain at some level. The brain has an incredible ability to determine the importance of each signal and then form a response. Depending on the circumstance, the brain can ignore the same signal that would be horrific pain. For example, we all have heard about soldiers in war who have been shot, but continue fighting with no loss of focus. Therefore, the real key player in all responses to pain signals is the brain and its interpretation of the signals.

Blocking Pain Signals

The key to treatment of pain then is altering the brain’s ability or desire to interpret sensory signals as pain. Blocking signals can be done anywhere along the path from the sensory receptor including:

The peripheral nerve to the spinal cord
Along the spinal cord pathways
In the brain itself

Although pain can be treated in multiple ways, all treatments try to prevent transmission and interpretation of sensory signals that are perceived as pain. There is no magic bullet and no one treatment alone that will work for everyone.

The simple reason why there are so many treatments for pain is that there are so many ways to alter signals that are perceived as pain. Medications have been designed to affect sensory impulses at a variety of locations from the skin and periphery to the spine and brain. Furthermore, there are a variety of techniques from proper movement, to acupuncture, to psychological training that can effectively treat pain.