
Chronic Pain Management
Pain is a natural human experience that can occur due to injury, chronic stress, or medical complications. When this pain stays with us longer than medically expected, we may become distressed and further physical or mental issues can develop. Managing and living with chronic pain is always a challenge though working with a chronic pain Psychologist can equip you with psychological and practical strategies to manage pain and help us live a meaningful and fulfilling life despite the pain.
What's the difference between Acute Pain and Chronic Pain?
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Acute pain happens suddenly and is often directly due to an injury, illness, or medical procedure. It starts out as intense and is short-term and temporary.
The experience of acute pain is our brain’s way to warn us of a threat, injury, or disease and serves to motivate us to check what is wrong, protect ourselves, or to seek help.
When we experience acute pain, our brain is typically getting us to:
(1) pay attention to the painful area to protect the injury or seek help,
(2) reduce our activity with rest to allow the body to recover, or
(3) seek pain relief with medication or other relief strategies like ice or heat treatment.
Over time, these strategies can help us manage the initial injury or illness and the pain subsides as we recover.
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Chronic Pain, on the other hand, is pain that has lasted longer than medically expected (e.g. >10-12 weeks with a typical broken limb) or has an unknown origin but lasting >3-6 months.
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When pain is short-term and temporary, the strategies for acute pain can help give us relief until we recover. But when pain is chronic, the strategies we use for acute pain may not be as effective and can even increase the intensity of our pain long term. We may even fall into a cycle that makes it harder and harder to manage our pain and fatigue.
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How many people are affected by Chronic Pain?
According to Pain Australia, in 2018, 3.24 million Australians lived with chronic pain. 44.6% of these Australians also lived with depression and anxiety.
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Rates of depression are 4x higher for people with chronic pain than those without pain.
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Why is it important to have a chronic pain psychologist on your team?
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The gold standard for chronic pain management involves a multidisciplinary approach with a chronic pain Psychologist on your team. This approach is helpful because it takes into account the fact that chronic pain can impact every part of our body from head (i.e. our mind) to toe.
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Our chronic pain Psychologists take a holistic approach to chronic pain management and can work with you on different psychological and practical strategies to manage chronic pain. Our chronic pain Psychologists use evidence-based strategies that can reduce the duration, frequency, or intensity of chronic pain. More on this below!
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Psychological Wellbeing
Chronic pain can significantly impact our quality of life and daily functioning. The long-term experience of pain can also make us more likely to develop other mental health issues such as depression, anxiety, sleep disturbances, fatigue and substance use issues. When in pain, we can also find it really hard to regulate our emotions which can increase the intensity and experience of pain.
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Because chronic pain is often “invisible”, others may not understand our experience which can cause us to feel alone and invalidated. This may lead to us being more likely to lash out and withdraw from our loved ones, responsibilities, and things we used to find fun.
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Pain Medication and Alternate Management​ Strategies
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Historically, pain and chronic pain has been treated with painkillers which can be problematic (particularly with opioids) as an addiction and tolerance can be developed and withdrawal symptoms are common. This can lead to an overreliance on medication in lieu of other treatments. Medications may also come with side effects, which over time, may lead to other health issues and the need to take other medications to counter those side effects.
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We can also become stuck in a cycle of taking pain medication, having temporary relief from our pain symptoms, overdo things because we are feeling better and potentially injure ourselves and cause more pain.
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On the other hand, some people may constantly rest because they worry the pain means something is wrong. Too much rest will lead to muscle deterioration and postural problems which will make everything physically feel harder and the body generally weaker. This can also lead to an increased sensitivity to any experience that may remotely resemble pain because our brain becomes used to us not moving at all (e.g., in the case of Complex Regional Pain Syndrome).
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Living a Rich and Meaningful Life Despite the Pain
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Our chronic pain psychologists can help by working with you on different strategies that can empower you to live a rich and meaningful life despite the pain. This could involve a combination of reflecting on your values and thinking about ways you can still live life accordingly despite the pain. More on this below!
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What's the goal of chronic pain management?
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The aim of chronic pain management is not to get rid of the pain per se, as this may not be realistic for lifelong or “incurable” (that we know of) conditions. Rather, it is to reduce one or more of three factors that we can measure and can improve our quality of life. These can include:
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Duration: How long a pain flare up lasts for, or how long the better days last.
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Frequency: How often a pain flare up happens, or how often the better days happen.
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Intensity: How intense the pain feels during a flare up or the average on the best days.
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If we can change any one of these factors, then that will translate into a noticeable change in the person’s quality of life and functioning.
For example, let’s say someone was averaging 5/10 pain, with 3/10 as their best days, and 8/10 their flare ups. These flare ups would have once/week and last for the whole day, which would in turn, knock them out physically, mentally, and emotionally, for at least 3 days following.
If the duration of the flare up only lasted half a day, then perhaps they would only need 2 days to recover from it. If the frequency was reduced from once/week to once/fortnight, then suddenly, the person has more energy and time on their hands where they are feeling better. And finally, if the intensity changes from 8/10 maximum to 7/10 maximum, that can make it more manageable emotionally which means the bounce back will be less distressing.
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It's always important to remember that everyone's experience of chronic pain is different. Our chronic pain Psychologists will always work with you to find the strategies that can work best for you.
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What approach or techniques will a chronic pain psychologist use?
Psychologists with experience in chronic pain can help as our brain plays a very key part in how our bodies experience the impact of pain. It’s very important to note that it is not “all in your head” (as some people might tell us), but rather, the science tells us that "your mind has something to do with it".
That’s where chronic pain Psychologists (like Jess Suetsugu) come in as we are very interested in the impact that our thoughts can have on our physical experiences. We come equipped with evidence-based strategies to reduce the intensity of chronic pain by identifying and managing triggers, reinforcing cycles, and unhelpful thoughts, and much, much more.
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Chronic pain Psychologists may use approaches like Cognitive-Behavioural Therapy or Acceptance and Commitment Therapy to help change the relationship we have with our thoughts around pain.
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Our chronic pain Psychologists (who also have lived experience of chronic pain) can support you by creating an empathetic, understanding, and compassionate space to navigate chronic pain. Together, we can help proactively build strategies to manage the experience of chronic pain so that we may lead meaningful and fulfilling lives despite the pain.
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If you'd like to read more about chronic pain management and how we can help, we've put together some resources from our chronic pain Psychologists here.
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Ready to get started?
Chronic pain is a common health issue that not only affects people’s physical but also mental health. Many Australians experience some form of chronic pain in their lives but may not seek treatment. Psychology can provide a significant benefit from those who suffer from chronic pain, especially if received in the context of a multidisciplinary team.
​For more information or to book an appointment with one of our chronic pain Psychologists, call the team at Reimagine Psychology Melbourne on (03) 8330 5588 or email us on hello@reimaginepsychology.melbourne.