PAIN

One in three adults is in pain. We are fortunate to have skilled physicians and other providers to address that. For the most part, that means surgical procedures, cautious medication, and physical therapy. I had all three during my last knee replacement. The focus of these treatments is on FIXING the pain.

Psychologists have done extensive research and provided evidence-based treatment for pain. The focus here is more on COPING with the pain. It takes years of arduous study and experience to become a pain psychologist. However, there are some common-sense strategies anyone may learn:

• Accept appropriate medication. There has been extensive publicity about opioid abuse. No reputable provider would do that, and our responsibility is to stick to their prescriptions strictly. When the time comes, talk to your prescriber about a gradual withdrawal, and follow their advice closely.

Avoid the “catastrophic escalation’’ cycle of falling into an over-focus on pain, emotional exaggeration, catastrophizing, decreasing activities, muscle weakness, restricted range of motion, social withdrawal, and giving into helplessness:

• Educate yourself about pain as a neurological event. It involves the brain and our nervous system, with similar paths as anxiety. Sometimes, that reaction can be modified.
• Exacerbating Factors are important. Address major stressors in your life such as work and relationships. These may cause coping with pain to be more difficult.
• Relaxation may be a starting point. There are good books, videos, and even apps to help you.

• Cognitive Behavior Therapy, simply stated, involves learning to recognize your own catastrophic self-talk and practicing making realistic statements to yourself. Research indicates that this is our most effective treatment approach.
• Consider “Mindfulness.” Simply stated, this means being able to use focus on immediate surroundings such as paying attention to all your senses such as sight, feel, taste in order to short-circuit the emotional escalation.
• Though it may be incredibly difficult, maximize your healthy activities, distractions, and socializing. Doing the opposite is a trap, leading to helplessness.
• Focus on your increasing skills and develop a Sense of Mastery.
• Pain will likely continue, but you may be less aware of it, increase your tolerance, live a busy involved life, and not allow pain to rule your life.

Excerpted from:

Integrating Behavioral Medicine for Pain Into Your Care Plan,

American Psychological Association

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