Chronic Pain

Chronic pain conditions are varied and can include musculo-skeletal pain, abdominal pain, joint pain, non-cardiac chest pain and headaches.  Some symptoms may fall under the umbrella of a condition that may not be very easily diagnosed or poorly understood, such as fibromyalgia and complex regional pain syndrome. 

Living with chronic pain symptoms requires considerable emotional resilience as there may be persistent feelings of frustration, worry, anxiety and depression.  People can report feeling helpless and hopeless. Typically, activities may be avoided or there may be periods of overactivity followed by underactivity, with disturbed sleep or irregular sleep patterns. 

Psychological and emotional distress can affect a person’s ability to cope with the pain symptoms effectively and they may even contribute to a worsening of the physical symptoms over time.  It can be difficult to understand why pain persists when injuries have healed or when there are no obvious signs of injury.  Individuals sometimes fear that “other people will think it is in my mind”.  Relationships may be affected which can feel emotionally challenging and difficult to cope with. 

The research evidence suggests that psychological interventions such as Cognitive Behavioural Therapy (CBT) and Acceptance Commitment Therapy (ACT) can help with these conditions. 

CBT can help to identify and bring about a change in thinking which may be getting in the way of managing the physical symptoms.  You may have unhelpful thoughts such as “I have to wait until I feel better before I can make any plans”, “I have to avoid doing this because it will make my pain worse” or “I need to check how I feel when I wake up”.  CBT can help with moving towards more helpful narratives and changes in behaviour. 

ACT uses strategies based on mindfulness, acceptance and values-based action to help the individual to reduce their struggle with the pain sensations and instead focus on increasing functioning and quality of life.  The goal is to shift the focus away from getting rid of the pain and instead to focus towards living a meaningful life in spite of the pain. 

Treating the psychological symptoms can help with managing the physical symptoms and learning to cope better overall. The research suggests that CBT and ACT approaches can help with a reduction in psychological symptoms, an improvement in life satisfaction and an increase physical functioning.