Thinking About Pain Can Make It Worse

Chronic pain sufferers may sleep better and lessen pain with behavioral therapy

/ Author:  / Reviewed by: Joseph V. Madia, MD

(RxWiki News) When it comes to chronic pain, a positive attitude may be just as effective as a painkiller if a person can successfully put the pain out of their mind. And they’ll sleep better too.

A recent study looking at one way to reduce pain showed a direct correlation between negative thinking about pain and poor sleep.

Those who ruminated over their pain also reported having worse pain than those who did not mentally focus on the pain.

"Discuss options for pain management with your doctor."

Luis F. Buenaver, PhD, an assistant professor of psychiatry and behavioral sciences at the Johns Hopkins University School of Medicine and the leader of the study, said the results of the study highlight the function of a major neurological pathway that links negative thinking about pain and reported pain increase and sleep disturbance.

Buenaver and colleagues conducted a study of 214 people with chronic face and jaw pain and found that sufferers who do not dwell on their condition suffer less. Positive thinking allowed the participants to sleep better and experience less pain.

The participants in the study were mostly white females who were 34 years old on average and suffered from myofascial temporomandibular disorder (TMD). TMD can be an extremely painful condition occurring as a result of problems with the jaw, jaw joint and surrounding muscles controlling the jaw. The condition can be temporary or long-term and mostly occurs between the ages of 20 and 40.

A dental exam was carried out on each participant to verify the patient had the disorder and questionnaires were distributed to evaluate the participants’ sleep quality, depression, pain levels and emotional responses to the pain. The questionnaire also sought to find out whether the participant had a tendency to think a lot about the pain or exaggerate it.

Results of the questionnaires were configured using a resampling technique recommended for tests of indirect effects that assumes that the basic shape of the results for the sample population is similar to that of the broader population.

A significant relationship was observed between focusing on the pain and self-reported sleep disturbance. More importantly, the inability to shift attention away from pain-related thoughts and worry about the pain had an indirect effect on the pain’s severity and sleep disturbance caused by the pain.

This result is similar to other reports that show rumination and worry contribute to sleep disturbance and insomnia and suggests that cognitive behavioral therapy for those living with chronic pain may help them sleep better and thereby lessen their condition.

Buenaver believes that cognitive behavioral therapy may be as much or more effective at treating patients than sleeping pills and painkillers.

The research was conducted at Johns Hopkins University in Baltimore, Maryland and was published online in the journal Pain. The research was supported by grants form the National Institutes of Health. One study author of the study owns an equity stake in BMEDI, a company that develops Internet-based behavioral health programs. The other authors report no conflict of interest.

Reviewed by: 
Review Date: 
June 1, 2012
Last Updated:
August 23, 2012