How Rehab Can Help You Learn to Manage Chronic Pain

Chronic pain can be as emotionally debilitating as it is physically. It can be frustrating to miss out on activities and events you normally love, and daily life can feel downright exhausting. Loved ones may not understand, and the loss of that social support can be draining.

However, you can find help. There are plenty of rehab centers that offer support for managing chronic pain.

Psychological Aspects of Chronic Pain

According to the Substance Abuse and Mental Health Services Administration, or SAMSHA, chronic pain is “persistent pain that may or may not have a known etiology.”¹ That is, you may or may not know where your pain came from, but it’s not going away on its own.

This condition doesn’t just affect your physical health–it can affect your mental health, too. There are 3 different psychological aspects that people with chronic pain may experience² that can either worsen or improve your mental state: pain catastrophizing, pain-related fear, and pain acceptance.

Pain Catastrophizing

Pain catastrophizing is a negative view of the actual or expected pain experience. You may magnify the negative effects of pain, encounter obsessive thoughts, and feel helpless in your ability to cope. Increased rates of depression, anxiety, and lower quality of life are all associated with pain catastrophizing. People who experience this report feeling a loss of control over their pain, worse emotional and social functioning, and a lower likelihood of responding positively to medical interventions. Research suggests that changing catastrophic thoughts about pain helps improve overall well-being and the likelihood of returning to work despite the pain.

Pain-Related Fear

You may also experience a fear of pain. This can include fear around a new injury or the worsening of your current condition. People with a fear of pain report higher pain intensity and may avoid any behaviors that can lead to more pain, even if they’re necessary in improving the person’s condition (for example, exercises prescribed by a physical therapist).

Pain Acceptance

In this process, patients learn to be nonjudgmental about their pain, to stop detrimental efforts to control their pain, and to live a happy and fulfilling life, regardless of their pain. This can help improve emotional functioning in 2 different aspects:

• willingness to experience pain, which prevents negative emotional reactions to pain
• continuing to do enjoyable activities despite pain, which helps increase positive feelings

Together, these 2 aspects can help decrease pain catastrophizing and increase positive well being, which minimizes the connection between pain intensity and negative emotions. Patients learn to cope with their pain, and no longer let it control their lives. This can be incredibly empowering, and is a vital part of any recovery plan.

Treatment Options

Chronic pain is no small problem. According to data gathered from the National Health Interview Survey, researchers estimate that over 50 million adults experience chronic pain.³ More than 1 in 5, or about 20.5% of adults living in the United States, reported feeling pain on most days or every day.

While you may already be familiar with treatment options for the physical effects of chronic pain, it’s helpful to know that there’s also treatment available for its mental effects. Chronic pain may contribute to other mental health conditions, like depression or anxiety. But fortunately, these are all highly treatable.

Here are a few therapies that are commonly used in chronic pain management:

In Vivo Exposure Treatment

This treatment helps people dealing with pain-related fear.² It’s based on the belief that chronic pain sufferers avoid pain to such a degree that they stop doing things that are, in fact, helpful. They may even avoid behaviors that don’t actually harm them but they’re afraid will, such as physical activity. In vivo exposure therapy aims to expose the patient to perceived “painful” activities to show them that they’re not actually as painful as they imagined. Research shows that this treatment helps reduce pain catastrophizing, depression, and anxiety in patients with pain-related fear.

Cognitive Behavioral Therapy (CBT) for Pain

CBT is a psychotherapy that focuses on changing negative thought patterns and behaviors. CBT can help people with chronic pain² develop coping skills. Techniques therapists may teach include structured relaxation, simple ways to modify behavior that can reduce the number and length of pain flares, and assertive communication. In addition, CBT can help people identify negative thoughts about pain and change them to positive ones that promote healthy functioning.

According to research, CBT “shows effects on pain and functioning comparable to standard medical care for pain.” CBT is especially helpful in helping patients overcome pain catastrophizing.

Mindfulness-Based Stress Reduction (Mbsr)

Mbsr teaches you to manage chronic pain² by using mindfulness meditation to separate the sensory feelings of pain from its emotional aspects. Like CBT, this method teaches you to reframe your thoughts around pain. You’ll also learn to become more aware of bodily sensations and to accept your current situation, whatever it may be.

Some meditation sessions can help participants learn not to catastrophize pain through exposure therapy. In these sessions, patients experience painful sensations, but without catastrophic consequences. This can help you increase your ability to tolerate negative emotions so you can have a better response to pain. Mbsr can also help with co-occurring conditions like depression and anxiety.

Acceptance & Commitment Therapy (ACT)

ACT teaches patients to respond non-judgmentally to negative or intrusive thoughts surrounding chronic pain,² rather than changing the negative thoughts themselves. In ACT, patients learn to acknowledge thoughts and emotions without judgment, and to accept them. They learn to focus on adjusting their behavior, as opposed to figuring out how to minimize thoughts around pain and reducing the pain itself.