Vicious cycle of pain

How does multi-disciplinary pain treatment work?

Understanding pain helps people understand why they feel the way they do. It can be part of a multi-disciplinary approach to treating chronic pain. Here, I talk about the bio-psycho-social model of pain, focusing on different parts of the pain process and how they can be modified.

I gave this talk on May 17, 2021 to a group, all of whom were over 70.

One of the best observations came from a woman who had obviously lived with pain a long time. She noted that attention can work two ways in pain. On the one hand, focusing on your pain can make it worse. If I ask you ‘where do you hurt’, every ache and pain will report in to your body check.

It’s one reason it’s wise not to ask people about their pain (and the reason the 1step2life app asks you how often you want to log your pain).

Because doing things that are fun and evoke positive emotions reduces the experience of pain, she tries to do that often. It steals attention from pain and reduces its impact.

On the other hand, a different strategy she uses to cope with pain is to really focus on the pain, approaching it with curiosity and attention.

She observes the pain, thinking about its origin, the quality of the sensation, and exactly how it makes her feel. Interestingly, that curious observation can also reduce her pain.

I would guess that what she has done is remove the emotional component of the pain and intellectualize it. There is some really interesting research I talk about in the video that suggests that doing something strictly logical (long division is what they did in the experiment), ‘turns off’ the part of the brain that processes pain. It works for her!

Understanding pain can help you think of different ways of breaking the cycle.

And speaking of cycles, I also discuss vicious and virtuous cycles. 1step2life is designed to break that vicious cycle and replace it with a positive trajectory.

In this vicious cycle, pain leads to withdrawal from functioning and ianctivity. The resultant muscle atrophy (which occurs very quicly) releases chemicals that increases pain, makes you wobbly on your feet, and makes you physically weaker, increasing the difficulty of getting up and out. Depression from being alone with your pain and anxiety about pain flares and the future can also feed into withdrawal and social isolation.

Well-meaning parents and partners can help by breaking isolation, but misplaced helping can decrease autonomy, self-reliance, and functioning.

The hard part? Finding a way to balance activity – mental and/or physical – with rest and stress reduction.

1step2life can help.

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One response to “How does multi-disciplinary pain treatment work?”

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