Psychology: Talking can help against chronic pain if done properly

Experts stated at the 7th EFIC Congress in Hamburg, called ‘Pain in Europe VII’, that psychological interventions can alleviate chronic pain, improve patients’ quality of life and prevent a spiral of ever-increasing disability. However, these interventions are only helpful if they motivate patients to live an active life with their pain instead of trying to escape the inescapable.

At the EFIC Congress Prof. Christopher Eccleston from Bath, UK said:

“A large body of sound scientific studies show that psychological interventions can do much to improve the quality of life in patients with severe chronic pain. Despite pain, therapeutically guided talk about it can actually change patients’ lives for the better. But this talk is not a passive sharing of unhappiness, but active focus on changing what is changeable, and working to live a full life despite pain.”

Vicious circle of chronic pain

Acute pain is a normal signal meant to alarm the body of possible dangers. The body will focus its attention on the area of pain, interrupting normal thinking, planning and acting. Prof. Eccleston explains:

“When pain becomes chronic, i.e. persisting for longer than 6 months, it loses its original alarm function and becomes an abnormal signal. Patients, however, tend to extend their normal reaction to acute pain to chronic pain, remaining inactive and seeking analgesia. The result is a vicious cycle of depression, social isolation, narrowing interests and physical decline due to a lack of exercise. This in turn increases pain. Psychological interventions are effective when they help a patient escape from this spiral.”

Chronic pain is real, not just psychological

Prof. Eccleston pointed out that chronic pain is by no means psychologically created, being physical and very real. It is the way we respond to the pain that can make it better or worse.

The first step would be to make patients more aware that their reaction to pain can be self-defeating. He emphasized:

“It is important that an intervention not prolong such patterns, let alone reinforce them, by just talking about how bad things are. What is needed, instead, is an active approach that first accepts the pain and then clarifies the possibilities for dealing with it by setting achievable goals, removing practical obstacles to them, and finding renewed meaning in life by taking part in it again.”

Sound evidence for efficacy of psychological therapy

The effects of psychological interventions have been scientifically proven. Prof. Eccleston carried on stating that approximately 70 randomized, controlled studies have demonstrated the efficacy of psychological interventions in at least three out of eight relevant domains in more than 60 % of studied patients. According to Eccleston good results can be achieved in improving activity and coping with pain in daily life whilst improvements in emotional wellbeing are at least moderate. Working on behavioral changes can therefore be a valuable co-therapy alongside physical exercise and pharmacological options but much remains to be done.

Eccleston said in a concluding statement:

“The spreading epidemic of chronic pain calls for harder work on the next generation of new and more powerful interventions. As there are many different types of chronic pain, we need a broader variety of tailored solutions for different clients.”

About EFIC and “Pain in Europe”

Established in 1993, the European Federation of IASP® chapters (EFIC®) is a multidisciplinary professional organization in pain research and medicine. It consists of the 35 so-called chapters of the International Association for the Study of Pain (IASP®), which are the IASP approved official National Pain Societies in each country.

EFIC’s constituent chapters represent Pain Societies from 35 European countries including almost 20,000 physicians, basic researchers, nurses, physiotherapists, psychologists and other healthcare professionals across Europe, who are involved in pain management and pain research.

The Federation’s aims are to advance research, education, clinical management and professional practice related to pain, as well as to serve as an authoritative, scientifically based resource concerning policy issues related to pain management.

EFIC Congresses have become a popular forum in Europe attracting more than 4,000 participants in 2011, with this year’s “Pain in Europe VII” in Hamburg (21-24 September 2011) being the 7th EFIC Congress since 1995.

Congress participants are predominantly Europeans, however, with delegates from over 75 countries worldwide, the Congress can be considered to be the major international educational exchange on pain issues of this year 2011.

Written by: Petra Rattue