Natural-Born Pain Killers

Over the course of several days in 2005, Laura Tibbitts, a 33-year-old director of operations for a San Francisco nonprofit, slid into the tubular confines of an MRI machine for extensive brain scans.

Her task: to increase and decrease her chronic pain by using her thoughts alone. Evidence of her success would be displayed on a monitor above her as the MRI trained its sights on an area deep in the brain that processes pain. Tibbitts desperately needed the cutting-edge therapy to work: Years before, she'd been thrown from a horse and severely fractured her upper arm and shoulder blade. Despite multiple surgeries that helped heal the breaks, the pain had never relented. Now, as a volunteer in a unique study at Stanford University School of Medicine's Pain Management Center, she was hoping to regain control.

As the MRI machine clunked and clicked, she first tried to make her pain worse. "I'd relive the injury," she says, "or imagine being stabbed in the back." By her own subjective measurement, her pain shot up to 9 on a scale of 10. Then she was asked to think in ways that might reduce her discomfort. Because she was lying down and couldn't move, she pictured little men, like Lilliputians in Gulliver's Travels, scooping pain out of her back and carting it away. Then she focused on her big toe "someplace that didn't hurt" to direct her mind toward neutral sensations. Or she repeated affirming phrases such as "This is going to get better" or "I'm going to be okay." To her great relief, she found that she could will her pain to plunge from a 9 to a 4 far below what it was when she started the mental exercises.

The investigators had expected to see benefits, but even they were astonished by what the MRIs revealed: Using mental strategies, Tibbitts and other patients were able to reduce their pain by nearly two-thirds, reports study leader Sean Mackey, MD, PhD, director of the Stanford Systems Neuroscience and Pain Lab. "It was really exciting to show for the first time that people could direct activity away from a specific region of the brain in this case, the area that processes pain and alter their perception of pain at will," he says. "It gave subjects a profound sense of empowerment and opened a window on pain in the brain that has huge implications.

"Thanks to state-of-the-art imaging technology, neuroscientists are gaining a new understanding of how pain works and of new ways to tame it. They now know that pain causes sparks of activity in multiple areas of your brain, not just in a centralized "pain center."

"Pain is both a sensation and an emotion," says Francis Keefe, PhD, associate director for research at the Pain and Palliative Care Program at Duke University Medical Center. "That means what you're thinking and feeling can modify your pain and make it better and that's great news because it substantially expands our armament for relieving suffering."

Among the most dramatic new findings about pain management:

You can intensify pain episodes by putting a negative spin on your pain fearing it, dreading it, considering it the worst thing in your life.

Conversely, you can significantly reduce your pain by recognizing and blunting such noxious thinking.

You can actually shut down the signals that are responsible for pain by doing relaxation exercises such as meditation, guided imagery, and deep breathing. The relief you'll gain can enable you to reduce your use of pain medication; when combined with the exercises, the lower doses are particularly effective.

In the same way that Buddhist monks' meditative practices can physically rewire their brains, yours could develop on its own the capacity to resist pain. "We think the brain may be able to build ongoing pain tolerance," says Scott M. Fishman, MD, a professor and chief of the division of pain medicine at the University of California, Davis. "It's consistent with what the Buddhists teach: We have enormous power to control the sensations that affect us."

But before you can start to exercise that control, you first need to identify the major mental pain magnifiers.