- Pacing of activities i.e. a regular schedule of activities and breaks is taught
to counteract any tendency to strain beyond your current physical capacity
and/ or to take prolonged rest. You can carry a timer with an alarm to
remind you to change position or activity. - Education sessions: These cover concepts of chronic and acute pain,
medical/ surgical treatments, medications and sleep problems. Teaching is
interactive, generally held as group discussions, using your own experiences. - Cognitive behavioural approaches to pain management directly
address the chief reasons for your distress and dysfunction. It may be
possible that your reactions to acute pain (such as resting, seeking medical
help and withdrawal from everyday duties and pursuits) persist beyond the
expected healing phase and you may become increasingly distressed by the
failure of the pain to respond. Such reactions are more likely to become
established habits when they are supported by ongoing financial, legal or
other problems and wrong advice such as to rest until recovered. Loss of
work, a solicitous and overprotective family which encourages dependence
and the unfruitful pursuit of further diagnosis and treatment worsens the
pain. Consequently, you may become increasingly unfit, fearful of activity
and pessimistic about the prospects of pain relief.
Having ongoing back pain can make you depressed. In turn, depression can
have an effect on your level of pain and whether your back gets better. People
with depression and chronic pain often benefit from both counseling and
medicine. The person who does this is called a cognitive behavioural
therapist. A cognitive behavioural therapist teaches stress management and
pain control skills. Cognitive and behavioural sessions are held on problem
solving, changing the mindset of fear avoidance, maintaining those changes
and the use of cognitive techniques to identify unrealistic and unhelpful
thoughts and beliefs and to change them. You are encouraged to monitor
your own achievements and record your thoughts. Reinforcement of your
achievements with praise (fading this towards the end) and avoid reinforcing
pain behaviours forms an essential part of this therapy.
mdmrcog
(mdmrcog)
#1