How CBT can help pain

148740-151520The vast majority of people with chronic pain rely on pain medications for relief, but as the use of these drugs has increased, so has the incidence of serious problems including overdose, addiction and health complications.

Often pain killers don’t improve a person’s ability to function well (because they feel too sedated) or their quality of life, which should be the main goal in treating pain.

Most pain experts advocate a more comprehensive approach to managing pain including exercise and cognitive behavioural therapy (CBT).

CBT includes talk therapy to change the way you think about your pain as well as behavioral approaches that reduce stress, improve sleep and manage anxiety.

A new study found that CBT is significantly more effective than standard care in treating people with body wide pain, like those with fibromyalgia. In the study, published in the January issue of the Archives of Internal Medicine, 442 patients with chronic body-wide pain, were randomised into one of four groups: one group received CBT over the phone; one group was  told to exercise 20 to 60 minutes a day, at least twice a week; one had CBT and exercise, and a control group that continued whatever treatments they were using.

In the group with the combined CBT and exercise intervention, 37 percent reported improvements in their general wellbeing after nine months, compared to only eight percent in the control group.  About 33 percent of those who only received CBT reported improvements and 24 percent of those who only exercised reported improvements.

CBT addresses factors that help reduce pain and help patients cope with pain symptoms. It’s short term therapy that can last as few as eight to 10 sessions. It includes a range of approaches including:

  • Behavioural activation.The main objective is to increase your activity levels by participating in positive and rewarding activities. People in pain tend to avoid activities because of fears, anxiety or depression.
  • Cognitive restructuring.This approach helps people identify unhelpful patterns of thinking and negative thoughts, replacing them with more constructive ways of thinking. So if someone is saying to herself, “I’ll never get better,” we may work on how to stop catastrophising the situation and take a more day by day approach. If you show signs of depression, I may advice you to be referred to a medical doctor for an antidepressant prescription. Many people with chronic pain suffer from depression and depression is known to worsen the pain.
  • Lifestyle changes. I will work with you to help improve your sleep (fatigue worsens pain) and teach you relaxation techniques, which could include deep breathing, meditation or even autogenics.  We would also examine your diet and exercise habits. Gentle exercise, though difficult If you’re in pain, is one of the best ways to reduce your pain.

Remember Rome wasn’t built in a day. From my experience when in pain and feeling poorly, it can be very difficult to imagine you can improve symptoms without feeling daunted of what you have to go through to get there. In your sessions you remain in control, we plan together what is best for you and this ensures you remain relaxed, positive and confident you are working towards long lasting results and a happier future. If you are suffering contact me today.