The behavioural treatment of chronic pain aims to improve physical
performance and coping skills and to transfer the control of pain and
management of its related problems back to you.- Drug reduction is a major goal of active rehabilitation. The aim is to cut
down and finally stop all pain related drugs including tranquilizers,
sedatives, hypnotics and antidepressants. Current drug intake is reviewed
along with you and the rate of reduction of each substance jointly agreed; the
aim is usually nil by discharge. You will be encouraged to substitute
alternative coping strategies for your usual recourse to medication. - Relaxation is a simple technique practiced during the day and evening. You
may be asked to imagine yourself in more pleasant surroundings, a holiday
on the beach in sunny Spain or beautiful scenery of rolling hills, blue skies
and green meadows with you in the middle of it. Distraction techniques and
imagery are taught to focus the attention away from the pain. Simply taking
up a hobby or pleasurable task occupies your mind and does not permit
unsavoury thoughts to enter your mind during your spare time. - Relapse prevention and maintenance of new behaviours and skills are
promoted throughout. These programs make allowances in case there is a
setback or relapse. - Family involvement: It is essential that family support is available
throughout the program and afterwards. Your family is required to help and
encourage you in your effort to improve your health and reduce your back
pain to such an extent that you can lead a relatively normal life.
What if there is no such program in your area?
A cognitive behavioural therapist is not a psychiatrist (shrink). He/ she is a trained
counselor who will try to help remove your impression that nothing can be done to
reduce or eliminate your pain. Therefore, do not shut this book thinking that I have
recommended you to a psychiatrist. If you do have a hospital or orthopedic
physiotherapy unit nearby that does active rehabilitation for chronic back pain, do go
ahead and make that appointment. However, not all hospitals, physiotherapy units or