The Psychology of Pain can trigger muscle tension or muscle spasms that may increase pain. Managing emotions can directly affect the intensity of the pain.
BY DR. MARY CATHERINE SEGOTA
Pain is one of the leading reasons patients seek medical care. Estimates of chronic pain among adults range from 11 percent to 40 percent (Interagency pain Research Coordinating Committee, NIH 2016).
• Chronic pain can result in opioid addiction. a patient’s difficulty coping with pain can lead to a greater dependence on pharmaceuticals to which makes the pain condition ultimately more difficult to manage. Opioid addiction has great financial, social, and emotional costs for both the patient and their loved ones.
A NHIS 2016 survey revealed that 50.0 million adults experience chronic pain and 19.6 million experience high-impact chronic pain that limits work, social, recreational, and self-care activities. More adults suffer from common chronic pain conditions than the number affected by heart disease, diabetes, and cancer combined (Tsang et al., 2008). Chronic pain contributes to an estimated $560 billion in yearly direct medical costs, lost productivity, and disability programs (Institute of pain Medicine, 2011). Because of this impact, it is imperative that we have a greater depth of knowledge of the complexities of living with and treating chronic pain.
The psychological and emotional effects of chronic pain Chronic pain is complex and difficult to manage. Chronic pain can cause mood alterations such as anger, hopelessness, sadness, and anxiety, sleep disturbances, fatigue or lack of energy, neurocognitive changes (impaired attention, concentration, problems solving, task persistence etc.), and other vague symptoms including generalized diffuse pain. Mental health diagnoses are associated with a higher reported pain experience. Effective pain management treatment addresses each aspect of the physical, emotional and psychological aspects of chronic pain.
The impact of chronic pain The chronic pain experience is the interaction of the following factors: • Biological (injury, trauma, infection, illness, cancer, nerve damage)
Psychotherapy Treatment Medical treatments, including medication, surgery, rehabilitation and physical therapy, may be the first line of defense in treating chronic pain. However, psychotherapy can also be effective at relieving chronic pain because it can alter how the brain processes pain sensations.
• Psychological (sleep, fear, anxiety, depression, coping skills) • Social (work, family, social network) These factors affect the patient’s health-related quality of life such as their physical functioning, daily life activities, mental health, and social and family functioning.
Understanding and managing the thoughts, emotions and behaviors that accompany the discomfort can help the patient cope more effectively with their pain—and can actually reduce the intensity of their pain. Mental Health professionals trained in pain management help the patient gain insight into their physical and emotional health. They asses the patient’s pain experience, location, intensity, and location, and what factors exacerbate it or alleviate it. They assess anxiety, worry, stress, and depressive factors related to the pain experience. Mental Health professionals trained in pain management assess the patient’s lifestyle, and help the patient make changes that contribute toward improved physical functioning, work, or activities. They utilize standardized assessments, as well as subjective measures to gain a deeper understanding of the patient’s pain experience. Mental Health professionals are trained in a wide variety of techniques that have been used in the successful treatment of the chronic pain patients, including:
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• Chronic pain results in reduced physical activity, which is influenced by intensity, duration, or location of the pain. The patient’s ability to walk, get up and down, do physical exercise, perform household chores, participate in hobbies, and maintain an independent lifestyle are all affected.
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• Chronic pain results in impaired sleep quality. This results in increased levels of stress, impaired cognitive ability, and impaired emotional coping. There is an association between sleep and pain experience, whereby poor sleep result in higher pain reports, and higher pain results in poor sleep reports.
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• Chronic pain impacts personal work and career trajectories. Chronic pain results in higher absenteeism, decreased work efficiency, decreased work, productivity, and contributes to early retirement. This not only effects an individual’s financial position, but also business structure and functioning, and the larger scale economy.
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• Chronic pain affects the family. Family members undertake additional activities, such as care duties, supervision, participation in medical appointments, and become involved in evaluating treatments and decision making. as a results of family member’s changing and often challenging roles, they may experience depression, anxiety, and decreased socialization as a result.
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• Chronic pain causes chronic stress. Chronic stress can contribute to many health problems including high blood pressure, heart disease, obesity, diabetes, depression and anxiety. In addition, stress
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