Don’t Worry, Be Happy…Because Research Says So!

Happiness is everywhere. It’s heard on the radio, it’s seen on billboards, it’s expressed as a smile or a good laugh, and it’s supported in the research. As I approach the end of my time as a physical therapy student at Foundational Concepts,  I reflect on how happiness and positivity can be such a powerful component to each patient’s plan of care. Additionally, research supports that a positive outlook can lead to positive outcomes.  By making small, positive habits a part of a daily routine, those habits could become second nature and could play a large role in relieving chronic pelvic pain.Chronic pelvic pain, or continuous or episodic pain in the lower abdomen or pelvis for at least 6 months, is a common occurrence for many patients at Foundational Concepts.2 If left untreated, this chronic pain has the capability to compromise quality of life, function, and increase the likelihood of psychological impairments.2 Negative thoughts about pain can proceed pain-related fear, and further play into functional disability.5 In order to target pelvic pain, a multidisciplinary approach that includes physical therapy interventions, and emphasizes an improvement in day-to-day pain management and function, should be utilized.2

Chronic pain is more than just a feeling of agony, it is a sensory and emotional experience that is related to how the brain organizes input and stimuli.1,4 Treating chronic pelvic pain should embody a mind-body approach to target more than the muscles and tissues affected but also to retrain how the brain perceives pain.4 Thoughts are considered to be nerve impulses, and research finds that negative thinking can exaggerate perceived pain states.4 However, the thoughts that the nervous system develops about threats and pain can be changed over time.4 Neurons in the brain can become less sensitive and stop misinterpreting a non-threatening stimulus as painful.4 Physical therapy encompasses the “mind-body” approach through manual skills, neuromuscular therapeutic interventions supported by research, and with the development of a unique plan of care to each patient.  Practice, persistence, and patience in conjunction with physical therapy, can restore function in a way that does not just mask the pain, but targets the pain.4

Negative beliefs and persistent stress, particularly without positive thoughts, lowers resistance, weakens the immune system, and increases the risk of health problems.4Researchers believe that successful results can come from visualizing not only the movement, but also visualizing a positive outcome as well as imagining a movement performed perfectly.6 If your goal is to run a half-marathon or even to sit for an hour without pain, research considers that even visualizing success through positive thoughts can be beneficial to reducing pain.  Affirmations and positive thinking can potentially help one to better learn how to control thoughts regarding pain and how to handle stress and conflict to be better managed.4  Furthermore, pain was found to be reduced, as seen on imaging by use of positive pictures, sweet tastes, and expectations.4There are a variety of ways to make positive thinking a part of your everyday lifestyle. One technique may suit you better, but here are a few places to start:

1. R-E-L-A-X: Research shows that people who mediate better stimulate the region of the brain that is important for attention and regulating emotions.4  In addition, meditation can also decrease anxiety and improve self-confidence.4  Deep breathing, a good tool for EVERYONE (see blog post September 6, 2014) is believed to calm down a hypersensitive nervous system, which exacerbates pain states.4 (Stuck on how to mediate? Refer to our Resources tab for a recorded step-by-step meditation piece.)

2. Exercise: Research supports that exercise can lower a response to stress and improve one’s mood.

-For cardiovascular exercise, the American College of Sports Medicine ACSM), suggests up to 30 minutes a day for 5 times a week, of exercise of moderate intensity (walking, biking, swimming, etc.).4

-Yoga is another great form of exercise that targets body perception, deep breathing, and awareness of one’s mental and physical state.4 Yoga has been shown to increase the amount of positive thoughts and emotions and could potentially reverse the effects of negative thoughts through a physiological effect.4

-Pilates has been found to provide pain relief by increasing flexibility, mobility, and strength. Literature supports that pilates-based exercises provide a significant benefit to reducing pain.3

3. Take note: Document your day in a positive way! A journal (or even just a blank piece of notebook paper) can act as a place for all of your positive thoughts and actions throughout your day. With the holidays approaching, a journal makes the perfect gift for a friend or loved one, and mostly for you. Take time from your day to see all that there is to be thankful for and document those positive actions that you should take responsibility for. If you made someone’s day by holding the door or by calling a loved one, take note. You may come across a day where writer’s block takes over or where you need a different approach to your journal. If so, write down at least 1 thing that was good about the day. If it snowed, if it was sunny, or if you got the promotion you had wanted, anything that was good. Write down 3 random acts of kindness: 1 to a stranger, 1 to a loved one, and 1 to yourself. Embrace each day by starting and ending it with a positive thoughts or statement.The small, positive thoughts can become everlasting habits into your day that can better target your pain. Try with just a few positive thoughts to start and see where your mind can take you.

— Lindsay Sureck, SPT

Resources:

1.  Bowering K, O’Connell N, Tabor A, et al. The effects of graded motor imagery and its components on chronic pain: a systematic review and meta-analysis. J Pain. 2013 Jan;14(1):3-13.  https://www.ncbi.nlm.nih.gov/pubmed/?term=The+effects+of+graded+motor+imagery+and+its+components+on+chronic+pain%3A+a+systematic+review+and+meta-analysis.

2. Chao M, Abercrombie P, Nakagawa S, et al. Prevalence and use of complementary health approaches among women with chronic pelvic pain in a prospective cohort study. Pain Med. 2014 Oct 3. https://www.ncbi.nlm.nih.gov/pubmed/?term=Prevalence+and+use+of+complementary+health+approaches+among+women+with+chronic+pelvic+pain+in+a+prospective+cohort+study.

3. Sullivan A, Scheman J, Venesy D, Davin S. The role of exercise and types of exercise in the rehabilitation of chronic pain: specific or nonspecific benefits. Current Pain Headache Rep. 2012 Apr;16(2):153-161. https://www.ncbi.nlm.nih.gov/pubmed/22258395

4. Vandyken A, Hilton S. The puzzle of pelvic pain: a rehabilitation framework for balancing tissue dysfunction and central sensitization II: a review of treatment considerations. J Womens Health Phys Therap. 2012 Jan;36(1):44-51.   https://entropy-physio.com/wp-content/uploads/2013/10/Central-Sensitization-Framework-Article-21.pdf

5. Vlaeyen J, Linton S. Fear-avoidance and its consequences in chronic musculoskeletal pain: a state of the art. Pain. 2000 Apr;85(3):317-332.            https://www.ncbi.nlm.nih.gov/pubmed/10781906

6. Warner L, McNeill ME. Mental imagery and its potential for physical therapy. Phys Ther. 1988 Apr;68(4):516-521.  https://www.ncbi.nlm.nih.gov/pubmed/3281175 

7. https://craniumcrunches.com/blog/hopeful-notes-the-middle-aged-brain-positive-outlooks-and-brain-research/