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  • Lemuel Tan

Psychology Week 2020: Chronic Pain in Adults

Psychology Week is an annual initiative of the Australian Psychological Society (APS) that aims to increase public awareness of how psychology can help Australians lead healthier, happier and more meaningful lives. This year's theme is "Pain: Finding the way forward with psychology. The APS has recently released "The Australian Psychology Pain Report 2020".

There are a whole bunch of resources about psychology and pain that members of the public can access here, Psychology Week 2020 - Resources

Below is a snippet from the APS's article - Chronic Pain in Adults: Strategies For Managing Pain.

What is Pain?

Pain is defined as “an unpleasant sensory and emotional experience associated with, or resembling that associated with, actual or potential tissue damage” (International Association for the Study of Pain). It is a personal experience that is influenced by a number of factors including biological (e.g., from injured structures), psychological (e.g., coping skills) and social (e.g., family environment) factors.

A person’s experience of pain is said to be chronic (or persistent) when it continues beyond the usual period of healing. This is often defined as pain that persists for three months or longer. Around one in five adults experience chronic pain; more commonly women and older individuals.

Pain is often experienced with other conditions including anxiety disorders (e.g., generalised anxiety, panic disorder, social anxiety, or post-traumatic stress disorder), mood disorders (e.g., depression), physical conditions (e.g., heart disease, cancer, and arthritis) and substance use disorders (e.g., overuse of prescription medication or alcohol).

Some people who experience chronic pain may have initially had a physical injury (e.g., a muscle sprain), others experience it as a symptom of another condition (e.g., Parkinson’s disease), whilst others are unable to identify why, or how, their pain began. Irrespective of the cause, once pain has become chronic, it is more complex in terms of the impact it has on people’s lives and the treatment it requires.

Impact of Chronic Pain

Getting timely access to the right treatment for pain is important to reduce the risk of the pain persisting and to minimise the impact of pain on physical, social and psychological wellbeing.

Many adults with chronic pain find it difficult to maintain their usual routines, including attending work and completing study. This can result in frequent or extended absences and a reduction in participation in social, community and sporting activities. Withdrawal from these important activities can lead to low mood, social isolation and inactivity, and in turn can lead to a further increase in pain.

Managing chronic pain can impact all family or household members. Partners/spouses may be required to take regular time off work for appointments, and this can create stress and frustration if treatments do not appear to be working quickly. The impact of chronic pain on the individual with pain may also change their ability to contribute to the household (e.g., complete chores) and impact the way they relate to other members of the household. Adjusting to these changes can be difficult for the individual with pain, as well as for other household members

Tips for managing Chronic pain

  • Investigate the cause of the pain If you are experiencing ongoing pain, it is important to have a thorough investigation conducted by your doctor, identifying the range of factors that may be contributing to your pain. Making an appointment with your GP is a good place to begin. You may be referred to a pain specialist and/or pain clinic if your symptoms persist. Once you have had the tests you have been advised to have it is important to focus on the recommended treatment, rather than seek ongoing investigations.

  • Involve a number of health professionals in your treatment plan Your GP may coordinate your care and collaborate with other health professionals (e.g., psychologist, physiotherapist, occupational therapist) or they might refer you to a specialist pain management clinic. Chronic pain is managed best using an interdisciplinary approach that includes different professionals working together on an agreed pain management plan. It is important to have your treaters communicate and collaborate under a shared understanding of the nature of your pain experience and an agreed approach to treatment.

  • Take a gradual approach to treatment Pain treatments often start with increasing a person’s functioning while managing symptoms rather than simply focusing on trying to reduce symptoms. Although this may seem counterintuitive, resuming your routines and activities can help reduce pain, improve your mood and increase your enjoyment from life. If you have not participated in certain activities for some time, a gradual approach to resuming activity is needed and this will require a supported program of agreed targets. Sometimes you may need to reduce what you are doing initially, before gradually increasing what activities you do.

  • Supporting someone with chronic pain If you are a family or household member of someone experiencing chronic pain, it can be useful to consider if you are being ‘too helpful’. Our intuition when someone is unwell or hurt is to be caring and allow them to rest. This is exactly the right response when someone has a temperature or a recent injury. With chronic pain, we need to respond differently, and this can sometimes be confronting. For example, with chronic pain, prolonged rest can lead to a worsening of symptoms and stopping all activities (e.g., domestic chores, hobbies, work) can contribute to feeling depressed and anxious. Therefore, the best response is to encourage the individual with pain to do what is a manageable amount of an activity and to assist with what still needs to be completed while they build up their capacity. To communicate your care for them, don’t ask your family member about their pain, but rather ask them about different aspects of their life and what kind of support would be most helpful. Living with someone who has chronic pain can be very exhausting so finding ways to deal with your own distress and frustrations is helpful. This might include contact with other people who are dealing with a similar situation, perhaps through a support group, or a trusted friend or family member. Feeling more on top of the situation and having a positive attitude can help your family member to adapt. Time-out for rest and relaxation is essential.

How can a psychologist help with chronic pain?

There is strong evidence that engaging with a psychologist with experience in treating pain early in your treatment can help your recovery. Psychologists can help address the barriers to your recovery. Psychologists are highly trained and qualified professionals skilled in helping people with a range of concerns related to wellbeing, mental health and behaviour, including the psychological difficulties that come with the experience of pain.

It can be stressful managing tasks and completing activities while in pain. Psychologists are good at helping people develop their self-management and problem-solving skills, focusing on behaviour change and identifying the barriers that may prevent them from making progress.

Psychologists can also assist individuals with chronic pain and their family to work towards their optimal functioning by setting goals and maintaining a balanced routine.

Psychologists play a leading role in the delivery of pain management programs and can assess the person’s suitability to take part in such a program.

Psychologists also play a key role in helping individuals with pain manage their ability to work. They can assist with managing concentration, motivation, behaviour, and emotions while at work and this can be very important for the person’s self-esteem and confidence.

In addition, psychologists can assist with sleep health. Pain can be very disruptive for sleep and lack of sleep can exacerbate the ability to successfully manage pain. Therefore, learning strategies to sleep well is helpful with reducing the pain directly as well as being helpful for managing work and other commitments.

Internet based resources

This Way Up - (This Way Up clinic) is an eight-session treatment program. There is a fee for use and clients need a referral from a clinician who needs to guide them through the program and the clinician gets access to information on the client’s progress

Mindspot - (Mindspot clinic) is a five-lesson treatment program designed to be done over eight weeks. It is free and does not require a referral or clinician’s assistance

Disclaimer: The material on this blog is not to be used by any commercial or personal entity without expressed written consent of the blog's author. The article above is an opinion of an individual clinician and should not be taken as full clinical advice. The statements on this blog are not intended to diagnose, treat, cure or prevent any mental health or mental illnesses. Always consult your doctor for medical advice or seek professional therapy.

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