Forgetting Pain

There was an interesting article in The New York Times recently called "Forgetting the Pain of Exercise" by Gretchen Reynolds. In the article, Reynolds mainly writes about physical pain associated with exercise, and more specifically pain experienced by marathon runners. Running a marathon is physically painful and brutal on your body, yet why do so many people want to do them? And then keep running in them, more than once? How and why do these seemingly gluttons for pain put themselves through what most of us would consider an agonizing ordeal? The author asks the same questions in the article, and the answers and theories actually make pretty good sense.

Reynolds writes of a new psychological study that offers some explanation of why people run in marathons and continue to sign up for them. Apparently some marathon runners seem to develop "selective amnesia." They forget over time their level and intensity of pain. But in addition to "time healing all wounds" (as that old phrase goes), a runner's "pain amnesia" may also depend on how much he or she enjoyed the race. So, basically, if you're in pain but you're having fun, you may have a better chance of forgetting your pain sooner and easier. Hmm. Interesting idea.

Reynolds states:

"A wealth of psychological science has established that someone's feelings at the time that an injury or ache occurs--the emotional context of the pain--can dramatically affect his or her sense of the pain. In general, pain associated with a positive experience tends to be perceived as less excruciating at the time than pain resulting from something rotten."

Reynolds hints at the potential for these findings to have implications regarding exercise in general, such as people being able to stick with their exercise routines. If you enjoy the activity that you're doing, even if it causes some degree of pain, you're more likely to do it again and continue doing it. But of course if an activity you're participating in causes pain AND you get no enjoyment or positive benefits from it, what's the likelihood of doing that activity again? Or being motivated to try something similar? Not very likely.

So how does this relate to RA and chronic pain? After reading this article, I've been wondering that myself. Having chronic pain from RA is obviously not the same as pain from exercise. The intensity of RA pain might be similar to that of someone running a grueling 26.2 mile marathon, but the cause of the pain and the situations are totally different. People with RA are struck with pain whether they want it or not--they have no choice. Marathoners and others who choose to engage in various forms of exercise and physical activity are willingly making themselves available to pain. But pain is pain, right? Nobody likes it (unless you're into that sort of thing). People usually want to avoid it or lessen their suffering from it, no matter what they're doing or what physical illness or condition they may have.

Is there any way to make RA enjoyable? I know that sounds ridiculous. Or how about just a little bit less, well, rotten? Personal experience has shown me over and over again how my mood and stress level can either positively or negatively affect my RA symptoms. Several times I've seen my flare-ups drastically improve when my mental state is also improved.

I vividly remember when I was supposed to go to Ireland to study abroad for a fall semester. Right before I was set to go, my right wrist flared-up very badly (I had had surgery on it a few years before but RA damage had already occurred). Devastated, and stressed-out, I had to cancel my plans and stay home. I spent that fall not even attending college , but just trying to get my wrist pain and inflammation under control. The pain was constant and unrelenting, forcing me to wear an ugly wrist brace day and night, and making me worry that I wouldn't be able to study in Ireland at all.

But I did go to Ireland. Even though my wrist was still constantly painful, with any slight movement of my hand or arm immediately causing shooting pain, I pushed past the pain and made myself do the study abroad program that winter semester. Living and studying in Cork, Ireland at the end of my undergraduate years turned out to be probably the best thing I've ever done in my life--thanks mostly to the close friends I made while I was there. And, once I was fortunate to cross paths with and join this wonderful small group of people, my wrist miraculously (?) began to get better. A lot better!

Coincidentally, the wrist improvement began to happen as my mental and emotional health also became stronger and better. For the first time in a long time I was happy. Really happy. No, the permanent damage to my wrist was not cured, but the pain became noticeably less and more bearable. My whole body felt better during my time in Ireland, really. Maybe it was something I was or wasn't eating. Or maybe it was the extra exercise I was getting, or having to walk so much every day (often uphill). Those things probably contributed to my lessened pain and health improvement, but I also firmly believe that my emotional state, my happiness, and my level of enjoyment affected my pain and my RA in major ways. I think the mind-body-spirit connection is something that's overlooked too often by most Western doctors today, yet it could be essential in helping RA and chronic pain sufferers find healing and relief.

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