Chronic pain - Cognitive behavioural approach towards Pain
5 important questions on Chronic pain - Cognitive behavioural approach towards Pain
Which CBT techniques can be effective for treating patients with chronic pain?
- Activity pacing
- Cognitive restructuring
- Exposure
How can you apply cognitive restructuring in the treatment of chronic pain patients?
- Identify maladaptive thoughts ("I exercise --> pain --> injury)
- examining the evidence ("why do I experience pain?")
- generate more adaptive thoughts ("I didn't use my muscles for a while, they need to get back in shape")
How can you apply exposure to feared activities in chronic pain?
Hurt your back --> certain movements are painfull -->restrict activities --> muscle weakening --> more activities cause pain--> more disability
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Out of what steps does problem solving exists as a CBT approach?
- Problem definition (what is the problem, what are obstacles?)
- generation of alternative solutions/strategies (how can I reach my goal?)
- decision making (evaluating alternative solutions/choose an option)
- implementation and evaluation (monitoring outcomes)
How does relaxation directly and indirectly influence chronic pain?
- Directly: catastrophic thoughts/fears --> increase the activity of the sympathetic nervous system -> increased muscle tone (tension) --> more pain
- Indirectly --> diverting attention away from pain, being more relaxed, less impact of emotional distress on muscle tension
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