Chronic Pain

Psychological Causes of Chronic Pain


Chronic pain is a more common symptom for therapy clients than many people may realize. Although it is important to first rule out medical conditions that can lead to chronic pain by talking to a physician, in some cases chronic pain can be a sign of untreated:

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Muscle pain or fatigue, shooting nerve pains, back tension and pain, and headaches are quite typical reactions to unexpressed emotions, needs, or desires. In psychology terms, this is called “somatisation” and may lead to a diagnosis of somatic disorder/pain disorder.

How Psychotherapy Can Help with Chronic Pain


People with chronic pain are often resistant to exploring the possibility that their pain has an emotional root. Sometimes they fear they are being accused of making up the symptoms or causing them on purpose, but as the diagnosis above makes clear, this is not the case with true somatisation. The pain is real, and may be a result of emotions that are literally stuck in the body. Emotions are, in large part, chemicals that released into our muscles and organs, and if they stay there, they can cause very real pain, as real as any pain caused by a medical condition.

People may also fear admitting their pain has emotions roots because it deprives them of the hope that there is a medical cure. Instead, if the pain is emotionally based, it means they must confront the very emotions that they avoided to being with, which is what caused the pain.

Fortunately, confronting those emotions and achieving “catharsis”, the release of pent-up emotion, can provide relief in both the short and long term. Unfortunately, it may not be enough, as emotions held for a long time in the body can actually become primarily physical symptoms and may not always be relieved by emotional release. Talking with a physician about an appropriate exercise regime can provide additional help if this is the case.

About Chronic Pain


 Several recent surveys point to around 1 in 7 of the UK population having chronic pain. Add to this those actually "affected" by chronic pain then the ratio changes to 1 in 4!

Yet the fight to get timely and effective treatment for your chronic pain is often long and difficult. It is incredible to think that despite the clear evidence provided by the above figures treatment for chronic pain is still one of the most under-funded services within the NHS. Despite the huge amounts of money that have been poured into the NHS by the present government the provision of specialised pain services continues to diminish.

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By being denied early access to such services which have been shown to provide real support for many people with chronic pain it is clear that far too many people experience a devastating long-term impact on their life. Financial hardship caused by the inability to work can and does put severe social and emotional strain on a family. The lack of effective on-going support is often the key factor in preventing them ever getting back into employment.

Chronic pain is just that - chronic - and likely to be with you for the rest of your life. Yet the truth can be and often is somewhat different as with the right treatment,support and your own determination to live your life to the full so much can be achieved.

Getting good advice and support at an early stage is critical. There is so much you can do whilst living with chronic pain. If you have not done so already why not take that first step? Good luck!



Fibromyalgia


Fibromyalgia is a condition associated with widespread chronic pain, fatigue, memory problems and mood changes. Fibromyalgia affects up to 4 percent of the U.S. population, and it occurs more commonly in women than in men. The average age of onset is between 30 to 50 years old. Fibromyalgia is not a disease, but a constellation of symptoms that can be managed.

Fibromyalgia can occur by itself but also can occur in people with various forms of arthritis or related diseases such as osteoarthritis, rheumatoid arthritis or lupus.

Although symptoms may vary in intensity, the overall condition rarely worsens over time. In a small study that traced how people with fibromyalgia felt 10 years after diagnosis, the study authors found that although symptoms may persist, many people felt better with treatment and time.

The cause of fibromyalgia is unknown, but is thought to be due to abnormalities in central nervous system function, leading to an “amplification” of normal pain signals.

It is as if the volume control is set too high in the nerves in a person’s body so things that wouldn’t cause pain in most people do cause pain in people with fibromyalgia. Fibromyalgia cannot be diagnosed with laboratory tests. The results of X-rays and blood tests are normal. Therefore, the diagnosis is based on a careful history and physical examination.

The main controversy is it that many physicians believe this is a psychological condition rather than a physiological one, and this is sometimes strengthened by the fact that the condition is diagnosed on the basis of history (as noted above).

Thus as a summary some of the points that raise conviction that fibromyalgia may be a psychological disorder include:-

•Physical examination and laboratory testing are usually non specific for this condition except for the presence of pain on characteristic soft tissue locations, termed tender points. There is however no pathology of the tissues at these points.

•Antidepressants and drugs that modify the serotonin and norepinephrine in the brain seem to provide relief in fibromyalgia. In addition, cognitive behavioral therapy also helps patients with this condition. This strengthens the arguments of the camp that does not believe fibromyalgia is a true disease.

•The camp that does not see fibromyalgia as a true physical disease considers it a 'non-disease'. Many of the patients with fibromyalgia continue to shuttle between numerous physicians and undergo numerous costly and sometimes unnecessary tests and ineffective treatments before the diagnosis. It has been seen that the mean duration of symptoms before the diagnosis of fibromyalgia is five years.

•Several critics have also pointed out that malingering is a major problem in diagnosis of fibromyalgia. The problem is further aggravated by the potential of availability of compensation for the condition. Due to the lack of specific diagnosis and availability of information on tender points etc. patients may malinger more effectively. This is a somewhat cynical view and is not one that I personally hold.

The points in favour of fibromyalgia being a true physical disease include the fact that there are several physical symptoms associated with the condition. These include migraine, irritable bowel syndrome etc. Interestingly, those physical symptoms also commonly result from psychological somatisation… which weakens the argument that fibromyalgia is physiological in nature!

Irrespective of the futile debate around what the cause may or may not be, Fibromyalgia is entirely treatable using Complementary and Alternative Medicine (CAM) therapies.

Fibromyalgia: signs & symptoms:


Pain - Widespread musculoskeletal pain is the most common symptom of fibromyalgia. Fibromyalgia pain has been described in a variety of ways, such as burning, aching, stiffness or soreness. It often varies according to the time of day, activity level, weather, sleep patterns and stress. Many people with fibromyalgia say that some degree of pain is always present, although the pain can come and go. For some people the pain may be quite severe.

Fatigue and Sleep Disturbances - Most people with fibromyalgia have fatigue, decreased endurance or the kind of exhaustion felt with the flu or lack of sleep. Sometimes the fatigue is severe and it can be a much greater problem than the pain. Equally, most people with fibromyalgia experience sleep problems. The problems with sleep are variable from person to person. Some patients have difficulty falling asleep; others sleep lightly and wake up frequently during the night. Almost all patients with fibromyalgia wake up feeling tired, even after sleeping through the night.

Mood and Concentration Symptoms - Changes in mood are a common symptom of fibromyalgia. Feelings of sadness or being down are common, and some people with fibromyalgia have depression. People with fibromyalgia also may feel anxious. People with fibromyalgia may have difficulty concentrating or performing simple mental tasks. These problems tend to come and go, and are often most prominent at times of extreme fatigue or anxiety.

Other Issues - Headaches, especially tension headaches and migraine headaches, are common in people with fibromyalgia. Fibromyalgia may also be associated with pain of the jaw muscles and face (called temporomandibular joint disorder or TMJ syndrome) or myofascial (skeletal muscle) pain in just one region of the body. These are sometimes considered forms of regional, localized or incomplete fibromyalgia. Abdominal pain, bloating and alternating constipation and diarrhea (called irritable bowel syndrome or spastic colon) also are common. Bladder spasms and irritability may cause frequent urination or the urge to urinate. Chronic pelvic pain can also be experienced. Additional problems that may be associated with fibromyalgia include dizziness, restless legs, endometriosis, and numbness or tingling of the hands and feet.


Fibromyalgia: A Short Video

Provided by the Pain Health Channel on eMedTV.com

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