Potsdam Fibromyalgia Support group
Newsletter
May, 2005
Pain in the Media
Pain is now considered the ‘5
vital sign’ – vital information to track
and treat. This is also the ‘Decade of
Pain.’ It is not surprising, therefore,
that pain has been in the media a lot
recently, making the cover of Time
Magazine this Spring and motivating
a whole week-long series in USA Today and on
ABC News (http://usatoday.com/news/health/painseries.htm).
The word ‘pain’ derives from the name of the
Greek goddess of revenge: Poine. According to
Greek mythology, Poine was sent to punish mortals
who had angered the gods. Many people still feel
that pain must be a punishment for something – but
pain is seldom ‘just.’
Acute pain is usually a warning of real or
potential tissue damage. It is a protective reaction to
get us to avoid situations that are dangerous. Acute
pain is usually localized and proportional to the
amount of tissue damage. Most causes of acute pain
can be identified and addressed.
Chronic pain is more than just pain that has
lasted for a long time – the physiology of chronic
pain is actually different than for acute pain. There
are different neural processes at work when people
experience chronic pain. Although chronic pain is
often initiated by the same kind of tissue damage as
acute pain is, eventually the pain is no longer linked
to actual tissue damage. As a result, it is not always
possible to find a current ‘cause’ for chronic pain.
Therefore, there is not always a ‘diagnosis’ or
‘cure’ for chronic pain like there is for acute pain.
The potential lack of relationship between tissue
damage and chronic pain is key to managing
chronic pain effectively.
One things occurring in chronic pain is the
body’s ‘memory’ of pain. An activity, image, or
thought can therefore trigger ‘remembered’ pain
just as a memory of a fearful experience can make
your heart race and your hands sweat. Just as
remembered fear causes real changes in your heart
rate, remembered pain causes a real experience of
pain – your nerves and brain act as though you are
really experiencing the same painful event.
th
Although remembered pain is not ‘all
in your head,’ you can train your body
to respond differently to pain
memories, just as you can train your
body not to react with fear to fear
memories.
Another aspect of chronic pain is
that the mind and body are not two
separate entities. Your brain and
nervous system are made up of neurons. The
question of whether ‘thought’ is more than just the
sum of nerve impulses may be metaphysical – that
is, beyond what we can prove in the physical world.
Nonetheless, there is no doubt that physical
experiences affect thoughts. There is also no doubt
that thoughts affect physical experience – remember
the racing heart during fear, or the sick stomach
during anxiety, or the flushed face when you are
embarrassed. There are many examples of how your
thoughts and feelings affect physical experience.
The relationship between mind and body is
particularly important in chronic pain. Stress,
anxiety, depression and fear actually increase the
body’s transmission of pain information. This is not
imagined pain, but real pain based on physiological
changes in the body.
Another important aspect of pain is that when
pain is interpreted in negative ways, it becomes
‘suffering.’ You are probably familiar with the
muscle ache experienced after vigorous exercise.
But this ache probably did not cause suffering – it
may have had the opposite effect of making you
feel good about your athletic accomplishment. Even
now, you may experience pain when someone
massages a tight muscle – but recognize this as
‘good’ pain indicating you will feel better later.
These are two examples of pain that does not cause
suffering. The difference is sometimes how you
interpret the pain: is it good, bad, or neutral?
Since negative emotions can aggravate pain,
decreasing negative emotions can also change the
pain experience. Stress management and thought
restructuring are therefore important in pain
management. Most of us have experienced a time
when we did something pleasurable and stopped
thinking about our pain. As a result, it is important
to do activities that you enjoy rather than sit and
think about your pain. It is also why you should
think about things you can do (positive thoughts)
rather than thinking about things you cannot do
(negative thoughts).
Pain is not ‘all in your mind’. But how you
think affects both your perception and your
interpretation of pain. So, rather than let pain
constantly drag you down, turn this to your
advantage. Try the following suggestions:
Make a list of things that make you happy and
refer to that list when you need a lift.
Make a list of activities you enjoy and can do;
make sure you do a few things from this list
every day.
Remember the positive aspects of activities that
might increase your pain rather than focusing on
the pain; for example, think about how amazing
your grandchildren are, or the beautiful flowers
you see on your daily walk.
Play music and sing songs that make you
cheerful.
Call or visit a friend and talk about upbeat
things.
Smile; the act of smiling raises endorphin levels
and can decrease pain.
Resources for more information about pain: The
American
Chronic
Pain
Association
at
www.theacpa.org/. The American Pain Foundation
at www.painfoundation.org. The National Pain
Foundation at www.nationalpainfoundation.org
May Potsdam Meeting:
The May 26th Potsdam meeting topic will be
“What is pain? A presentation describing the
physiological and emotional components of pain."
The presentation will describe how pain perception
is altered in FMS, as well as how various treatment
options impact pain. The meeting is at 6:30 at 59
Main St, in Clarkson Hall.
June Massena Meeting:
The Massena Fibromyalgia Support Group’s
June 14th meeting will be “What Can You Do About
Stress and Anxiety?” The meeting is at 6:30 at
Massena Memorial Hospital. For more info, contact
facilitator Maxine Dodge, at 769-5778 or
maxinesbeach@wmconnect.com.
Sleep
We all know that sleep
has a big impact on FMS:
it causes fatigue, trouble
concentrating, and muscle
pain. How much do you
know about sleep?
There are 5 phases of sleep:
 Stage 1 – Drowsiness, where we drift in and out
of sleep and can wake easily. We may have muscle
contractions.
 Stage 2 – Light sleep, where eye movement
stops and brain waives slow.
 Stage 3 – Deep sleep, and
 Stage 4 – Slow-wave deep sleep where
extremely slow brainwaves appear and it becomes
very difficult to wake.
 Rapid eye movement, or REM sleep, where
breathing becomes rapid, irregular and shallow,
heart rate increases and muscles become
temporarily paralyzed. You dream during REM.
It takes about 1½ hours to go through all the
cycles of sleep. At the beginning of the night we
spend more time in deep sleep and later in the night
we spend more time in REM and stages 1 & 2.
People with FMS have particular trouble with
Stage 4 sleep, which is when growth hormone is
released, resulting in less growth hormone to
stimulate body healing processes.
The above information is from Medline Plus at:
http://www.nlm.nih.gov/medlineplus/tutorials/sleep
disorders/nr249101.pdf. They also have a tutorial on
sleep
disorders
at:
www.nlm.nih.gov/medlineplus/tutorials/sleepdisord
ers/htm/index.htm. You can test your knowledge
about
sleep
by
doing
a
quiz
at:
www.nhlbi.nih.gov/cgi-bin/tfSleepQuiz.pl
The National Sleep Foundation also has
information,
including
self-assessment
questionnaires and quizzes of your knowledge about
sleep at: www.sleepfoundation.org/
This newsletter is a joint effort of Clarkson University and
Canton-Potsdam Hospital. If you would prefer to receive these
newsletters electronically, please send your email address to
gilberta@clarkson.edu. You can access current and previous
Potsdam Fibromyalgia Support Group Newsletters on our web
site: www.people.clarkson.edu/~lnrussek/FMSG.