Coping With Chronic Pain

Chronic pain is one of the most pressing health care issues in the U.S. and other industrial nations because of the magnitude of the problem. It is estimated that between 25 and 30% of the U.S. population suffers from chronic pain and 1/2 to 2/3 of chronic pain sufferers are partially or totally disabled.

Many physicians define chronic pain as a pain that is present for over 6 months or recurs periodically for over 6 months, although others define chronic pain as any pain that lasts for over a month past the normal healing time for an injury or disease. Whatever the time span, chronic pain from injuries or disorders such as arthritis fibromyalgia, reflex sympathetic dystrophy (RSD), temporo-mandibular joint disorder (TMJ), migraine headaches, back or neck pain, and other pain disorders cause challenges that test the limits of our personal strengths and coping mechanisms.

CEPD Behavioral Health Services offers a multimodal health psychology treatment program that helps patients to realize the importance of the mind-body connection, learn how personal problems can lessen ability to cope, and what to do to strengthen personal self confidence and discover adaptive coping strategies. Like stress, chronic pain can cause one to tense or brace muscles and this can excerbate or worsen the pain. We work to help clients break out of this cycle of chronic pain and learn enhanced, adaptive coping strategies. Effectively enhancing skills to increase the ability to cope and reduce stress are essential to managing trying times.

Health and Wellness

	Sleep disturbances, anxiety, and depression are the most common complaints among chronic pain patients.
	Pain that persists for long periods of time can result in lost income, increased family stress, anger and loss of self-esteem.
	Health problems create stress and anxiety problems in more than 75% of pain patients.
	Worry about social conditions, health and personal finances due to chronic pain increases risk of stress-related and immunological diseases and decreases the ability of immune system to perform effectively in times of stress.

What Do We Do?

At CEPD our treatment program includes helping clients to control and manage their pain. With the use of technology, we work with clients to identify their pain sites, see the impact of any muscular tension, and learn to reduce this effect. Therapy includes teaching breathing and relaxation techniques, mental relaxation techniques such as mental focusing, imagery and hypnotherapy, and cognitive techniques of managing stress through changes of attitudes and thought patterns. Counseling around areas of stress, such as work or family stress, and problem solving skills are part of our cognitive behavioral approach. In addition, therapy may focus on other health related behavior changes that may be indicated.

Clients are taught stress and pain reduction strategies using several methods including the use of psychophysiological biofeedback systems. For example, the interactive program, HeartMath, is a behavioral feedback system that measures heart rate variability. Heart rate variability shows up as different patterns when a person is in a stressed state or a relaxed state. We use the feedback from the HeartMath system to teach valuable relaxation skills to reduce the stress-pain cycle.

Another system uses EEG biofeedback, also known as neurofeedback, and enables the patient to "see" and "hear" the physiological aspects of stress and pain on their body and to use these cues to learn to reduce them. Neurofeedback is used for a variety of conditions that appear to be associated with irregular brain activity, including sleep disorders, depression, anxiety, chronic pain, learning disorders and attention deficit disorders.

We Treat the Whole Client

We use a multimodal treatment plan that includes these technological strategies, along with the following components as needed, to address each client's unique and personal situation:

	assessment: objective tests and personal interviews offer baseline measures of problem symptoms
	self-regulation strategies: help clients reduce reliance on narcotic pain medication
	behavioral strategies: effective methods to address specific problem behavior areas
	stress reduction: relaxation training and coping strategies to enhance the client's ability to cope with the anxiety, stress, and depression reactive to chronic pain
	personal counseling: to address the personal stressors, manage feelings and provide coping strategies depression, anger and stress management
	marital and couples therapy: to help significant others cope with the chronic pain of a loved one
	family therapy: to provide an opportunity to clarify the roles and responsibilities of all family members and to enable the family to function in a healthy manner