NPR had an interesting article on 1-13-14 about chronic back pain. The article noted, of course, that many people with serious back pain have surgery, even multiple surgeries, with minimal or no reduction of pain. Interestingly, the article also notes, “Lots of people who are pain-free actually have terrible-looking MRIs.” And, Research is showing that the pain often has nothing to do with the mechanics of the spine, but with the way the nervous system is behaving….” The person learns, unfortunately, to be “paranoid about any twinge of pain, and all the while they lose strength and flexibility.”
The article goes on to discuss new thinking about some times of chronic pain as being caused by, rather than the injury, “hypersensitivity” of the person’s nervous system (I am condensing a lot here). This leads to, potentially, alternate treatment options. The article describes a novel “boot camp” treatment program for people with chronic back pain, in which they are helped to gradually face, and hopefully overcome, their pain by doing exercise and other physical activities. There is, I think a significant psychological component to this program, which I think is crucial for it’s effectiveness; the patient learns to think differently about his or her pain, and to react differently. For example, one patient is described during a “boot camp session,” as follows: “(The patient) has a sudden twinge in her back. But (the physiotherapist) , who’s trained to evaluate these things, says it’s OK. (The patient) is building strength. And along the way, she’s learning not to be afraid. “It’s learning not to fear the pain, learning that you can live with pain,” Wertheimer says. “Understand what that pain is, but then put it aside.” (emphasis added)
It seems to me that “Learning to not be afraid,” and “learning to put the pain aside,” based on graduated exposure to pain, has strong psychological component- and that this could be an opportunity for psychologists interested in expanding their practice to contribute to treatment that is integrated with the services of other healthcare professionals to help people with chronic pain.
The full article is at:
Richard Sethre, Psy.D.