Many patients have been looking for alternatives over the last two decades as the opioid epidemic has changed the way people view painkillers. Pharma companies are also under fire because of their marketing tactics. Talk therapy is one of the most popular ways to treat pain.
Psychologists, social workers, and therapists have quietly been incorporated into pain management program. They are just as effective, or even more effective, than medications. In 2018, the medical journal The Lancet recommended that education and psychological treatment be used as the first line of treatment for chronic low-back pain
The American Psychological Association has only recently begun tracking pain psychology. In 2021, nearly 40% of their members reported that they frequently treat patients with chronic pain. The A.P.A. is drafting guidelines on chronic treatment. According to Lynn Bufka, a Maryland psychologist who is a senior director of the A.P.A., this shows that it’s a growing field and has science-based solutions.
Finding the best pain counseling may require some effort from the patient. Before you start, here are some things to think about:
What is the role of a pain psychologist?
Most pain psychologists use cognitive behavior therapy (C.B.T.) to treat chronic pain. This involves reframing thoughts in a way that positively impacts behavior and emotions. Another option is mindfulness, whereby the patient learns to be aware of their feelings without reacting. Acceptance and commitment therapy is a combination of mindfulness and CBT To help patients accept and deal with their emotions.
Biofeedback is another method that psychologists use for treating pain. It monitors the patient’s heart rate, muscle tension, brain activity, or other functions in real-time to help them become aware of stress and control it. Some clinicians also use hypnosis to manage pain.
Six tips for treating chronic pain.
1. It is important to understand. Chronic pain is a disease in itself, not merely a symptom. Scientists say that could be caused by nerve cells that go haywire.
2. Exercise helps. Exercise is still possible if you suffer from chronic pain. In many cases, exercise can help reduce discomfort and increase your pain threshold.
3. Control the pain at its source. You can control chronic pain, even though it is a condition. Keep a journal to express your emotions.
4. Reframe your thinking. Pain psychologists have been found to be able to help change the way your brain perceives pain.
5. Use helpful, descriptive language. Use different metaphors and second languages when describing your pain.
6. Find your team. In a perfect world, doctors would be able to treat chronic conditions such as pain. In the real world, it might be necessary to track down your care team.
All of these treatments are based on the idea that patients can learn to use their minds to manage pain.
How can you locate a pain psychologist in your area?
Finding a psychologist who specializes in pain can be difficult. The majority of pain treatments are provided by large medical centers or boutique practices, but they tend to be located in urban areas. Rachel Aaron, assistant professor of physical and rehabilitation medicine at Johns Hopkins Medicine, says that people in rural areas, or those who cannot afford services, are left out. Even in urban areas, some large medical networks do not offer pain management services.
No matter which system you are in, it’s a challenge getting from the initial diagnosis of pain to the psychological care,” said Dr. Aaron.
The American Psychological Association does not track the number of pain management therapists. Most experts do agree that there is a lack of psychologists who specialize in pain, as well as other mental healthcare professionals.
If you’re interested in a pain psychologist, Dr. Aaron says your primary doctor is the best place to start. Some insurance plans include pain psychology, while others don’t. Talk to a mental healthcare provider about getting treatment covered.
Then, call hospitals in your locality or use the Locate a Therapist feature on the Psychology Today site to find specialized pain clinics. Find a specialist who can treat your condition, such as fibromyalgia, migraines, behavioral medicine, or chronic pain in general. Online programmes are available that are free and evidence-based. Dr. Aaron recommends a pain trainer and a pain course.
Interviewing professionals who have a doctorate or master’s degree in psychology, clinical social work, or with additional training in chronic pain management and asking them about their approach and training before starting is recommended by some experts.
Dr. Garland stated that if a doctor cannot give you a clear answer about their approach or the way they would treat ‘your specific pain issue’, then they are probably not well-trained.
You should be comfortable with your partner.
What can you expect?
Fadel Zeidan is an associate professor of Anesthesiology at the University of California, San Diego, and the executive director of the Centre for Mindfulness. The first session will usually be an evaluation to determine the severity of the pain and any emotional problems it might cause. Then you might learn how to separate the emotional and physical aspects of pain. You could also train yourself to reframe your negative thoughts or pay more attention to pleasant feelings.
A recent article in JAMA Psychiatry showed that two-thirds of chronic back-pain patients who received four weeks of psychotherapy were pain-free or near-pain-free afterward. Most studies, however, show a modest impact; approximately one-third of participants experience a significant reduction in pain.
This is similar to opioids’ effect on chronic pain, but these benefits diminish with time (and come with risks). Psychological pain management techniques, however, are more effective with practice.
Dr. Zeidan suggested trying several methods simultaneously: individual therapy, pain management classes, and group therapy. We don’t know the answer to pain because there isn’t a silver bullet. Testing, validating, and optimizing multiple approaches is therefore a crucial step.
What if you cannot see a psychologist personally?
Insurance companies’ definitions of chronic pain have been changing rapidly. Pain is now increasingly seen as a separate disease. But for the moment, it’s difficult to get a visit to a pain psychologist covered. This can make one-on-one therapy out of reach for some.
Beth Darnall is the director of the Stanford Pain Relief Innovations Lab. She said, “We don’t have enough psychologists trained to meet all the needs.” “We have to go beyond what we do now.”
Dr. Darnall stated that technology may provide new options, as many psychological tools that have been shown to reduce pain can be easily learned and shared. She has developed a programme based on CBT. Empowered Relief is a programme that can be performed from home and is based on C.B.T.
The class is usually free and can be taken by patients. It’s taught online by either her or any of the 300 instructors, who are all medical professionals. They teach simple techniques to calm down your nervous system, change how you perceive pain, and alter how your brain processes that pain. The Cleveland Clinic has integrated it into their programme for patients with chronic pain or spine surgery, as have several insurance companies. In one study, it was equivalent to eight CBT sessions. She is also working on a virtual reality platform and a mobile app.
She said, “You can have access to quality, evidence-based pain care while living on a ranch.”
Dr. Darnall emphasized that psychological counseling was only one part of a comprehensive treatment plan for chronic pain. Other components can include medication and lifestyle changes.
“It is not medication or psychological treatment,” said Dr. Darnall. “It is a menu, and patients may choose two or three options that are right for them.”