Mind-Body-Pain Connection: How Does It Work?

WebMD Live Events Transcript

Pain experts Brenda Bursh, Ph.D., Michael Joseph, M.D., and Lonnie Zeltzer, M.D., discuss the way that the mind and body affect, and are affected by, pain.

The opinions expressed herein are the guests' alone and have not been reviewed by a WebMD physician. If you have questions about your health, you should consult your personal physician. This event is meant for informational purposes only.

Moderator: Welcome to WebMD Live's World Watch and Health News Auditorium. Today we are discussing "The Mind-Body-Pain Connection: How Does It Work?" with Brenda Bursch, Ph.D., Michael Joseph, M.D., and Lonnie Zeltzer, M.D.

Brenda Bursch, Ph.D., is the Associate Director of the Pediatric Pain Program, Co-Director of Pediatric Chronic Pain Clinical Service and Assistant Clinical Professor of Psychiatry & Biobehavioral Sciences at UCLA Department of Pediatrics in the School of Medicine. She has written about asthma, developmental & behavioral pediatrics, emergency medicine, AIDS education and prevention, chronic digestive diseases and pediatric bowel disorders. She has membership in the American Pain Society, American Psychological Association, Munchausen Syndrome by Proxy Network, and the UCLA Center for the Study of Organizational and Group Dynamics.

Michael Henry Joseph, MD, is an assistant professor of pediatrics and co-director of Chronic Pain Services at the University of California at Los Angeles Children's Hospital. He is a recipient of the Golden Apple Award for Excellence in Teaching.

Lonnie Zeltzer, M.D., is an expert in the field of pediatric pain. She is a former president of the Society for Adolescent Medicine and member of the National Institute of Health?s Human Development Study Section. She is currently a Professor of Pediatrics and Anesthesiology at the UCLA School of Medicine. She is Director of the UCLA Pediatric Pain Program and Associate Director of the Patients & Survivors Section, Cancer Prevention and Control Research Branch of the UCLA Jonsson Comprehensive Cancer Center. She has well over one hundred scientific publications, reviews and chapters in medical journals, and has lectured internationally.

Moderator: Doctors, welcome back to WebMD Live.

Dr. Bursch: Thank you.

Dr. Joseph: Thank you.

Dr. Zeltzer: Thank you.

Dr. Zeltzer: As you know, the mind-body pain connection is the basis upon which our pediatric pain program at UCLA operates, both in terms of how it conceptually views pain and its approach to treatment. I would like to begin by discussing the physiology that is underlying a lot of our functional definitions of pain and our basic philosophy and our mind-body connection model.

Dr. Joseph: I'd like to say the differentiation into components is a fallacy. Your brain and nervous system communicate with the rest of your body just like all other organ systems. All work together. Pain is not a simple entity in which it's like pulling on a string and ringing a little bell in your head. It's more dynamic than that, in which you do have nerve input from fingers and toes and organs that goes to spinal column and then to your brain. You also have nerve pathways that are coming from your brain down your spinal column. There are many factors that change the way we actually perceive pain and can make pain more intense or less intense depending on the situation. This is also true for other symptoms. This connection between your central nervous system and your brain communicates with your peripheral nervous system so nerves coming from organs, arms and legs, and all symptoms that you may be feeling can be altered by your nervous system either increased or decreased. That's true of nausea or difficulty breathing or any symptom you might be feeling. In fact, it's true of all of your senses. Your sense of hearing, smell, taste, vision are also all interpreted perceptions. Different factors that can alter your perception specifically when it comes to pain include how much attention you pay to the symptom, what the meaning of the symptom is. For some people, pain is a good thing such as when you've been working out and you're waiting to feel that burn and the burn has a good context, as opposed to if you pull a muscle, you may have exactly the same amount of tissue damage but the way you perceive the pain is very different. Memory can affect perception of pain. When we are awake, it takes much less stimulus to cause pain than when we are asleep. If we were in a coma, it would take even more, possibly we don't even experience pain.