AustinPUG Health

AustinPUG Health


People suffering from chronic pain have often had to contend with people who didn’t accept that their pain was real, telling them that it was “all in their head,” or they were “just seeking attention.” People may just be told to be quiet because no-one wanted to hear about their pain. No matter what you are told, your chronic pain is real, as are its impacts on your life. Often, drug treatments for chronic pain fall short of optimum relief, and can also expose people to dangerous side effects, including addiction in the case of the most commonly-prescribed chronic pain medication: opiates.

Therapy For Chronic Pain Cognitive Behavioral Therapy For Chronic Pain

However, for many people a non-drug treatment has shown a great deal of promise: cognitive behavioral therapy (CBT). For many different types of chronic pain, CBT has shown promise that makes it an important option to consider.

What Is Cognitive Behavioral Therapy?

CBT is a form of psychotherapy that takes a practical approach to solving problems, whether they’re psychological problems or physical ones. It emphasizes action, solutions, and coping mechanisms that are applicable immediately.

CBT utilizes a cooperative problem-solving approach between the therapist and the patient. The two are working together to solve problems or achieve goals that are defined by the patient. Although the therapist may provide direction, especially during the initial sessions, decisions about what to focus on in any given session are made with both people participating equally.

How Cognitive Behavioral Therapy Treats Pain

Again, the emphasis in CBT is practical solutions. Often, there is nothing that can be done to eliminate or even significantly reduce the pain, but CBT enables patients with chronic pain to better cope with pain, reducing depression and overcoming disability to produce improved quality of life for pain patients.

Specific aspects of CBT that improve quality of life include:

  • Identifying negative thoughts
  • Overcoming negative thoughts
  • Utilizing positive thoughts
  • Turning positive thoughts to action

For many people with chronic pain, becoming more active, including regular exercise, can result in reduced pain.

Types of Pain Where CBT Has Shown Promise

CBT has been tested for many types of chronic pain, and has shown promise for:

  • Rheumatoid arthritis
  • Osteoarthritis
  • Lower back pain
  • Cancer-related pain
  • Fibromyalgia
  • Musculoskeletal pain
  • Migraines

Some evidence suggests that for pain like fibromyalgia, CBT may be better than conventional therapy, with 30% or more of patients saying they experienced a positive outcome. CBT has often been explored for use in the treatment of conditions in teens and adolescents, such as in the treatment of teens with migraines.

Objections to Cognitive Behavioral Therapy for Chronic Pain

However, CBT is not universally accepted as a valid treatment option for chronic pain. Among the objections are the difficulty of comparing treatments because of nonstandard care protocols.

Other objections include the marginal benefits shown, and the fact that CBT researchers seem to accept these minimal gains as positive. As a result, a Cochrane Review suggests that the benefits of CBT for pain treatment are “weak.” However, a review of CBT for the treatment of chronic pain in adolescents concluded there were effective for pain control in children and gave sustained results.

With the minimal risks associated with CBT and the significant risks associated with other treatments, most pain patients would probably benefit from talking to their doctor about this treatment option.

About the author : Dr. Matthew B. Candelaria (PhD, U of Kansas 2006) is a freelance writer who has written about chronic pain from many different angles, including psychological treatment, medical treatment, and legal aspects, such as personal injury and medical malpractice.
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