Chronic Pain Management provided by Hampshire & Surrey Psychology
Our psychologists are experienced in providing assessment and treatment for managing chronic pain, for which there is no medical cure.
What is Chronic Pain?
Although it can be unpleasant, pain is something that we all experience and it acts as an effective warning system that alerts our body to injury, damage or the potential threat of injury. This type of pain (acute pain) usually resolves with the removal of the painful stimulus and with some healing, rest and treatment. Unfortunately sometimes the pain does not resolve, and this is known as chronic pain. Many people with chronic pain will have tried lots of different ways to get rid of the pain, such as medication, injections and even surgery, but without success.
Sometimes there is an underlying medical condition that explains the pain, however there are times where no medical explanation or diagnosis can be provided. This is difficult to understand and can lead people to seek out further investigations to no avail. We have learnt from research that even after an initial injury may have healed and when nothing has been identified by scans like an MRI, ongoing pain can alter nerve pathways and the central nervous system can become highly sensitised through a process known as ‘central sensitisation’- a hyperactive warning system. For example, light touch, changes in temperature and pressure can cause a lot of pain due to this heightened sensitivity.
Some medical conditions that may lead to chronic pain are:
- Musculoskeletal (e.g., back pain, arthritis)
- Spinal cord and nerve injury
- Complex regional pain syndrome
- Post-surgical pain
Chronic pain often results in the emergence of a complex set of physical and psychosocial changes. Whilst it is important to understand the biological basis of pain, we also recognise the importance of cognitive, emotional, behavioural and social aspects of pain. All these areas are of great importance in the overall experience of pain and the interrelationship of these is often referred to as the biopsychosocial model of pain. The assessment we provide is informed by this model.
When you come to the pain management appointment you will be assessed by one of the psychologists. The appointment should take around 90 minutes. During this time the psychologist will ask you many questions and may also ask you to fill in some standardised questionnaires and measures. This specialised assessment will provide us with a detailed pain history and a better understanding of how the pain is impacting on your life.
At the end of the consultation there will be time to explain and discuss any pain management plans or treatment options. These may include:
- Education about pain pathways in the body and what happens with chronic pain
- Dealing with emotional issues connected with pain such as frustration, guilt, depression or anxiety
- Learning helpful pain management techniques such as pacing, relaxation and mindfulness
- Setting and achieving goals to connect with valued activities
- Exploring different ways of thinking so as to reduce the influence of unhelpful thoughts that may be holding people back or getting in the way of achieving goals
Our pain psychologists are experienced in supporting clients with all of the above. We use a range of psychological approaches that have been proven to be effective in this area, such as cognitive behaviour therapy, acceptance and commitment therapy, and mindfulness based work. It may also involve being referred to other professionals if we feel that their input is required. We have close links with physiotherapy colleagues who can provide expertise in optimising physical functioning.
Assessments can be conducted at the Hampshire Psychology in Petersfield, Rownhams, Southampton, Southsea and Bournemouth.
What is Chronic Pain Management?
Pain management aims to improve and maximise people’s functioning and quality of life, in spite of continued pain. It involves looking at strategies aimed at keeping the pain to a manageable level, as well as finding ways to engage with valued and enjoyable activities. Pain is a physical process, but anyone who lives with chronic pain will know that it affects how they think, feel and behave. Therefore pain management involves making changes to how one deals with difficult thoughts and emotions connected to pain, so as to reduce the amount of psychological distress and suffering that accompanies physical pain. It also involves changing old habits and learning new ones.
Pain management often starts with acknowledging that there is no complete medical cure for the pain, and that therefore one is going to need to find a way to move forward in life even though pain is part of the picture. This is clearly a very difficult thing to do, and many people will have spent years trying to find a cure or solution to the pain until they come to this point of acceptance. Before engaging in pain management it is important to have had the underlying condition investigated by medical doctors and to have tried any appropriate treatments that may help to cure or alleviate the pain.
Often people who live with chronic pain will push themselves to keep going until the pain tells them to stop. The amount of activity they do is often based on how they are feeling: on a ‘good day’ they want to make the most of things and get extra tasks and jobs done. This can often lead to over doing it and feeling much worse later in the day or the following day. This is invariably followed by a period of rest, taking painkillers and feelings of frustration and despair. In times of prolonged rest the body loses its condition, joints become stiffer and muscles become weaker. Consequently, it is harder to do things and can feel even more painful to move. The difficulty with this type of cycle is that it can lead to more flare-ups in pain severity, and the person feels less in control of daily activities and may start to experience a sense of failure and even depression.
Whilst people might recognise that this ‘boom and bust’ cycle can be self-defeating, they often feel stuck and find it hard to break. People’s expectations of themselves may cause them to push themselves too far. Or they may feel that they have little choice but to overdo things (e.g., due to financial circumstances or childcare). There may be ways to break the over/under activity cycle and increase activity level without stirring up the pain too much, so that people can enjoy a range of activities again. Pacing aims to help people to be able to do everyday activities without making the pain worse. For example, engaging in activities at a level that feels manageable and then gradually increasing this over time.
Mindfulness is about paying attention to the present moment, bringing qualities of openness, kindness and a non-judgmental approach to our experience. Mindfulness has its routes in Eastern traditions such as Buddhism, where the value of meditation has long been recognised. Mindfulness, as used in Western healthcare, is not linked with any particular religious tradition, and so it can be comfortably aligned with one’s own beliefs. It is simply about being open to our experience in the present moment, and letting go of the tendency to want to avoid our experience when it is not to our liking. The benefits of mindfulness are far reaching and growing evidence is showing that regular mindfulness practice leads to outcomes such as improved quality of life, less anxiety about pain, reduced levels of pain, better physical functioning, improved sleep and less use of analgesic medication.
At Hampshire and Surrey Psychology our therapists are experienced in teaching mindfulness techniques. In the future we may be offering group sessions that will help people to learn and develop mindfulness practice.
EFT is a unique therapy that involves the client tapping on points on their head, upper body and hands as a part of the therapy. It is also known as ‘tapping therapy’ or ‘acupuncture without needles’.
EFT is one of the energy psychologies and as such is related to EMDR. EFT has been widely studied in its application to treating trauma and PTSD. Find out more on the EFT page.