Everyone has pain from time to time. Do you remember when your brother-in-law shut the trunk lid on your fingers or you hit your thumb for the third time trying to hammer that nail? Now that's pain!
Everyone has pain from time to time. Do you remember when your brother-in-law shut the trunk lid on your fingers or you hit your thumb for the third time trying to hammer that nail? Now that's pain! Acute pain serves a purpose. It signals a message to your spinal cord that a body part has been injured and needs help. It also allows you to instantly react. So get your hand out of the trunk and put some ice on it and you will be all right. A more complex type of pain is called chronic pain. This type of pain doesn't seem to go away. Long after the injury has healed the pain continues. In other cases the pain could be a result of a disease, but it no longer serves a useful function of warning the person and becomes a disease in itself. A finely tuned system that is designed to alert you when you are injured has gone awry. In some cases the source of chronic pain cannot be located. Chronic pain persists longer than the normal course of time associated with an injury and can last from six months up to several years. Patients with chronic pain often experience depression, anxiety, anger and grief that frequently makes the experience of pain worse. Chronic pain can include physical, neuropathic (nerve damage) and psychological factors. There are a number of medical treatments for chronic pain that can result in reduction of pain symptoms, however, a multidisciplinary approach that includes psychological care has helped to improve patient outcomes. Pain does not exist in a vacuum and there are many psychological forces at play that influence the course and intensity of pain. A person's beliefs, emotions, environment, relationships and personality all play a role in the pain experience. Pain is influenced by the amount of attention a person pays to it. It is also true that people who expect to feel pain often experience it at a higher intensity. Feeling helpless - that you have no control over the pain - can increase the distress and intensity of pain. Objective pain is seen as a physical sensation however suffering is a combination of the physical pain and a person's psychological reaction to it. Suffering involves the interpretation of the meaning of pain in negative ways that can affect all facets of life including self esteem, relationships, employment, and life plans. Pain is measured by the patient's report. Different patients have different perceptions of their pain intensity and beliefs about how pain will affect their lives. Psychologists may use several interventions listed below to teach patients to manage pain and encourage patients to play a bigger part in their self-care: Cognitive behavioral therapy helps the patient to change the self-talk and beliefs that influence the pain. Changing the way patients talk to themselves about the meaning of their pain helps them to change their reaction to it. They can learn new ways of thinking about pain and focus their attention on their abilities instead of their limitations. Behavioral interventions include relaxation training, meditation, hypnosis, and distraction strategies. Visualization of pleasant scenes, guided imagery, progressive muscle relaxation and deep breathing can reduce the tension in the muscles and the intensity of the pain experience. Paced progressive activity and self-monitoring can allow patients to determine their safe activity levels. Distraction seems to reduce pain by taking the focus away from the pain to more pleasant experiences. Talk therapy assists a patient to deal with the changes caused by pain and to reduce the accompanying depression and other emotional factors that may be exacerbating the pain. Responsible use of medications prescribed by the pain management physician along with these psychological interventions can help many patients to improve their quality of life and reduce the overall impact of pain on their lives. David Gannon, Ph.D., Psychological and Family Consultants, Canton, Ohio.