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What is chronic pain?
Pain that is explainable or unexplainable, that has lasted for more than six months beyond its expected healing time and pain medication is not effective even at the maximum dose, can be described as chronic pain. Chronic pain can also be caused by disease e.g. cancer, rheumatoid arthritis and osteoarthritis, auto-immune disorders, and many other conditions. The pain is persistent, and disrupts routine life. The experience of chronic pain is not simply the result of the underlying physiological cause but a combination of the unhelpful thoughts, feelings and behaviours that accompany it. This explains why it if often not sufficient to treat only the physical aspects of pain (e.g. with medication).
People suffering from chronic pain often experience enormous distress and hopelessness, both because of the pain itself, and because of the effect that it has on their quality of life. It may cause depression, fatigue, sleep difficulties and irritability. It can even interfere with work, social life, relationships and activities of daily living. In some people no physical reason can be found for the pain they suffer, and they are doubly afflicted – by the pain and by the fact that they can be accused of malingering, or told that their problems are “all in their head”.
How common is chronic pain?
Despite the huge advances made in medicine in recent years, chronic pain is an epidemic in much of the world. It is estimated that 14 million people live with chronic pain in England alone.
What is the treatment for chronic pain?
Evidence suggests that Cognitive Behavioural Therapy (CBT) can significantly reduce the physical and psychosocial disability experienced by those suffering from chronic pain.
Cognitive Behavioural Therapy (CBT) for chronic pain involves:
Being introduced to how the thoughts, feeling and behaviours that accompany your pain, influences your quality of life
A combination of physical and psychological strategies are taught to enable you to alter your thoughts, feeling and behaviours so that they diminish the intensity of the physical pain rather than exacerbate it. This might include careful planning of tasks and daily activities, and the use of relaxation training or mindfulness.
Techniques for ensuring that these coping strategies are applied over the longer term are taught along with problem solving skills and the development of plans for future pain flare ups.
There is now a strong evidence base for using Acceptance and Commitment Therapy (ACT) for chronic pain.