Thu. Oct 22nd, 2020

Count backwards from 1,000 to distract yourself from pain, study

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Counting backwards from 1,000 in increments of seven is one of the best ways to distract yourself from pain, study finds

  • Volunteers were exposed to a painful cold stimulus as part of the experiment
  • Researchers had volunteers try out three techniques for distraction from pain
  • This included counting backwards, picturing something and willing away pain
  • Counting backwards helped to reduce levels of painful stimulation by up to half 

Counting backwards from 1,000 in steps of 7 is the best way to distract from pain, according to a new study that found it can relieve up to half of any painful sensation.

Researchers from the Ludwig-Maximilians University, Munich, exposed 20 volunteers to a pain and asked them to distract themselves using different techniques.

People use a range of different strategies to distract from pain, according to lead neuroscientists Enrico Schulz, who linked this to specific neural circuits in the brain. 

Using an MRI machine, the researchers found that counting backwards from 1,000 was better than ‘thinking of something beautiful’ and ‘willing the pain away’. 

One of the volunteers later used the counting backwards from 1,000 in increments of seven technique during child birth and found it made a notable difference.

Researchers from the Ludwig-Maximilians University, Munich, exposed 20 volunteers to a pain and asked them to distract themselves using different techniques. Stock image

Before the brain can properly react to pain it has to evaluate the sensory, cognitive and emotional factors that drive our perception of the sensation, the team said.

To do that information has to be exchanged between different regions of the brain, according to Schulz, who said that is why distraction techniques help relieve pain. ‘

RESEARCHERS STUDY PAIN DISTRACTION TECHNIQUES

Pain management specialists from Ludwig-Maximilians University have been examining distraction.

They had already shown that three specific methods can work to reduce the perception of pain.

  • Attentional shift: Count backwards from 1000 by sevens
  • Imaginal strategy: Imagine you’re in a safe and happy place you know well with colours and music you like
  • Cognitive reappraisal: Concentrate on the pain sensations and reinterpret as ‘not painful’

Attentional shift worked best at reducing pain as it distracted the brain from processing pain signals.  

No single region of the brain was triggered by all three methods but they each lit-up different networks.

For example, the imaginal strategy triggered the frontal lobes (control centres) as it required the brain to hunt for memory fragments. 

New studies have confirmed that there is a link between the subjective experience of pain and the relative levels of neural activity in various sectors of the brain. 

Schulz and colleagues wanted to discover how different distraction strategies could affect the subjective perception of pain while studying the neural activities. 

In the study, 20 subjects were exposed to a painful cold stimulus and asked to adopt one of three approaches to distract from the pain and potentially reduce the pain.

They involved counting down from 1,000 in steps of 7, thinking of something pleasant, and trying to persuade themselves that the pain isn’t really that bad.

During the experimental sessions, the subjects were hooked up to an MRI scanner to visualise the neural activity in the brain, which were later analysed in detail.

In order to assess how effective the different coping strategies were, participants evaluated the subjective intensity of the pain on a scale of 0 to 100. 

The results revealed that the countdown strategy was the most effective of the three methods as it ‘required a high level of concentration’.

Schulz says the level of intense concentration distracts the subject’s attention significantly from the sensation of pain.  

‘In fact some of our subjects managed to reduce the perceived intensity of pain by 50 per cent,’ the lead author explained. 

‘One participant later reported that she had successfully adopted the strategy during the most painful phase of childbirth.’ 

The team picked those strategies as they’d already shown that they can all help in the perception of pain – with each evoking a different pattern of neural activity.

In the new study, Schulz and his collaborators carried out a more detailed analysis of the MRI scans, for which they divided the brain into 360 regions. 

‘Our aim was to determine which areas in the brain must work together in order to successfully reduce the perceived intensity of the pain,’ Schulz explains. 

They didn’t find one single region or network in the brain that was activated by all three strategies. Different neural circuits in different brain regions acted in concert. 

Schulz says this shows that the attenuation of pain is a highly complicated process requiring cooperation between many regions of the brain. 

Analysis of the response to the countdown technique revealed close coordination between different parts of the insular cortex, among other patterns. 

One of the volunteers later used the counting backwards from 1,000 in increments of seven technique during child birth and found it made a notable difference. Stock image

Distracting from the pain by picturing something beautiful or peaceful worked only when it evoked intensive flows of information between the frontal lobes. 

The frontal lobes are important control centres and so this technique may require more control as the brain needs to search from more ‘compartments’ to find the right memory traces required to conjure up the ‘beautiful image’ being imagined. 

Comparatively speaking, counting backwards stepwise – even in such awkward steps – is likely to be a more highly constrained task. 

‘To cope with pain, the brain makes use of a recipe that also works well in other contexts,’ says Anne Stankewitz, a co-author of the new paper.

That is the idea that ‘success depends on effective teamwork’, and in this case the different parts of the brain working together to reduce perceived pain levels.

Her team now plans to test whether their latest results can be usefully applied to patients with chronic pain.

The findings have been published in the journal eLife. 

WHAT IS PAIN? A COMPLEX MIX INVOLVING OUR WHOLE BEING

Health professionals use different terms for different types of pain.

  • Short-term pain is called Acute Pain. An example is a sprained ankle.
  • Long-term is called Persistent or Chronic Pain. Back trouble or arthritis are examples.
  • Pain that comes and goes is called Recurrent or Intermittent Pain. A tooth ache could be one.

Pain signals use the spinal cord and specialised nerve fibres to travel to our brain.  

Pain is never ‘just in the mind’ or ‘just in the body’ – it is a complex mix involving our whole being.

Source: British Pain Society  

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