Mind-Body Medicine for Chronic Pain
Our medical system is focused on treating disease rather than preventing it. People go to the doctor when they have symptoms—often pain—somewhere in the body. The doctor may do a focused exam near the site of the pain and either prescribe medicine or physical therapy or do some tests (blood, urine, X-rays, or other imaging).
But with most chronic pain, the tests show nothing abnormal, and the recommended treatments are not working. So, what do you do? Go to more specialists? Are you so desperate that you get influenced by doctors with good marketing skills who offer expensive miracle cures not covered by insurance and provide testimonials from people who had “exactly the same” symptoms you have and were “cured?”
Do you go to a “functional medicine” doctor who will do all kinds of “tests” to “show” what your body is deficient in and then prescribe a bunch of supplements? (Note: Good mind-body functional medicine doctors do not do this.) Functional medicine doctors vary in training, knowledge, and focus. I am wary of doctors who directly sell you their products: supplements, vitamins, minerals, and combinations with fancy names. The doctors I trust understand the value of a healthy lifestyle and diet and will help guide their patients in this direction without the need for “special diets” or supplements.
What is Mind-Body Medicine?
Fortunately, “mind-body medicine” is coming into vogue. But what does mind-body medicine mean?
When your child has pain and other symptoms, you become even more desperate to find a diagnosis and cure. You want a doctor to find “the cause” and rapidly “fix it” with a medicine, procedure, or surgery. However, if the pain has gone on for a while, it starts attracting other symptoms: insomnia, fatigue, depression, anxiety, school absenteeism, isolation, and maybe food restriction, loneliness—even suicidality. As a parent, you become more desperate for help.
This is what mind-body medicine is all about. When a symptom persists, such as pain, and a good medical history and exam can’t determine the cause, it’s likely because the pain has become “centrally mediated.” This means that the brain has created a new neural connection, like a new “pain highway,” causing extra electrical energy from the brain to travel along sensory nerves down through the body. Yes, the pain moves from the body up to the brain downward. There now becomes a central brain control station for pain.
For intestinal pain, there are abnormal electrical signals along the autonomic nervous system (ANS). For body pain, the abnormal electrical signals spread through sensory nerves. For some people, the whole neural electrical system goes off balance, causing Postural Orthostatic Tachycardia Syndrome (POTS), with symptoms such as dizziness, fatigue, abnormal sweating, hot or cold flashes, and others.
People begin to accumulate “diagnoses” such as POTS or CRPS (Complex Regional Pain Syndrome). If they are hypermobile without a history of joint dislocations or stretchy skin, they may get a diagnosis of EDS (Ehlers-Danlos syndrome). The list of diagnoses can increase when what they have is a mind-body system that has gotten “out of whack” (dysregulated or out of balance).
We know that medications alone are not the solution, but they may provide some “bandwidth” for other strategies to work. Helping provide good restorative sleep is a first step. Procedures below the brain might give some temporary relief but will not fix the problem.
The Mind-Body Approach to Treatment
A mind-body approach to treatment restores homeostasis or balance to the nervous system. This happens from the body up (physical therapy, aqua therapy, yoga, exercise, craniosacral therapy, acupuncture, and others) and brain down (cognitive behavioral therapy (CBT), dialectic behavioral therapy (DBT), hypnotherapy, mindfulness, biofeedback, family therapy, trauma therapy (if needed), and even helping parents deal with their teen who has chronic pain).
The treatment goal of a mind-body approach to chronic conditions is to rebalance a nervous system that has gotten out of balance, from the brain downward and the body upward. This often requires a multidisciplinary team of different kinds of clinicians who work together and regularly communicate with each other, with a leader who directs the team’s ongoing communication.
Social support for parents and the child, teen, or young adult with chronic pain is a critical component of a mind-body approach to care. This is why I started our all-online, non-profit Creative Healing for Youth in Pain (CHYP). CHYP provides state-of-the-science information about chronic pain, self-help tools, social support for both youth and parents/caregivers, and creative arts opportunities to use mind-body connections in novel ways to impact pain.
