Friday, June 9, 2017

More Than Trivial: Working Memory and Pain Management

by Lauren Sweeney, Office Manager
Knowledge of American history, popular music or sports may not be the first thing someone might be thinking about when they begin physical therapy, but our patients have come to expect that, when they walk through the door, they will be greeted by a Question of the Day. This rotating slate of various trivia and logic puzzles delights and challenges our patients so much that often a patient will end a phone call or email by asking, "What's the question today?"

While it may seem just a simple distraction, engaging the brain in recalling information or cracking a puzzle can serve a more useful purpose: pain management. Working memory, the part of short-term memory that takes on immediate cognitive tasks and processes language, also manages attention, meaning it is to a degree responsible for what we perceive and experience. When that working memory is engaged in a task, then, it can do so to the exclusion of other stimuli, such as pain. In a study conducted at the University Medical Center Hamburg-Eppendorf, participants were given a painful stimulation which was then followed by a cognitive task. The more complex the task, researchers found, the less pain the participants reported. And it wasn't all in their heads - MRI data showed a decreased neuronal response as well, meaning that fewer pain signals were making it to the spinal cord.

All that said, there's no evidence that working memory engagement is helpful in alleviating chronic pain, and it's certainly no substitute for seeing your doctor or setting up an appointment with a physical therapist. It may, however, lower pain just enough to start off a physical therapy session on the right foot. On that note, I'll leave you with my favorite riddle: A man lies dead, surrounded by 53 bicycles. What happened? (Feel free to answer in the comments below!)

Sprenger, Christian et al. Current Biology, Volume 22, Issue 11, 1019-1022.