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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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Disclaimer:  You know, we see a disclaimer like this in every ad that lawyers put out, and it probably is a good idea for us to use one, too:  "No representation is made that the quality of the psychological services to be performed is greater than the quality of psychological services performed by other psychologists.  The outcome of assessments or psychotherapy, or individual client satisfaction, cannot be guaranteed and is dependent on many factors.  Material on this site regarding symptoms, disorders, and treatment is informational only.  Diagnosis and treatment of mental disorders requires the expertise of a trained professional."

The information on this site regarding psychological disorders and treatment comes from many sources that cannot be credited, simply because they have been integrated over the years into our general knowledge base. However, one important source is the Diagnostic and Statistical Manual of Mental Disorders, 4th Edition (1994) published by the American Psychiatric Association.