As athletes we often focus on our bodies but forget to work on our minds. When athletes are in pain they have a tendency to think very negative thoughts as our self image is heavily linked to our physical prowess.
This article will help us examine our attitudes, values and beliefs about back pain.
Here's where Cognitive
Behavioural Therapy comes in and chronic pain sufferers should consider
exploring this method as an avenue to back pain relief.
So what is Cognitive
Behavioural Therapy and how can it help?
Over the recent couple
of decades cognitive behavioural therapy (CBT) has become an accepted first
line psychosocial treatment which can help patients to deal with chronic pain,
including low back pain. CBT states that individuals, not the outside
environment, create their own experiences, including pain. The theory behind
CBT is that the process of changing the patient's thoughts about their pain can
bring about changes in how the body responds to that pain.
The sensation or
perception of pain actually occurs in the brain, so the theory behind CBT works
on the premise that the sufferer can change the perception of physical pain by
controlling the thoughts and behaviours that feed it.
The patient cannot
physically stop or alter the level of the pain, but with practice, he or she
may become able to control how their brain deals with that pain. For example a
negative thought such I can no longer do this activity anymore might be changed
into a much more positive outlook along the lines of "I will do it again
just like I used to do."
What the therapist will
seek to do is to encourage the patient to focus his or her thoughts
(Cognitive), and then focus on subsequent actions which to address
(Behavioural). This process may take place over many sessions with the
therapist seeking to help the patient to identify negative thoughts and
feelings encountered during bouts of back pain. These CBT sessions would
attempt to train the patient in how to convert this negativity into positive
thoughts and actions, and to develop healthy thinking. This healthy thinking
involves positive thoughts and calming your mind and body by using techniques
such as yoga, massage, or imagery. Positive or healthy thinking helps to make
you feel better, and feeling better reduces the pain perception.
This transition of
negative to positive thought processes has been demonstrated to help in
enabling the patient to better manage their pain, and change the way in which
the patient's body actually responds to the pain. So although the physical pain
is still present, changing the patient's mindset can alter and improve their
ability to deal with it.
CBT can relieve pain in
several ways. It transforms the way in which the patient perceives the pain. It
changes the thought processes, emotions, and behaviours in relation to pain,
helps to develop coping strategies, and puts the level of discomfort into an
improved context. As a result the pain tends to interfere less with the
patients quality of life enabling the patient to function better. In addition
we can also alter the brain's physical responses that tend to worsen pain. When
we are in pain, this causes stress which can negatively affect the production
of pain control chemicals like Norepinephrine and Serotonin, which are the
body's natural painkillers. CBT can therefore positively impact on the natural
pain relief response.
CBT can also help the
patient to become more active, which is important because regular, low-impact
exercise, for example yoga, pilates, walking and swimming, can help to reduce
back pain in the long term.
So how does CBT work in
practice?
In order to effectively
treat chronic pain, CBT is usually used in conjunction with other pain
management treatment such as pain relief medications, physiotherapy, weight
loss regimes, various massage techniques, or indeed surgery. In a lot of
instances CBT is considered to be one of the more effective forms of treatment,
having less risk or potential side effects than pain relief medications or
invasive surgery.
CBT sessions can be
carried out through a range of formats ie
Individual sessions
Group therapy with
other patients addressing the same pain issues
Self Help modules -
usually in the form of a book from which assignments are carried out
Computer program or App
(CCBT)
Group and individual
CBT sessions generally last between 30 minutes and a hour over anything from
six to twenty sessions
During the CBT sessions
the therapist will work with the patient to break down their problems
surrounding their pain into separate components ie their thoughts, physical
feelings and actions. These would then be analysed jointly to determine which
are unrealistic or negative and then analyse the effect they have on each other
and the patient. The therapist and patient will then draw up an action plan to
alter unhelpful or negative thought patterns and behaviours.
The challenge then for
the patient to practice the application of these changes in their daily life
and provide feedback at the next session, with the objective being to teach the
patient the application of these skills during the CBT sessions to daily life.
By doing this the patient is learning to manage their issues or problems to
prevent or reduce the negative impact on their life, and to carry this on after
the CBT has been completed.
To summarise cognitive
behavioural therapy involves
Developing a positive
or problem solving attitude in the patient to reduce the sense of helplessness
over their pain and giving them a sense of control
The patient carrying
out homework or assignments designed to keep track of thoughts or feelings
associated with pain and recording these for review
Developing life skills
and coping mechanisms for not only in pain control but in other problems
encountered in life such as stress or anxiety
Self help for pain
management.
How to benefit from CBT
for pain control
Have faith in the
concept. There are many research papers demonstrating its effectiveness in
assisting pain relief or pain reduction so its important to engage with the
process
Actively engage with
the concept. You have to put the effort in to get a positive outcome from the
sessions
Ensure that you finish
all the modules. For CBT to be effective its important to attend each session
and complete all the assignments given to you. Indeed one of the major
drawbacks of CBT is that of patient non compliance. Ie skimping or not
bothering with all the elements of the CBT program
Be open minded about
the possibility that CBT could work for you, but it does need your full
commitment.
What now with CBT
If you are interested
in trying CBT for pain management, talk to your GP or healthcare professional
in the first instance. They can point you in the direction of cognitive
behavioural therapists specializing in back pain available in the UK through
the NHS although there are likely to be waiting lists.
If you wish to have CBT
privately then ask your GP to recommend, or alternatively contact the British
Association for Behavioural and Cognitive Psychotherapies (BABCP) who will be
able to provide details of accredited CBT practitioners.
David Pegg, from
Manchester, UK is a director with Lumbacurve International Limited,
manufacturers of an effective lower back pain therapy device, developed in the
UK and Netherlands.
The concept behind the
device was to combine the best of East and West therapies, designed to combat
back pain.
Lumbacurve initially
provides a passive gravity assisted traction (PGAT) - put simply it gently
stretches the lower back, causing the vertebral joints to separate.
This in turn, relaxes
the discs and frees up the spinal nerves, thus giving pain relief, as practised
by Western physiotherapists, Chiropractors, and Osteopaths.
In addition to this the
design features provide the combined benefits of shiatsu stimulation, yogic
stretch, and acupressure massage, all recognised techniques, employed in
Traditional Oriental Medicine.
It's easy to use.
Simply lie on it for a few minutes, do a few simple exercises, and prepare to
be amazed.
How to get back pain
relief
Article Source:
http://EzineArticles.com/expert/David_Pegg/785947
Article Source:
http://EzineArticles.com/9319262
Video: https://www.youtube.com/user/DocMikeEvans
