Psychology works for Chronic Pain

What is chronic pain?
Chronic Pain is pain that does not go away. When pain lasts over a period of six months, or beyond the usual time for recovery, it is said to be chronic. There are different types of chronic pain, many of which are not clearly understood. Chronic pain may be associated with an illness or disability, such as cancer, arthritis or phantom limb pain. Some types of chronic pain start after an accident. Others may start as acute episodes but then the pain becomes constant over time, such as low back pain. With some types of chronic pain, like migraine headaches, the pain is recurrent, rather than constant. There are many other kinds of chronic pain, such as chronic postsurgical pain, fibromyalgia, temporomandibular disorders, etc. While in some cases the cause of pain is known, in many other cases it is not clear why pain persists.

Pain medication is helpful in managing chronic pain, but the suitability of long-term use of medication needs to be considered in regard to the individual and the type of pain. Scientists are continuing to search for medications that take the pain away but also allow people to continue to function in their daily lives without side effects.

About one in ten Canadians has chronic pain. Chronic pain affects both sexes and while it is most common in middle age, it can occur at any age - from infancy to the elderly. Chronic pain can make simple movements hurt, disrupt sleep, and reduce energy. It can impair work, social, recreational, and household activities. People who have been injured in accidents may develop anxiety symptoms as well as pain. Chronic pain can have a negative impact on financial security, and can provoke alcohol or drug abuse. It can disrupt marital and family relationships.

As no one can see pain, people who experience chronic pain often feel alone in their suffering. Some people find that the legitimacy of their pain is questioned. Given the impact pain can have on quality of life, it is no surprise that more than a quarter of all people who develop chronic pain also experience significant depression or anxiety.

How can a psychologist help a person with chronic pain?
Psychologists use several different techniques to help people with chronic pain to recover their strength and sense of self, and improve the quality of their lives, in spite of the pain. Specific techniques to help people with chronic pain include support, education and skill building in areas such as relaxation, biofeedback, stress management, problem solving, goal setting, sleep hygiene, and assertiveness.

Cognitive approaches foster thoughts, emotions and actions that are adaptive for managing a life with pain. Behavioural approaches help people plan their activities in ways that give them more control without increasing the pain. Vocational assessment examines a person's interests, aptitudes and abilities and is useful for individuals who may need to change the way in which they work, or the kind of work they do, because of pain. Psychological therapy for anxiety and depression is helpful in managing the emotional consequences of chronic pain. When indicated, therapy for drug or alcohol abuse helps people deal with addiction. For people who find that chronic pain has affected their personal relationships, marital or family therapy is often recommended.

Are psychological approaches effective?
Psychological techniques and approaches have been proven to help people with chronic pain improve the quality of their lives. People report that they are more active, less depressed and anxious, and feel more in control. Even though they continue to have pain, it is more manageable.

While individual therapy may be offered, often people with chronic pain are treated in groups where they are able to share their experiences with others who live with pain. As chronic pain is complex, psychologists often work on teams with other health care professionals, such as physiotherapists, occupational therapists, physicians, nurses, social workers and pharmacists to help people with disabling chronic pain develop satisfying and healthy lifestyles.

They can put a man on the moon, and replace a heart, why can't they get rid of my pain? Or: Is there research being done to help people with chronic pain?

In addition to working directly with people who have chronic pain, psychologists have advanced our understanding of pain through different kinds of research. Clinical research is done by psychologists in collaboration with organizations and workers in an attempt to reduce the incidence of some types of chronic pain, either through injury prevention or early intervention programs. In addition, research involving people with chronic pain has helped develop effective management approaches.

Where do I go for more information?

For information about chronic pain, you can contact the North American Chronic Pain Association of Canada at 1-800-616-PAIN (7246), 150 Central Park Drive, Unit 105, Brampton, Ontario L6T 2T9; or visit their web site at www.chronicpaincanada.org.

Information about pain in children is available at the web site entitled "Pediatric Pain - Science Helping Children" at Dalhousie University, http://is.dal.ca/~pedpain/.

Consultation with or referral to a registered psychologist can help guide you as to the use of these therapies. For a list of psychologists in your area, please press here.

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