Chronic Pain: Is it all in my head?

Unfortunately, individuals suffering from chronic pain frequently hear others say "It's all in your head." This happens all too often when health care professionals are unable to establish a definitive diagnosis or identify a useful treatment and when family members and friends become frustrated with the slow pace of change. In fact, chronic pain is NEVER "All in your head."

We now understand that chronic pain may best be understood as a form of chronic stress. We also know that stress will make pain worse. Thus, as the individual grappling with chronic pain suffers, they experience significant stress, which makes the pain worse and sets up a vicious cycle. PAIN leads to STRESS which leads to more PAIN which causes more STRESS and on and on.

Given this information, it will come as no surprise that over 50% of chronic pain sufferers experience clinically significant levels of depression. When you are almost always in pain, you can't do the things you enjoy, you often can't even do the things you feel you should do (which might at least give you a sense of accomplishment), and you may feel like you are letting down your family members, friends and colleagues. How else would you be likely to feel other than depressed?

Frequently, this PAIN-STRESS-DEPRESSION cycle leads to a sense of helplessness. While understandable, this is very unfortunate, because current research suggests that individuals who maintain an active coping style do best. Active copers:

1. partner with their health care professionals in the management of chronic pain and other medical conditions;
2. use additional active means to personally manage their problems
   -exercise as prescribed
   -pace activities so they can continue to do things that give them a sense of pleasure or accomplishment
   -work to maintain and expand social support networks
   -engage in regular relaxation training or meditation

The individuals who make use of these coping strategies suffer the least disability and maintain the highest quality of life.