Prayer, imagery, pills: What works with pain?

Doctor treating male patient

Carol Forsloff - Men and women are not the same in how pain is felt or expressed,according to studies presented by the American Psychological Association.  So how can pain patients learn to express their conditions, get the help they need and be in balance about it?

"Chronic pain affects a higher proportion of women than men around the world," said Jennifer Kelly, PhD, of the Atlanta Center for Behavioral Medicine. "We need to encourage women to take a more active role in their treatment and reduce the stigma and embarrassment of this problem."


Women have been found to have more chronic pain, suffer more intensely and more often.  They spend more time with diseases and conditions that produce suffering.  But why is this?

Scientists remind us that pain is a complex condition and is considered chronic when it lasts more than six months.  Such conditions as fibromyalgia,irritable bowel syndrome, rheumatoid arthritis and migraines impact more women than women, according to Kelly.  She references the International Association for the Study of Pain's 2007-2008 report on pain in women for her analysis.

Women have more symptoms and conditions where there are multiple pain problems, and these can lead to greater psychological distress and potential for disability.

Scientists like Kelly believe hormonal differences are at the root of these differences in pain experiences and perceptions.  Estrogen, for example,has been found to play a role in the condition of migraines.

 "Pain perception does vary according to the menstrual cycle phases in women with chronic pain," said Kelly. "For example, temporomandibular [jaw] pain, or TMJ, is highest in the pre-menstrual period and during menses."

Men and women also react differently to pain medications.  These studies are ongoing because of the variations in how men and women are impacted.

Here are suggestions from the experts to help people balance their treatment, understand and cope with pain:

• "Encourage patients to take an active role in their treatment and in caring for
  themselves, such as eating well and getting exercise


• Provide psychological support


• Explore cognitive coping strategies


• Offer relaxation and biofeedback training

Despite all this, however, people are concerned frequently about what they perceive as the relative lack of understanding of their pain from employers and doctors.

That is especially true of conditions like fibromyalgia, a health problem that can widespread pain in many parts of the body.  For years the medical profession, and employers as a result, denied such a condition existed.  Even now as there are descriptions of the condition and recommended treatments, it is still difficult for some doctors, and the public at large, to accept a condition as painful if there is no frank physical evidence of the pain itself.  Patients express considerable frustration when doctors seemingly don't understand their pain or treat it in a fashion that truly helps.

What many experts recommend when doctors don't understand or are able to deal with that "unseen" complaint is to simply get a different doctor.

WebMd offers support for those who need to define their pain and get a doctor to listen in those initial stages.  That is to use a pain scale, a discussion of where the pain might be on that scale and how the pain specifically affects activities of daily living.  These things can help doctors and employers understand how the pain, which is often personal, can impact a person's daily life.

Many health experts also maintain most diseases are brought about by the mind.  Then they are quick to suggest their book or their direct healing help for the conditions from cancer to fibromyalgia.  In these cases pain physicians say to examine the patterns of recommendations to see if the trend is to make recommendations that are not specific to the disease and that deny certain interventions that may be urgent and require a doctor's support and move on to a different strategy.  

Others remind us that treatment of pain often requires a balanced approach that considers both mind and body and that helps understanding the connection without denying the patient medications and therapy that touches the pain in a direct way.  For it is difficult to do imagery exercises when the pain of the body is overwhelming.

Then there are those well-meaning folks who simply say, "I'll pray for you," then walk away with the patient and friend both hoping that prayer just may work.  Often, however, the advice is prefaced with the story about dear Uncle Harry who went to work every day of his life with severe arthritis, a bad back and poor eyesight as well--and never complained all that time.  Or the person giving advice will tout their own prowess with their experience of being able to do almost anything while knowing God was helping.

Those who reject the idea that prayer can heal may be interested, however, in the science.  Medical experts have consistently found that spiritual support can truly help healing and helping gain relief from pain.  The multiple studies conducted in recent years have demonstrated that.

So it is often the intervention that uses medication, imagery or biofeedback and psychological support--and even prayer--as all have been noted to be helpful, as the belief system of the patient is often involved in that personal perception of pain.

Yet in the final analysis when all else fails and neither employer nor doctor nor even critical friend understands and therefore does not provide support or real help, is make a change up front and not be fooled into staying with a failing intervention for pain.  And you can get new friends, although it is likely harder to get a different job, especially when a person is in pain.  But bottom line is not to allow the notion that it's all in your head to get in the way of getting treatment that really works.

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A synopsis by Editor - from the Symposium: "Translating Research in Women's Health and Mental Health to Practice"
"Translating Research on Chronic Pain in Women to Practice," Jennifer F. Kelly, PhD, American Psychological Association