Chronic pain is defined as any pain that lasts longer than 3 to 6 months. It can be continuous or intermittent, and can affect any part of the body. Some people experience chronic pain as a constant, nagging sensation, while others may have episodes of severe pain.
Chronic pain impact on daily life
Chronic pain can have a significant impact on a person’s quality of life. It can interfere with daily activities, work, personal relationships and emotional well-being. People with chronic pain often experience sleep problems, fatigue, difficulty concentrating and mood changes.
Chronic pain management
Chronic pain management includes medication, but in many cases a multidisciplinary approach is required, such as the biopsychosocial model that integrates biological, psychological and social factors. This model explains that pain cannot be fully understood without considering the interaction of these three components. Biological factors include the underlying injury or disease, while psychological factors include emotions, thoughts and behaviours related to pain. Social factors include the person’s social environment and support. Treatment based on this model is usually multidisciplinary, addressing all these aspects to improve the patient’s quality of life.
One model that explains how psychological reactions to pain may contribute to the development and maintenance of chronic pain is the Fear-Avoidance Theory.
Key Concepts of the Fear-Avoidance Theory of Pain
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Fear of Pain
After an experience of acute pain, some people develop an intense fear that the pain will return, perceiving it as a sign of serious or impending harm.
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Pain Catastrophising
Pain catastrophisers interpret painful sensations as danger signals and think of the worst-case scenario, which amplifies the fear and may lead to avoidance of activities.
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Pain Evocation and Avoidance Behaviour
Fear and catastrophising can lead to avoidance of activities that could cause or increase pain, such as exercise, work and social activities.
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Fear-Avoidance Cycle
Avoidance of activities leads to physical deconditioning, decreased social activity and increased disability, which increases the experience of pain and reinforces fear and avoidance, creating a vicious cycle.
The more we avoid pain, the more we experience fear and pain. It is a paradoxical effect described in the scientific literature: not only do the pain and discomfort not go away, but they increase and expand.
How can we break out of this vicious circle and manage chronic pain?
One of the answers comes from Acceptance and Commitment Therapy (ACT) and the concept of psychological flexibility. Psychological flexibility refers to a person’s ability to adapt to changing situations, to maintain a balance between the demands of life and their personal values, and to move forward even when faced with difficulties such as pain. The patient learns to ‘live with pain’, connecting with his or her sensations and ceasing to struggle with pain, while increasing meaningful actions and activities that give meaning to his or her life.This concept is central to Acceptance and Commitment Therapy, a therapeutic approach that has been shown to be effective in the management of chronic pain. At Open Psychology, we are specialists in Acceptance and Commitment Therapy.
