The phrase “maintaining your balance” probably makes you think about keeping your body upright without falling over. Although physical balance can be an issue when dealing with certain medical conditions and taking medications, there is another type of balance that is equally important and often overlooked in the treatment of chronic pain. When dealing with chronic pain “the other balance” is your emotional balance.

Chronic pain is both a physical and emotional stressor. All patients who have a chronic pain condition also naturally experience chronic, pain-related emotional stress. Like physical pain, emotional distress is variable. It usually goes up and down with your pain level and makes you more emotionally sensitive to the influence of day-to-day stressors. Knowing how to effectively respond to and manage this emotional distress is a key part of developing successful pain management coping strategies. These coping strategies assist patients as they search to find ways to live with their chronic pain.

Over time, chronic pain patients learn a lot about the physical aspects of their pain. This knowledge includes medical terms and diagnoses, medication names and types of procedures. Unfortunately there usually isn’t much discussion or information about the emotional challenges chronic pain brings into your life and how to best handle them. Properly managing pain-related stress is very important. The longer pain-related emotional distress stays elevated, the greater the risk for losing emotional balance. When emotional balance is lost, the consequences can be much more than feeling stressed, depressed or frustrated. Loss of emotional balance is associated with higher levels of pain, decreased ability to tolerate pain, poor immune functioning, increased use of pain medication and loss of quality of life. Continue reading »

 

The 1990′s was officially the decade of the brain, but the science and management of pain was also receiving considerable attention. Traditionally, patients with chronic pain are difficult to manage and costly to treat (Hoffman, 1996; Bearman and Shafarman, 1999). Most experience difficulties in performing common daily activities, and many are depressed, hopeless, and without supportive family or social contacts (Cianfrini and Doleys, 2006). They are more likely to experience other clinical problems, be unemployed, and use alcohol and other drugs to excess (Weisberg and Clavel, 1999). These patients tend to be demanding of their primary care providers and generally unhappy with their health care. Providers have been frustrated with an inability to provide adequate symptom relief, and are left with few options when conventional treatment regimens fail.

Pain symptoms are a major reason for seeking health care in all industrialized nations (Smith et al., 2001). Epidemiologic data from the first National Health and Nutrition Examination Survey (NHANES-1) identified the prevalence of chronic pain in the U.S. to be about 15%. This data has been corroborated by several authors in Western Europe (Smith et al., 2001; Andersson et al., 1999; Bassols et al., 1999) and Australia (Blyth et al., 2001). The data indicate chronic pain is a common problem, impacting millions of people in terms of general health, mental health, employment, and overall functioning. Specifically, older adults, females, those of lower socioeconomic status, and the unemployed seem to be disproportionately affected (WHO, 1992).

The International Association for the Study of Pain defines pain as “an unpleasant sensory experience associated with actual or potential tissue damage or described in terms of such damage” (NIH, 1995). Pain taxonomies vary, but most authorities recognize three distinct categories of pain: acute, cancer-related, and chronic nonmalignant. Chronic nonmalignant pain may develop in response to trauma, misuse, disuse, or disease processes other than cancer, but it is primarily defined as pain that persists long after a reasonable period of healing is expected (NIH, 1995). Continue reading »

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