By Benjamin E. Ruark
This conjectural account is based solely on anecdotal observations of long-term care patients suffering from chronic pain in nursing-home settings. Acknowledging that many elderly residents in long-term care facilities have hearing impairment, it’s no surprise to witness generally loud decibel levels for television and radio in their rooms. Nonetheless, there appears to be an association between residents who’re most vocal about their pain level and the decibel level of their entertainment devices. Also noted—again, without scientific application and evidence—many of those same residents do not exhibit hearing impairment.
In the figure, above, are two hypothetical self-rated pain levels plotted over a 40-minute time interval. The upper pain-profile denotes a patient who has minimal or no noise distraction. S/he could be watching TV at a moderate volume, or reading, or staring off into the middle distance. Regardless, pain mostly occupies their thoughts. If the TV is on, it isn’t working any magic. It’s assumed that, for chronic pain sufferers, mind-on-pain has an amplifying effect on pain level—viewed as another instance of psychological priming.
In the same figure, the lower pain-profile denotes the same patient who now mostly operates their entertainment devices at very loud decibels. Despite the noise level, they’ve learned to adjust to it. They can attend to a TV program, read, listen to music, etc. The noise, itself, however, is sufficiently loud enough to directly impede perception of pain; hence, the pain threshold is now artificially higher, and equally true, pain has been considerably dampened more than the patient would otherwise experience if the room was silent. The principle believed to be in force is that some patients instinctively detect loud noise’s pain-dampening effect and get rewarded (instrumental conditioning) for their subliminal discovery.
If this hypothesis were proven, then is benefit to be had from its knowledge? What first comes to mind is hospitalized patients experiencing acute pain. Perhaps supplying recovery rooms with ample background noise—where staff and select patients wear ear plugs—would dampen pain mindfulness for acute pain sufferers; if there pain medication has limited efficacy, then noise would provide a supplemental analgesic. As well, chronic pain sufferers who’ve instinctively failed to adopt the pain-dampening principle could be so advised and given that option.