Managing Chronic Pain: How Pain Psychology Can Help

Chronic pain can significantly impact the daily lives and well-being of people worldwide. This complex symptom can persist for months to years, pushing far beyond the typical course of an acute illness or injury. Exploring the intricacies of chronic pain and how pain psychology can offer relief and improve quality of life may help you or a loved one move forward and have hope alongside chronic pain. 

Chronic pain relief is possible

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What causes chronic pain?

Chronic pain can arise from numerous sources. The symptom may originate from a past illness or injury from which one has recovered, current illnesses, disabilities, mental health challenges, infections, inflammation, and other challenges. Conditions like arthritis or cancer can cause ongoing pain, while some people experience chronic pain without any apparent injury or illness. In some cases, the exact cause of chronic pain is unclear.

When a person sustains an injury or illness, specific nerves transmit pain signals to the brain. In cases of chronic pain, these signals continue to fire for weeks, months, or years after the initial recovery. Chronic pain might follow a significant injury or illness, such as a back injury or shingles, or it may appear without a known cause. In some cases, the brain chemicals that typically suppress pain stop functioning correctly, leading to prolonged discomfort.

The nature of chronic pain can vary depending on where it occurs in the body. Pain can affect muscles, bones, and joints, often resulting from injuries or muscle strain. Conditions like osteoarthritis, rheumatoid arthritis, and fibromyalgia are common culprits. Nerves and the nervous system can also be sources of chronic pain, particularly when nerves are damaged or compressed by injuries or health conditions like diabetes, shingles, or sciatica. 

Organ-related pain is another possibility, stemming from injuries, infections, or conditions like inflammatory bowel disease, irritable bowel syndrome, pelvic pain, and stomach ulcers. Individuals can experience multiple types of pain simultaneously, including in the case of fibromyalgia, which is a disability that affects both muscles and nerves.

The effects of chronic pain

Chronic pain, by definition, lasts longer than six months and significantly impacts daily life. While doctors can address the physical aspects of chronic pain, psychologists are uniquely equipped to help individuals manage the mental and emotional challenges associated with this condition.

Pain is a common reason people visit doctors, yet alleviating it is not always easy. According to a Centers for Disease Control (CDC) report that analyzed data from a 2021 National Health Interview Survey, over 51 million adults are living with chronic pain. This significant figure represents 20.9% of the US population, amounting to more than one in five Americans. 

Chronic pain serves as a complex signal that involves biological, psychological, and emotional components. Unlike acute pain, which alerts individuals to immediate harm, chronic pain often leads to feelings of anger, hopelessness, sadness, and anxiety. Effective treatment often aims to address both the physical and psychological dimensions of pain.

What is a pain psychologist?

Pain psychologists are specialists who help people cope with the thoughts, feelings, and behaviors associated with chronic pain. They may work in individual practice or as part of a healthcare team in clinical settings. Other healthcare providers may refer clients to pain psychologists to address the emotional aspects of pain while they continue to receive physical support from a separate doctor. 

In sessions with a pain psychologist, clients may discuss the impacts their physical and emotional health have on their mental well-being. The psychologist may ask about the pain the client experiences, its location and frequency, and any factors that may influence it. Clients may also be asked to complete questionnaires to capture thoughts and feelings about the pain. This comprehensive understanding helps the psychologist develop a tailored treatment plan. However, psychologists are not medical doctors and cannot prescribe medication or offer medical advice and treatment. 

Psychological treatment plans are personalized, often including relaxation techniques, changing negative beliefs about pain, building new coping skills, and addressing any anxiety or depression linked to the pain. Pain psychologists can teach you to challenge unhelpful thoughts about pain and develop new perspectives. Studies have shown that some psychological treatments can be as effective as surgery in altering how the brain processes pain sensations. Additionally, psychologists may help you make lifestyle changes to stay active in work and recreational activities and address sleep issues that often accompany chronic pain.

Types of pain psychology therapies 

Just as chronic pain can affect each individual differently, there are different psychological treatment methods available. Exploring different types of pain psychology may help you find a method that suits your unique needs. Below are a few types of pain psychology therapy methods.  

