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Chronic Pain

Pain Is Ubiquitous; Suffering Doesn't Have to Be

A huge number of us live in chronic pain—but we can do something about it.

Key points

  • It is estimated that one in five people live with chronic pain.
  • Unsurprisingly, there is a strong correlation between chronic pain and depression.
  • While drug therapy is an option, there are other interventions that are proven to be helpful.
John-Silver/Pixabay
Cry, Fear, Despair
Source: John-Silver/Pixabay

According to the Centers for Disease Control and Prevention, a little over one in five U.S. adults suffers from chronic pain. This means 68 million people in the United States alone are experiencing some form of pain on a regular basis.

Many of my patients experience chronic pain, and it has a huge impact on their quality of life and mental health. Their presenting problem is often depression or anxiety. This is not surprising, since data suggest 30 to 50 percent of people with chronic pain also struggle with depression or anxiety. It tends to be a bit of a chicken or egg situation, with experts debating whether depression precedes or follows chronic pain. Regarding the physical pain itself, arthritis, fibromyalgia, and back pain are the most common culprits. Of course, there are many other types as well. So, what can be done? Drug therapy may be an option, but many are wary of taking this step, especially in light of our current opioid epidemic and physicians’ growing hesitancy to prescribe. Fortunately, there are non-drug options from which people report benefit. Here are some of them.

  • Mindfulness meditation: In many studies, meditation has been proven to reduce the experience of pain. This shows us how powerful our minds can be. Without changing a single thing, beyond the way of viewing our pain, we can alter the quality of it. The approach is somewhat paradoxical, actually. Those in pain spend most of their time trying not to think of the pain. Meditation for pain does just the opposite. It encourages us to focus on that pain, to better understand it, and, ultimately, to accept it. Once we acknowledge its presence, we may no longer live in fear of it. The beauty of meditation is that it limits your focus on the pain for the allotted time. If you meditate for, say, 20 minutes a day, the hope is you can spend the rest of your waking time focused on other things.
  • Cognitive behavior therapy (CBT): Interestingly enough, people report benefit from therapy sessions even though the quality and intensity of the pain may not diminish. For example, in one study, even though the nature of the pain did not diminish, subjects reported improvement in measures of depression, anxiety, and disability. In other words, it appears that therapy can help someone experience improved mental health and a sense of efficacy in their life, even if the pain does not improve materially, which is promising.
  • Various mind-body interventions: I am including these interventions under one heading because they are not in my area of expertise. Nonetheless, some studies have shown improvement in pain management using them. These include physical and/or occupational therapy, yoga and tai chi, and therapeutic massage. All have been shown to help with some forms of pain. Some people swear by acupuncture, although the evidence is mixed on this.

Working together with your doctor, you can explore any of the above options. More in the realm of psychosomatic medicine—i.e., the intersection between physical and mental health—biofeedback (learning to control more of your body’s functions such as heart rate) and clinical hypnosis have both been helpful in managing pain as well.

Finally, please do not hesitate to tell your doctor about your pain. One patient of mine who suffers from chronic neck pain told me he did not wish to discuss it with his doctor for fear of appearing drug-seeking. Another who went to the emergency department for an unrelated concern had to hear something like, “My, you’re on a high dose of pain medication,” and, not surprisingly, she felt judged. Yes, people can become addicted to certain kinds of pain medication, for which their physician will counsel them, but you deserve to consider all options to hopefully live with a tolerable amount of pain.

To find a therapist near you, visit the Psychology Today Therapy Directory.

References

Elkins G, Jensen MP, Patterson DR. Hypnotherapy for the management of chronic pain. Int J Clin Exp Hypn. 2007 Jul;55(3):275–287.

Skelly AC, Chou R, Dettori JR, et al. Noninvasive Nonpharmacological Treatment for Chronic Pain: A Systematic Review Update [Internet]. Rockville (MD): Agency for Healthcare Research and Quality (US); 2020 Apr. (Comparative Effectiveness Review, No. 227.) Evidence Summary. Available from: https://www.ncbi.nlm.nih.gov/books/NBK556236/

Taguchi K, Numata N, Takanashi R, Takemura R, Yoshida T, Kutsuzawa K, Yoshimura K, Shimizu E. Integrated cognitive behavioral therapy for chronic pain: An open-labeled prospective single-arm trial. Medicine (Baltimore). 2021 Feb 12;100(6).

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