| Chronic
Pain Chronic pain is best treated as more than just a physical problem. Whatever the
underlying physical problem that causes the chronic pain, there are psychological
considerations, too.
First, people who
suffer from chronic pain often develop secondary psychological reactions, such as
depression, anxiety, stress (e.g., from financial woes caused by the pain), and social
withdrawal/avoidance.
Second, psychological
problems can contribute to the intensity and duration of chronic pain. For example, people
who are depressed tend to have a lower threshhold for pain. They can experience more pain,
and more intense pain, than their physical condition alone would cause. Also, people under
a lot of emotional stress tend to have physical reactions (such as tensing muscles all the
time) that can make their pain worse. As you can imagine, the chronic pain/emotional
distress cycle interaction can become a vicious circle, with pain causing psychological
distress and that psychological distress increasing the pain.
Finally, chronic pain
can be responsive to psychological interventions that teach the person to manage the pain
more effectively. While these techniques cannot remove the physical source of the pain,
they can help the person with chronic pain experience less pain and live a more normal
life. For example, relaxation strategies can help you decrease the tension in your
muscles, which can have a significant impact on the pain you feel. Even techniques as
simple as breathing exercises have been shown to reduce the subjective experience of pain.
The Role of the Psychologist
Psychologists play an
important role in pain treatment offered by physicians who are experts in pain care. These
physicians often refer their pain patients for psychological assessment, pain education,
and psychotherapy.
Psychological
assessment is useful to identify psychological conditions that could contribute to pain
(such as depression) that the physician might want to treat in addition to the physical
pain itself. Asssessment can also help the physician understand the patient better, so
that personality characteristics that could affect treatment can be addressed. For
example, a Type A personality -- hard-driving, ambitious, stressed out -- is likely to
respond to pain treatment differently than someone who is more laid back and passive.
Pain education involves
teaching the person with pain about their pain, as well as teaching the techniques
referred to above. Again, the idea is to learn strategies for managing the pain so it is
less troublesome, allowing the person to get on with life.
Psychotherapy can be
helpful when psychological distress coexists with the chronic pain, such as depression,
anxiety, or other issues.
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