Introduction to chronic pain article 2.
These articles are written to help you manage long-term or chronic pain more confidently. Many people have chronic pain for many different reasons. For example:
- following an injury to bones, joints and other tissues that have healed
- after an operation
- in conditions like diabetes
- in nerve disorders like trigeminal neuralgia or peripheral neuropathy
- after a viral infection like shingles
- in different arthritis conditions like osteoarthritis or rheumatoid arthritis
It may have started gradually, like back pain or fibromyalgia, or suddenly with no clear cause. There are usually several reasons for chronic pain, rather than one specific reason. Chronic pain has an impact on all areas of a person’s life and on the people around them. These articles aim to help you understand pain and how it effect your body and also look at medical investigations and drug treatments. They cover ways of managing your activity levels, solving everyday problems, overcoming mood changes and unhelpful thinking patterns, coping with poor sleep and using relaxation techniques.
Who may benefit from reading these articles?
- are learning to cope with a chronic pain problem and want to be more confident about managing their lives better.
- would like to be as fit and active as possible even though they have pain.
- would like help while investigations and treatments for pain are waiting to be done or have been done.
- have found out that no more new medical treatments are likely to help.
- have a stable dose of medicines they use (if any).
- would be willing to use self-help written materials either by themselves or with support.
What does chronic pain mean?
Chronic pain problems are very common. About 10 per cent of adults in the UK are affected by pain in different parts of the body at any one time. If you have chronic pain, you will have found out that it is more than a very distressing sensation in the body. The pain can affect all aspects of you as a person and your life situation, including your feelings, your thinking, your activities, your working life, your home life, your relationships and your hobbies.
Pain is usually defined as ‘an unpleasant sensory and emotional experience which is due to actual or potential tissue damage or which is expressed in terms of such damage’. Chronic pain usually means pain that has lasted for at least three months. Sometimes different words are used by healthcare professionals, such as ‘long-term’, ‘persistent’ or ‘long-lasting’ pain. Sometimes pain lasting six months or more is defined as chronic pain. It can be confusing, as these terms are all used to mean the same thing. The definition used in this book is pain that has lasted three months or more. Sometimes in chronic pain the nerves carrying the pain messages may have developed a ‘memory’ for pain that is difficult to change. This is a bit like an annoying tune that you find yourself humming all day. Sometimes the reasons for the pain are not discovered even when many tests or scans are done.
For some people, chronic pain means slight restrictions on lifestyle. For others, there may be a severe loss of independence and confidence. Pain can become long-term in spite of efforts to relieve the pain itself, or its causes if known.
People with pain problems often worry about what it means for them, their lifestyle and their future. Being limited by the effects of pain can be difficult and frustrating, especially if no ‘cure’ is possible. This can in turn lead to anxiety or worry and depression for some people.
What is Cognitive Behavioral Therapy?
Cognitive Behavioral Therapy (often called CBT) is a talking therapy. Talking with a trained CBT therapist helps to identify and understand what the problems are at present. This approach enables you to understand the links between body symptoms, thoughts, feelings and behavior, and how this affects your everyday life.
‘Cognitive’ means ‘to do with thinking and beliefs’; ‘behavioral’ is about what we do or do not do, our behaviors or actions.
CBT was developed by Professor Aaron Beck in the 1970s, based on previous research which showed that changing the environment and using rewards could help people to function more successfully. This was the basis for behavioral therapies. Professor Beck demonstrated that CBT could be a successful treatment for a number of problems, including anxiety and depression. CBT is also useful for managing widespread chronic pain, chronic fatigue syndrome, sleeping problems, worry and panic attacks, anger and frustration, severe angina and other health problems and relationship difficulties.
Research and clinical experience with CBT has shown that it can help people with chronic pain manage their lives better. CBT is a practical approach to learning how to make changes in the problems caused by the impact of chronic pain.
How can a "self-help" article be of benefit?
You may have tried many different approaches to managing your pain and you may have lots of ideas about how to deal with the impact it has on your life. Alternatively, you may feel completely overwhelmed and ‘stuck’. Or you may just think that a few suggestions would help. Whatever your situation at present, this book aims to give you the tools you need to manage your chronic pain better. Many people are told that there is no ‘relief or cure’ for the pain and they will have to ‘learn to live with it’. But this can be hard if you don’t have the information and skills you need.
The articles here suggest ways of overcoming low mood, and a sense of loss and frustration. They help increase skills to lessen worry and anxiety, deal with unhelpful thoughts and beliefs about chronic pain. They offer ways to talk and share issues with those close to you.
Practical problem-solving can help to increase your quality of life. For example, you can find ways of getting necessary things done, and doing enjoyable activities. You can set goals and plan ways of achieving them step by step. You can also learn pacing skills to balance activity and rest. These skills will help you to gradually boost what you do, enabling you to increase your fitness without overdoing it and causing a setback.
New skills can be learned to reduce the impact of the pain. This is how articles, advice, guidelines and information can be helpful. Your pleasure and self-confidence can increase and your frustration and worry can be reduced.