Managing all pain

Experts advise that treatment of chronic conditions include addressing physical and emotional aspects

Experts advise that treatment of chronic conditions include addressing physical and emotional aspects

August 13, 2007|By TIFFANY ARNOLD

Clinical psychologist Amy Fox says that for her patients, chronic pain sufferers, the pain affects more than just their bodies. Their pain also effects their minds.

As the murky link between chronic pain and mental health becomes better understood, more health-care professionals are rethinking how they treat chronic pain.

There is evidence that treating the mental-health issues tied to pervasive pain can actually reduce suffering from pain, said Fox, a clinical psychologist for Washington County Hospital's Behavioral Health Services.

The problem, health care professionals said, is that pain and mental health are often compartmentalized as separate medical issues.

For chronic pain sufferers, the path to self-sufficiency involves the adoption of a pain-management routine that addresses both the mental and physical aspects of pain.


"This involves much more than giving a medication," said Dr. Jerome Kurent, professor of medicine and neurology at the Medical University of South Carolina.

Kurent, who is also the former chair of the American Academy of Neurology's pain and palliative care division, said a combination of doctors, mental therapists and physical therapists should be involved in the patient's treatment.

The psychology of pain

There are two kinds of pain: acute and chronic.

The incidence of acute pain is a straight-forward process. If you cut your finger or break your leg, nerves in the body send signals to the brain, which interprets the signals as pain.

Treatment can get rid of acute pain for good, whether it stems from a cut finger or a broken leg.

But chronic pain is essentially permanent. It doesn't go away.

Over time, the presence of chronic pain can become part of the brain's "hard wiring," Kurent said.

When that happens, the experience of chronic pain becomes the norm, making it harder to treat and making the sufferer more prone to mental-health issues such as depression.

Kurent said neurologists know very little about the process, but they do know that there is a tangible link between mental health and pain.

The way we perceive pain

One challenge, Fox said, is helping people with chronic pain accept that while their suffering due to pain can be diminished, their pain might not ever go away entirely.

Such news usually evokes two kinds of reactions from patients, Fox said.

"Thinking 'That can't be true. I can be fixed, I'm still useful' or thinking 'I can't be fixed, I can't do anything. I'm no longer useful,'" she said.

Fox said she tries to present chronic pain much the same way other chronic illnesses, such as diabetes, might be presented.

"They're able to learn to live with the illness," she said. "It's about realizing life goes on."

Fox said she helps her patients learn how to control their suffering from pain through mental imagery and breathing exercises. Prescribed medication and alternative medicine such as yoga and massage therapy might also help, Fox said.

Ryan Diener, founder of Holistic Health Associates in Frederick, Md., said nearly half of the 35 to 40 patients he sees a week are chronic pain sufferers.

One of the challenges, he said, is encouraging some of his clients not to victimize themselves.

"One thing we can control is how we react to things, how we react to stressors," Diener said. "Pain is just one of those stressors. Life isn't about how much you're suffering."

Can we transcend chronic pain?

Whether or not people are capable of transcending chronic pain depends on whom you ask.

Diener said he's seen clients' suffering due to pain diminish over time. But it's not something that happens overnight, and he said there's no one-size-fits-all solution to pain management.

Linda Potts, owner of Healing Waters Wellness Center in Smithsburg, is convinced chronic pain can be diminished.

Years ago Potts was diagnosed with fibromyalgia, chronic fatigue syndrome and Lyme disease. She was told that she might have to live with pain for the rest of her life.

"That's not easy to take," said Potts, a registered nurse who used to work in emergency rooms. "I didn't accept it. That's why I started looking for other options."

She said alternative medicine such as homeopathy and acupuncture alleviated her pain. Her experience prompted her to open the Healing Waters Wellness Center, which offers alternative treatments, in January 2006.

Susan West had a similar story. She too was a chronic pain sufferer.

"The pain is with you 24 hours a day. Your life revolves around the pain," West said.

Then she tried acupuncture in the late 1980s.

"I pretty well had the gambit done for me in Western medicine," West said of what it was like before she tried acupuncture. "I was amazed."

West is now an acupuncturist and specializes in other aspects of Chinese medicine, operating out of her business, Acupuncture Associates in Hagerstown.

West and Potts said they occasionally have bouts with pain, but they say they aim to offer people relief from their suffering.

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