Chronic Pain Does Not Discriminate, Why Should You

OR What can Psychology do for my Aching Back?

My entire life I have known all sorts of people who cope with chronic pain of one type or another. From an early age I witnessed many approaches to living life with pain, from those who take a faith-based comfort, to the stiff-upper-lip & white-knuckles technique, to masking with rage, hiding pain with addiction and the cycle of dependency, and anxiety of so called hypochondriacs. In my early teens I actually considered a career in nursing because I wanted to be part of the solution to the pain I saw around me. Then I experienced my own critical, chronic pain and felt thoroughly chewed through the medical machine. As a result, I found I was more interested in what others, like me, did as a result of such experiences, felt about the the pain, and how the family responded. Over the years I found myself in the counseling professions, encountering physical and emotional pain every day. This is stressful, under-appreciated poorly paid, in-the-trenches-of-human-suffering-type work. It caused me to carry stress in my jaw, neck, and back. This is highly common; however my response to my common pain event was uneven. I wanted to be stoic, as I was taught, however, the trauma from the past pain events was unresolved. I was highly conflicted, exacerbating my stress levels, then my bodily responses. As the saying goes, “sooner or later something’s gotta give” and sure enough it did. I joined the ranks of the “back patient.”

The ache of the lower back, called lumbago, is the most common ailment to mankind. According to the publication ScienceDaily (3/13/10) approximately 21 million visits were made to physicians’ offices due to back problems in 2006. While countless adults experience back pain and stiffness, many suffer from serious spine and back conditions -including injury, herniated discs, and the deterioration of the vertebrae. ScienceDaily (5/19/07) also reports that chronic back pain is a condition that affects a significant part of the population, with patients falling into three major groups; those with herniated discs, spinal stenosis (a nerve affecting narrowing of the spinal cord), and complications from failed back surgery.

Low-back pain is one of the most costly and disabling health problems in developed countries, the researchers write in The Lancet (renown peer reviewed medical publication), but so far effective treatment has been lacking, writes Frederik Joelving of Reuters (2/26/10), however, when they added group therapy sessions to standard care — which includes pain medication and advice to stay active — the proportion of patients who got better doubled.

Talk therapy for pain is now fashioned under the heading of Cognitive Behavioral Therapy (CBT) a therapeutic approach which aims to solve problems concerning dysfunctional emotions, behaviors and cognitions through a goal-oriented, systematic procedure. To examine the impact of CBT on pain, researchers from the University of Warwick enrolled 701 people with troublesome daily pain and stiffness in the back and buttocks. Each person was randomly assigned to receive either standard care or standard care and cognitive behavioral therapy. Experienced nurses or psychologists worked with the 468 people in the therapy group, who received one individual session and six group sessions. The therapists focused on behaviors and beliefs about physical activity and made patients try to counter negative thoughts. Over the course of a year, the researchers tested patients’ pain and disability. After a year, those participating in talk therapy experienced twice the improvement of patients receiving only standard care. The percentage of patients reporting recovery was 60 percent in the therapy group and 30 percent in the standard group.

This is good news for pain sufferers who might be seeking insurance reimbursement for pain psychotherapy. CBT was found to be enormously cost effective in this study and the researchers commented upon the potential effectiveness as a first prescription before more invasive and expensive pain management techniques. I suggest that even in cases where patients need steroid injections, Radiofrequency thermolesioning, or surgery; CBT and group therapy for pain management would increase positive outcomes.

The nature of pain involves medicine, psychology, philosophy, spirituality and a large perceptual component. No two people experiencing the same trauma (pain is a trauma) perceives it identically. It is relevant to assist the patient in organizing their emotions and real life challenges. Identity development, social/family issues, culture, body image, adaptation to limitations, are the usual concerns, however, addiction, suicidal thinking, severe anxiety, and sometimes PTSD are frequent accompaniments to those afflicted with chronic pain, chronic disease, and accident recovery; if a counselor is not at hand during the impact of these issues, it can have mind/body affects which slow physical recovery, healing, and physical therapy outcomes.

So few of us have ever been referred to mental health professionals, even in serious situations, and many of us have mistakenly refused the services of counselors or social workers.”There’s nothing wrong with my mind” the patient withdrawals, fearing that the counselor will investigate them rather than provide healing services. I’ve seen this so many times, as people I know are hospitalized and visited by social services and do everything to get the counselor out of their room – as if they are the enemy. I even did this myself to a degree, after my emergency caesarian to a premature baby, I attended the 2 sessions required ‘mothers group’ as instructed, but I was emotionally numb and did not avail myself of services. Then, as the severe post-partum depression set in, along with its perspective that there was ‘no one to turn to,’ I had failed to make a connection with the hospital counselor, who could have found assistance for me in my time of great need.

So yes, a therapist could help you with your chronic backache. Along with regular or alternative medical treatment and physical therapy a counselor could help you “get that monkey off your back” in terms of dealing with stressors, learning new lifestyle techniques from relaxation to sleep hygiene. A counselor can assist you in problem solving, for example: “Should you get a different job, change shift, wear a support brace, ask the boss for a stool,” …things like this. If you are ever in need of this type of care, please take advantage of it. It can cut months and years from your physical misery. It can save money on expensive medical treatments and possibly invasive surgeries. Counseling gently supports everything your doctors are recommending. It can also sharpen your perspective and renew goals gone fuzzy in the confusion of modern life, giving your recovery a sense of renewal.

I provide this CBT for Chronic Pain and Talk Therapy, for health, wellness, chronic pain or disease, addiction, grief, trauma, life coaching or general concerns: please contact Gail-Elaine Tinker, M.S. at  www.tinkerpsychotherapy.com or 610-216-4319. We offer a monthly FREE monthly Adult Chronic Pain Support Group at our Bethlehem, PA office.