Chronic Pain: A New Treatment

Sometimes the most effective way to manage distress is to stop struggling against what's painful. It doesn't necessarily make it go away; however, we at least let go of the additional stress we cause ourselves when we struggle against something we can't get rid of. Chronic pain is a great example of this.

Chronic pain is pain that persists for months and years, and it can be a complicated and frustrating condition. Those who struggle with pain know that medical treatments have limited use in helping to manage it. Although pain had traditionally been treated as a physical problem, we now know that psychological and environmental conditions influence the experience of pain. Pain can be exacerbated by stress, too much activity, too little activity, and a whole host of other factors. Additionally, it is common for people with chronic pain to struggle with anxiety and depression.

Recently, a new psychological treatment was added to the list of pain treatments. Division 12 of the American Psychological Association, the main organization for psychologists, evaluates psychological treatments that are shown to be effective for certain conditions. They require several high quality research studies in order for a treatment to make their list of what they call "empirically supported treatments." (Click on these links to see the list of treatments and the list of disorders.)

Acceptance and Commitment Therapy (ACT), a relatively newer treatment with an expanding research base, was recently added to the list as a treatment for chronic pain. In fact, a new category of pain was created for ACT: "chronic or persistent pain." This is unique in that the four other accepted pain treatments are listed for specific types of pain (e.g., headache, fibromyalgia), while ACT was recognized as being useful in treating a broad range of pain conditions.

Additionally, there's brand new research showing effectiveness for an ACT self-help book targeting chronic pain called Living Beyond Your Pain. As I've written about before, because there are virtually no standards for self-help books, I'm always interested in learning about self-help books that actually have been shown to work! Research helps us distinguish between treatments that actually work and those that make grand claims that cannot be backed up. (I've also touched on this in a previous post.)

This new study shows that people who spent 6 weeks reading the book and completing the exercises reported reduced pain, greater quality of life, more acceptance, greater satisfaction with their lives, and increased engagement in activities that are important to them. This is great news! There is one caveat to these findings: these people received weekly phone calls from someone checking in and answering questions about the book. What this means is that it's not clear if the book would have been as helpful if people had picked it off the shelf and worked through it on their own. That said, it's very promising and does indicate there is at least some value in Living Beyond Your Pain. Moreover, it suggests that the book may make a useful adjunct with psychotherapy.

When pain is such that it cannot be managed by medicine alone, psychotherapy can be invaluable in helping people learn to roll with their pain. For nearly 30 years, there's been a growing literature supporting the use of mindfulness and acceptance-based treatments for managing pain. Acceptance and Commitment Therapy is the first to make it onto the APA's prestigious list of empirically supported treatments for chronic pain. Those seeking chronic pain treatment for himself or herself or for a loved one may consider seeking out ACT, or picking up Living Beyond Your Pain.