When an injury or acute pain condition continues to cause pain and incapacity for more than 3 (or 6 depending on the source) months, that pain is then considered to be “chronic”. During this time, a sufferer of pain may have tried many standard (e.g. physiotherapy, surgery, massage, analgesic medication) and alternative treatments (e.g. acupuncture, anti-inflammatory diets etc) – these treatments may or may not work, either short, medium or long-term.
Chronic pain can occur when the nervous system that creates “pain signals” becomes more sensitive – just like the volume knob has been turned up on it.
So what happens when the pain continues? Can it have an impact on your mood/emotions?
Absolutely – this emotional effect can be related to the ongoing pain levels, incapacity which may reduce your level of activity, and lack of understanding around how/why your pain isn't going away.
Some chronic pain sufferers can become quite low or depressed, and some even begin to consider suicide as an alternative to the ongoing pain they experience.
Did you know that there is a clear link between our Body and our Mind?
Whilst chronic pain obviously can't be CAUSED by depression, depression can result from chronic pain. There is a link between how we think about a situation and what is happening in our body. For example – try imagining a situation that often leaves you feeling anxious (for example, public speaking) – is your heart racing, are you starting to feel clammy/sweaty, is your stomach filling with butterflies?
The same mind-body connection applies in the case of pain: if we focus on, and believe an activity will cause a lot of pain, most likely, we will feel pain (or at the least, anxious and stressed about experiencing more pain!).
This mind-body connection therefore means that your thoughts, emotions, stress and activity level can actually contribute to your body's nervous system networks that are responsible for creating pain, and these factors can in turn influence your experience of pain!
So how can I use this mind-body connection to reduce my pain/suffering?
It is recommended for chronic pain sufferers to take develop a multidisciplinary team around them to manage all the aspects of the pain experience – for example, a GP/doctor/specialist to manage the physical issues, recommend treatments/medication etc, allied health professionals such as a Physiotherapist, Occupational Therapist or Exercise Physiologist, PLUS consider linking with a Psychologist or Psychiatrist who can help you utilise the mind-body connection to help reduce pain, rather than amplify it.
Seeking assistance from a Psychologist or Psychiatrist is NOT to say that the pain is “all in your head” - it is just acknowledging that there is a mind-body connection, and trying something else to manage your pain and improve your quality of life.
How can this help me feel better?
Our perception of a problem has a huge impact on how difficult/insurmountable/unbearable it is – using psychological therapies such as Cognitive Behaviour Therapy (CBT) can help change the way chronic pain sufferers think and behave – it is not expected to remove any physical issues, but to manage them in a more positive way. It can help people see their situation/s in a positive, realistic, and rational way.
Another helpful psychological approach to pain is Acceptance and Commitment Therapy – research has shown that use of this approach can lead to improved quality of life as well as reduced anxiety (Johnston, M., Foster, T.M., Shennan, J., Starkey, N. J., & Johnson, A. (2010). The effectiveness of an acceptance and commitment therapy self-help intervention for chronic pain. Clinical Journal of Pain, 26(5): 393-402).
Skills from Acceptance and Commitment Therapy can teach chronic pain sufferers to understand that there is more to life than their pain: the aim is to stop fusing with the pain. This means accepting that your pain is there, but identifying what is important to you and setting appropriate goals. The following is an example of how to validate pain as well as acknowledge what is important, just by substituting the word AND for the word BUT:
“I'm having pain AND I love my children AND I'm going to have pain AND I'm going to do homework with them AND I'm going to push my daughter on the swing AND I want to spend time with my wife AND my back hurts again AND I want to go out and be active rather than sitting on the couch AND my pain hurts AND I want to be gardening.” (source: http://actskills.com/pain-management-acceptance-commitment-therapy/)
Considering developing a new approach to your chronic pain?
I have extensive experience in the Workers Compensation system, providing both case management and Adjustment to Injury counselling, and incorporate techniques from Acceptance and Commitment Therapy, CBT and Solution-Focused Brief Therapy to help you de-fuse from your pain and focus on the more important things in life: to help you live, not just survive, in spite of your pain.