Managing Chronic Pain
Acute pain is pain that usually occurs as a result of physical injury to the body and usually resolves within 3 months from either natural healing or when the underlying physical cause is treated. Examples of acute pain may be short-lived pain associated with a twisted ankle, toothache, a burn, or after surgery. Acute pain can be an alarm system to the body that something is wrong and motivate us to ice the pain, rest or seek medical treatment. Acute pain can usually be “cured”.
Chronic pain is when pain persists beyond 3 months or beyond the time of expected healing. Chronic pain is a common condition occurring to 1 in 5 Australians. Sometimes chronic pain may be due to ongoing physical issues in the body, for example arthritis or nerve pain. Sometimes chronic pain may be due to sensitization of the nervous system. This is when there is an “over-active alarm” that turns up the volume of pain due to such factors as stress, tension and inflammation. Chronic pain does not mean the pain is not real, just that it is more complicated. Chronic pain can be distressing and debilitating for people and impact on mood, sleep, confidence, relationships, work and daily life coping. People with chronic pain may develop adjustment disorders, anxiety and depression. As chronic pain can be influenced by stress and worsened by stress, which suggests a mind-body link, a multi-disciplinary team is recommended, whereby the person may benefit from a GP, Pain Specialist, Physiotherapist and a Psychologist.
Can you relate to any common reactions to chronic pain?
Tensing the body
Avoiding activity altogether
Pushing past your pain limits
Withdrawing socially
Frustrated with self or pain
Fearful of the pain
Sense of helplessness
Sense of hopelessness
Despair
Depression
Having thoughts that:
“There is nothing I can do”
“I can’t go on”
“The future is terrible”
“My life is not worthwhile”
“I am weak and useless”
“My life will never improve”
These reactions, although common, may add fuel to the fire of pain and increase sensitization of the nervous system.
It is possible to learn how to respond, rather than react to the pain in order to regain a sense of control and choice. It is possible to learn how to relax with the pain, manage triggers, pace yourself, explore things that are possible and enjoyable, communicate with others more effectively, gradually build up physical functioning and cope more effectively. It is possible to experience a sense of confidence, relief, hope, pleasure, peace, acceptance and personal power. People can develop perspective to accept what is outside of your control and focus on what is in your control, look for opportunities for growth, live in the present moment, exploring strengths, capabilities, values, goals and skills.
Chronic pain may not be able to be “fixed” or “cured” but can be managed to reduce distress and intensity of pain, improve coping and quality of life. Psychology can help with chronic pain management.
Evidence based therapies include:
Cognitive-behavioural therapy, which aims to help the individual identify triggers for, flare-ups of pain, associated thoughts, feelings and reactions, and how to think and respond in helpful ways.
Acceptance and Commitment Therapy aims to help the individual to accept the pain, defuse from unhelpful thoughts and explore values and valued living despite the pain.
New evidence for Compassion Focussed Therapy which aims to help the individual become less critical of themselves when the pain flares up, be more kind to one’s self when suffering, and learn be more compassionate. This can help to reduce stigma and increase self-worth.
Katherine Bonaldi has trained and worked with individuals with chronic pain in a specialized public hospital pain clinic and private practice. She has a passion for working with people to reduce their suffering and improve their life. Please contact her via our website to discuss suitability and to book an appointment time.
Written by Katherine Bonaldi.
References: Pain Australia and Chris Germer.