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Psychology

The role of Psychology in Chronic Pain

Overview

Our psychologists empower patients by providing:

 

  • Goal Setting Strategies
  • Education
  • Ways to Manage Pain Flares
  • Advice on Managing Unhelpful Thoughts

The Psychological and Emotional Impact of Chronic Pain

Chronic pain is defined as pain that persists beyond the time you would expect an injury to heal (around 3-6 months). The word ‘chronic’ simply means that it is ongoing. It doesn’t indicate how bad the pain is. Chronic pain relates more to what’s happening in our nervous system, than to any injury. Over time, our nerves can become sensitised and overactive, which means we continue to feel pain, even if there is no physical evidence of tissue damage.

 

Studies suggest that chronic pain can impact on an individual’s quality of life, limiting their ability to perform daily tasks, and sometimes leading to emotional distress.1 The experience of pain, including chronic pain, is complex. It involves our minds as well as our body, and is often influenced by genetics, culture, our thoughts, previous pain experiences, and stress.

Treating Chronic Pain

Due to its complexity, best practice in treating chronic pain often involves a multidisciplinary approach. This typically includes multimodal treatments such as combinations of analgesics, physical therapy, behavioural therapy, and psychological therapy. These approaches have been shown to lead to superior and long-lasting outcomes including improved pain reports, mood, restoration of daily functioning, work status, and medication or health care use. Using a number of different therapies has also been shown to be more cost-effective than unimodal approaches. 2,3

Psychologically-based Treatment

Psychologically-based interventions for chronic pain are recognised as valid adjunct treatments. They can result in self-management of pain, improved pain-coping resources, reduced pain-related disability, and reduced emotional distress.

 

Relaxation training

It is generally accepted that stress is a key factor involved in the exacerbation and maintenance of chronic pain.4,5 Learning relaxation techniques will enable you to reduce tension levels (physical and mental), thereby achieving reductions in pain and an ability to increase control over pain.

 

Cognitive-behavioural approaches

Cognitive-behavioural therapy (CBT) treatment for chronic pain focuses on psychological principles to help manage pain. The goal is to increase your understanding of your pain and help you manage it by changing your behaviours, thoughts, and emotions surrounding pain. This kind of treatment will help you feel more in control in managing your pain.
Research has found CBT to be an effective treatment for chronic pain.6

 

Acceptance-based approaches

Acceptance and commitment therapy (ACT) is the most common of the acceptance-based psychotherapies. Acceptance encourages you to actively embrace pain and its effects, rather than attempt to change it. By doing so, you can still derive meaning from life, despite the presence of pain.

 

Mindfulness

Many patients with chronic pain experience stress, fear and depression, which along with their associated behaviours, increase the perception of pain. Research with chronic pain sufferers has found increased brain activity causes the person to become very emotionally reactive and preoccupied with the pain. Over time this results in more suffering and a vicious cycle begins.

Mindfulness based approaches can be very helpful in managing chronic pain. Mindfulness enables you to shift your attention to stimuli other than the pain. Mindfulness based approaches also help patients develop acceptance towards their chronic pain symptoms. When you are less focused on your pain, you’re able to focus on other, more satisfying and valued activities.7,8

How We Can Help You

Our clinical psychologists have extensive experience in the area of chronic pain. We understand that your pain is real and has a potential to negatively impact on your quality of life. To this end, we are committed to helping you get back to doing what you love. We can help you achieve this by providing a multimodal approach to treat your pain.

 

Through some of the treatments mentioned above, we can effectively help you feel in charge of your pain control, and enable you to live as normal a life as possible, despite your pain. The skills that you’ll learn will also empower you to become active in managing your condition.

References

1. Linton SJ, Shaw WS. Impact of Psychological Factors in the Experience of Pain. Physical Therapy. 2011;91(5):700-711.
2. Flor H, Fydrich T, Turk DC. Efficacy of multidisciplinary pain treatment centers: a meta-analytic review. Pain. 1992;49(2):221–230.
3. McCracken LM, Turk DC. Behavioral and cognitive-behavioral treatment for chronic pain: outcome, predictors of outcome, and treatment process. Spine. 2002;27(22):2564–2573.
4. Melzack R. Pain and stress: a new perspective. In: Gatchel RJ, Turk DC, editors. Psychosocial factors in pain: critical perspectives. New York: Guilford Press; 1999:89–106
5. Turk DC, Monarch ES. Biopsychosocial perspective on chronic pain. In: Turk DC, Gatchel RJ, editors. Psychosocial approaches to pain management: a practitioner’s handbook. 2nd edition. New York: Guilford Press; 2002:3–29
6. Morley S, Eccleston C, Williams A. Systematic review and metaanalysis of randomized controlled trials of cognitive behaviour therapy and behaviour therapy for chronic pain in adults, excluding headache. Pain. 1999;80(1–2):1–13
7. Kabat-Zinn J, Lipworth L, Burney R. The clinical use of mindfulness meditation for the self-regulation of chronic pain. J Behav Med 1985;8:163–90.
8. Carmody J, Baer RA. Relationships between mindfulness practice and levels of mindfulness, medical and psychological symptoms and well-being in a mindfulness based stress reduction program. J Behav Med 2008;31:23–33

Disclaimer
Please note the contents contained in this Patient Fact Sheet are not intended as a substitute for your own independent health professional’s advice, diagnosis or treatment. At Metro Pain Group, we assess every patient’s condition individually. As leaders in pain intervention, we aim to provide advanced, innovative, and evidence-based treatments tailored to suit each patient. As such, recommended treatments and their outcomes will vary from patient to patient. If you would like to find out whether our treatments are suitable for your specific condition, please speak to one of our doctors at the time of your consultation.

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