Cognitive-behavioral therapy (CBT) 

CBT focuses on changing thought patterns that contribute to emotional distress and chronic pain. CBT may guide clients in understanding how their perceptions influence their feelings and behaviors. By altering these thought patterns, individuals may reduce depression and anxiety symptoms often associated with chronic pain. Research indicates CBT can improve mood and functional status and decrease pain levels.

Acceptance and commitment therapy (ACT)

ACT teaches individuals to accept aspects of their pain that they cannot change while committing to actions that align with their values. This dual approach may help people live meaningful lives despite chronic pain. Studies have shown that ACT can lead to greater acceptance of pain, improved physical functioning, and lower levels of depression and anxiety.

Chronic pain self-management 

Pain management involves a combination of methods proven to help individuals manage pain more effectively. Approaches might include CBT, ACT, relaxation training, stress management, and activity pacing. These techniques may empower individuals to take control of their pain and improve their quality of life.

Group therapy for chronic pain

Group therapy offers a supportive environment where individuals can learn and share effective pain management strategies. Programs like the PRISM (Pain Rehabilitation through Improved Self-Management) program at Missouri Baptist Medical Center provide weekly sessions led by pain psychologists, yoga therapists, and mindfulness training providers. Topics covered can include theories of chronic pain, relaxation strategies, stress management, activity pacing, CBT, and ACT. Group discussions may provide a sense of community and shared understanding.

Clinical hypnosis

Hypnosis uses techniques to induce a natural, altered state of consciousness called a “trance.” In this state, the conscious mind is relaxed, allowing the subconscious mind to access hidden resources and abilities. This process enhances suggestibility, heightens senses, increases mental absorption, and activates controlled imagination for insight and solution-focused skills. 

Hypnosis may only be effective when the participant is willing, requiring collaboration between therapist and client. The process does not induce sleep or unconsciousness but a state of relaxation. Individuals in trance remain aware of their surroundings and can recall the session. Some professionals may view all types of hypnosis as self-hypnosis, meaning the individual controls the trance state and can end it at any time.

Coping with chronic pain

The American Psychological Association (APA) offers additional tips and information on coping with the effects of chronic pain, including the following. 

Manage your stress

Emotional and physical pain are closely linked, and chronic pain can increase stress levels. Managing stress through healthy practices like nutritious eating, adequate sleep, and approved physical activity may improve your ability to cope with chronic pain.

Talk to yourself constructively

Positive thinking can be a powerful tool in pain management. Focus on your progress, no matter how “small” it may seem. Remind yourself that you are working toward managing your pain and living a productive life.

Become active and engaged

Distracting yourself from pain by participating in enjoyable activities may highlight the positive aspects of your life. Engaging in hobbies or pastimes may help you combat feelings of isolation and foster a positive outlook.

Accommodate yourself

If aspects of your life worsen your chronic pain, consider seeking accommodations for daily life that reduce the pain. For example, you might try using a cane when you go out, sorting your laundry in buckets instead of folding it, working in a soft-backed chair with a TV tray, keeping healthy snacks in a cart near your bed, and using tools like pain patches, joint braces, and cooling packs.

Alongside treating chronic pain with a doctor’s support and guidance, find out what works for you and advocate for yourself, even if others do not understand why you are acting differently or unable to do activities in the same way you may have been able to in the past. 

Find support

Dealing with chronic pain can be challenging, especially if you have a sense that you’re alone. Seek support groups online or in your community to connect with others who understand your experiences. Sharing your highs and lows with others may reduce the emotional burden of chronic pain.

Chronic pain relief is possible

Connect with a therapist

Consult a professional

If chronic pain continues to overwhelm you and disrupts your daily routine, you might consider talking to a mental health professional. Psychologists may help you address the physical and psychological effects of chronic pain, providing strategies and support to improve your quality of life.

Mobility issues and challenging symptoms can make it difficult to attend in-person therapy sessions. Online therapy through a platform like BetterHelp may be more accessible for individuals with chronic pain, as it offers flexibility and the ability to attend therapy from home. 

Additionally, online therapy offers a broader range of providers, allowing you to find a therapist that meets your specific needs more efficiently. Someone living with chronic pain may find it easier to connect with a provider who is familiar with their symptoms. Studies show that the ability to stay home for therapy makes it easier for clients to receive consistent support.