Column: Behavioral Health and Chronic Pain

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Chronic pain can be a devastating condition. But with an integrative approach that involves both physical and behavioral health treatments, people can find relief.

Amy Goodwin, a licensed professional counselor and behavioral health specialist at UCHealth Behavioral Health Clinic in Steamboat Springs, who also sees patients at UCHealth Primary Care in Craig, describes how behavioral health is an important part of treating chronic pain.

First steps first

When treating chronic pain, it is important to first calm the overactive nerves that continually signal pain, even after the injury or illness has healed.



“There’s a physical problem, in that the nerves are on and hyper-triggering, but the off switch is still in the brain,” Goodwin said.

Interventional procedures can help disrupt the overactive nerve, so other treatments — such as physical therapy, meditation, massage, and acupuncture — can help.



After problematic nerves are soothed

When the brain no longer receives constant signals of pain, behavioral health treatments come into play.

“It’s my job to take advantage of this so people can improve their physical functioning by calming their minds and central nervous systems,” Goodwin said.

Patients are encouraged to choose behaviors that support their overall health and functioning: for example, following a healthy diet and committing to regular exercise.

“The more people build muscle and maintain a certain level of health, the better their body can recover,” Goodwin said.

And, Goodwin helps patients identify how their pain affects their overall thoughts.

“When we have a pain response activating in our body, we increase our brain’s focus on other disturbing issues and ideas,” Goodwin said.

The importance of thought patterns

Slowly, patients are able to think about their situation in a more positive or accepting way.

For example, if someone has trouble wanting to be at the same physical level they were before their injury or illness, they can learn to accept their functional level at that time.

“We have to accept where we are and be aware of it, instead of being in a rush to get back to where things were before the accident or the surgery,” Goodwin said.

Goodwin can also help patients identify and address beliefs that may actually be preventing healing and recovery. This includes “all or nothing” thinking such as “if I can’t be a top athlete, it’s not worth doing anything”, which can create feelings of defeat or helplessness and hinder recovery.

Dispelling Pain Myths

Although we feel pain in our physical body, pain itself is not just a physical problem. “Pain is always an interaction between the injury and the body and brain’s interpretation of the injury,” Goodwin said. “It’s like a dialogue between the brain and the body. It’s not just in your head, but it’s not just in your body.”

And even with treatment, chronic pain may not just go away.

“Our pain awareness isn’t like an on/off switch — it’s like a dimmer switch,” Goodwin said. “We may never be able to completely turn off the pain, but we can certainly teach people strategies to lessen it.”

When to ask for help

Much of the healing can take place within three to six months of injury or illness. But if there is no substantial change after that, people should get help.

“If people start experiencing chronic pain, the sooner they respond by getting the support and information they need, the better their outcomes,” Goodwin said. “It’s more important than ever that people ask for help when they need it.”

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