Saturday, July 13, 2013

Chronic Pain: Treating the Whole Person

Treating the suffering of chronic pain can be one of most challenging and vexing of all health related problems. Pain is the most common reason for a physician consultation in the U.S., and it has been estimated that 30 million people experience chronic or recurrent pain conditions – defined as pain that lasts for longer than three months or after the tissue damage initially associated with the pain has healed. This perhaps is one of the places where the phenomenon of chronic pain begins its confounding stature: why should pain persist after the damage has apparently healed? While there have been a number of theories proposed at the neurological level for this, what patients experience is that if the pain persists, then treatment may become a sometimes frustrating search for a treatment that targets the symptom but not necessarily the underlying cause which may remain elusive.

Depending on the type of pain, opioids, anti-depressants, steroid injections or even surgery may be prescribed. In some cases these work well, in others repeated and even long-term treatment is the result. In either case, the toll on the patient and on the patient’s family can be tremendous. Chronic pain can result in significant physical impairment and emotional distress, loss of work, family distress, and subjective feelings of an overall diminished quality of life.

Because of this, the most recent research has shown that simply addressing symptom reduction is an inadequate goal in itself. The reality is that, sadly, the treatment of chronic pain, even in successful cases, often means an improvement in but not the full elimination of symptoms. Rather, treatment teams may focus on the physical, emotional and social aspects of a patient’s life and experience as it is impacted by chronic pain. What patients will often report is that these three areas of their life are actually found to strongly impact one another. For example, a reduction in depression that is often associated with pain also reduces the pain itself.  Improved social relationships also serve to improve mood, and through that, the experience of pain. Chronic pain takes away a person’s sense of control over their life. It makes one feel bound to their body and unable to participate in social and physical activities that a person previously enjoyed. But while it is true that in many cases there is no “cure” for chronic pain, patients can learn to retake control and to lessen the constraint that pain has on their lives.

As a psychologist, my job is to help my patients think of themselves not just as a set of pain symptoms to be treated, but as a whole person who is in pain. The change in perception between these two ways of being opens up possibilities that at first are often hidden to the person struggling and in pain. I talk to my patients about what does healing mean to them. Sometimes it may mean full remission, but even when it doesn’t, important questions remain about how a person with long-term pain lives and relates to his or her family, friends, and loved ones; how that person relates to his or her own body and emotional self; and all in all, how that person works, lives, loves and plays – in control of, not controlled by their symptoms.

I am a Licensed Psychologist. Many of my patients are older, and while illness is not necessarily linked to aging, some of my patients also suffer from chronic pain and other physical ailments. My office is in Conshohocken and I can be reached at (484) 534-8830 or at For more information please go to

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