Overview
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Getting Help
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Fast Facts
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Myths and Misconceptions
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Children and Pain
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Pain Definitions
Medications
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Complementary
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Physical Therapy
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Psychology
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Surgery
Psychology of Pain Peer Review
Committee
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Content Editor:
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Mark
Disorbio, Ph.D.,
Denver, Colo.
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Editorial Review Board:
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Daniel
Bruns, Psy.D.,
Greeley, Colo.;
Dan
Doleys, Ph.D.,
Pain and Rehabilitation Institute;
David
Tollison, Ph.D.,
Carolina Center for Pain, S.C.
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The Psychology of Pain – Arthritis Pain
Arthritis in its many forms has become
more prevalent in the United States as the post-World War II "Baby Boom"
population ages. Primary care practitioners are reporting a higher incidence of
patients complaining about the aches and pains associated with arthritis. As with other chronic pain conditions,
painful arthritis attacks can prompt feelings of depression, sadness and
loss. Often
depression is heralded by other symptoms, such as increased
fatigue, less energy, less interest in or enjoyment
of activities, poor concentration, loss of appetite, worse sleep, and feelings
of guilt or worthlessness. When
these feelings or symptoms persist on a daily basis, the resulting depression may
need to be treated with medications.
Frustration and anger also are normal responses to any chronic pain
condition, including arthritis. However, because the mind can influence the
body (and vise versa), such negative emotions can further aggravate arthritis
pain.
To complicate matters, arthritis can be accompanied by a
physical reaction to the pain known as "muscular bracing" — or holding the body
in an extremely rigid posture in an effort to "protect" an area from further
pain. Unfortunately, muscular bracing
can lead to major muscular tightness that require additional treatment with
medications and physical therapy. That's because at the basic brain level
muscles develop a "memory" that continues to produce a repetitive muscle
bracing pattern and subsequent pain.
Along with arthritis medication management and arthritis physical therapy, psychological pain management
techniques that incorporate a "mind-body" connection can help break this
vicious cycle. These include breathing exercises, self-hypnosis, various forms
of biofeedback training and other alternative therapies. As an arthritis
patient, it's important for you both physically and psychologically to become
actively involved in your treatment. Developing a behavioral pain management program that works best for you
can help you gain a sense of control over your arthritis pain. It's important to find a qualified health
care provider who is knowledgeable about arthritis pain and muscular bracing,
as well as the use of behavioral pain management techniques.
Here are some other ways to make the most of your arthritis
pain treatment:
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Find a qualified health care provider who is
knowledgeable about arthritis pain and muscular bracing, as well as the use of
behavioral pain management techniques.
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Make sure that your treatment simultaneously
includes all available therapeutic approaches, including behavioral pain
management techniques. It is essential to address arthritis pain from a
multi-disciplinary perspective.
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Pace yourself to make sure that you participate
in just the right amount of physical activity — not so much or so little that
you aggravate your condition. Moderate, well-timed exercise is important to
both your physical and emotional well-being. A trained physical therapist can help design the activity regimen that
will work best for you.
Finding a Qualified Mental Health Professional
In terms of finding a qualified professional to help with
emotional issues, mental health specialists vary considerably in their level of
training and their experience in helping patients with chronic pain. Here are
some questions you can ask to find out a professional's qualifications
in helping you with emotional problems that frequently accompany pain:
If
the mental health specialist is a psychiatrist (a medical doctor with special training
in evaluating and treating emotional disorders):
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Do you have experience in
consultation-liaison (medical) psychiatry, a sub-specialty dealing with the
emotional problems that commonly occur with any chronic medical illness,
including pain?
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Do you frequently consult with pain
medicine specialists?
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(Better yet) are you Board Certified in Pain
Medicine?
If
a psychologist (a non-medical doctor with special training in emotions and
their evaluation and treatment) or social worker (non-medical counselor):
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Do you have training in health
psychology and/or behavioral medicine?
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Do you affiliate with professional
organizations in these fields?
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Do you have experience in working
closely with medical doctors?
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Do you have specific training
and/or experience working in a Pain Center or with Pain Medicine physicians?
You want to make sure that your provider is not isolated from
multi-disciplinary treatment?
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Do you have close affiliations with
expert psychopharmacologists (psychiatrists with expertise in the medications
used to treat emotional problems) who can prescribe medications skillfully when
needed?
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Do you obtain consultations easily
and frequently? Again, you want to make sure that your provider is not
professionally isolated.
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Do you understand the role of
physical therapy and medications in pain management?
Unfortunately,
often there are no credentials that can help you distinguish among
psychologists, psychiatrists, medical social workers and the numerous others who
advertise themselves as chronic pain specialists. In any case, it is best to obtain a referral
from a qualified arthritis specialist who is knowledgeable about chronic pain
issues, or a Pain Medicine doctor who may know the answers to many of the above
mental health specialist prior to referring you for treatment.
Overview
|
Getting Help
|
Fast Facts
|
Myths and Misconceptions
|
Children and Pain
|
Pain Definitions
Medications
|
Complementary
|
Physical Therapy
|
Psychology
|
Surgery
|