Chronic pain isn’t just a condition we treat as physical therapists. For our patients, chronic pain is a personal struggle that bleeds into all aspects of their lives.
While it’s manifested (and often treated) as physical pain, the experience of dealing with chronic pain over the long term can create deeper, harder-to-access layers of mental and emotional hardship.
These hardships, studies show, can lead to a vicious spiraling effect when it comes to chronic pain which can (and often does) lead to anxiety, depression, anger and fear. Not only can this enhance the perception of pain, but it can lead to reduced activity and the avoidance of behavioral changes that could improve the condition.While it’s manifested (and often treated) as physical pain, the experience of dealing with chronic pain over the long term can create deeper, harder-to-access layers of mental and emotional hardship. Click To Tweet
Chronic pain causes fear – plain and simple – and this fear often causes a person to try and avoid the problem altogether, perhaps leading to more convenient “solutions” like inactivity or the dangerous long-term use of opioids.
That’s why the acceptance of pain and, more importantly, the acceptance of fear that comes with it, is often the first step in treating chronic pain most effectively (i.e., holistically, through physical therapy and nutrition interventions).
Often, this all starts with Acceptance and Commitment Therapy (ACT).
Acceptance and Commitment Therapy for Chronic Pain
Acceptance and commitment therapy is a form of counseling that uses mindfulness and the acceptance of life’s difficulties as a way of moving forward toward behavioral changes and solutions.
Rather than teaching people strategies to better control their thoughts, patterns, emotions or sensations (as in cognitive behavioral therapy), acceptance and commitment therapy teaches people to be mindful of such challenges – even embrace them – in order to bring about change and action.
It’s called achieving “psychological flexibility,” says Lance M. McCracken, a professional of behavioral medicine in London and a leading researcher in ACT.
According to McCracken, psychological flexibility is “the ability to be more aware, more focused on goals, and more engaged. Another aspect of psychological flexibility pertinent to chronic pain … is called committed action, which involves goal-directed, flexible persistence.”
Such goals include replacing avoidance of one’s pain experiences with acceptance, overcoming the lack of direction by establishing a set of values, and taking small steps toward said values through committed actions.
In short, acceptance and commitment therapy strives to create hope through acceptance, making it possible for one to feel more in control of their chronic pain condition.
“The message of traditional pain management is that you’ve got to manage the pain first, and then get back to your life. But entire lives can be lost in the pursuit of pain relief that may never come,” said Dr. Kevin Vowles, clinical psychologist and associate professor at the University of Mexico. “The message of acceptance and commitment therapy is that it’s possible to begin to rebuild one’s life even with pain.”
Research Supporting ACT for Chronic Pain
Studies just within the last couple of years show that acceptance and commitment therapy can indeed offer relief to those suffering from chronic pain – a population as big as 25 million in the U.S. alone, according to the National Institutes of Health.Studies just within the last couple of years show that acceptance and commitment therapy can indeed offer relief to those suffering from chronic pain. Click To Tweet
Research published in the June 2017 edition of Journal of Pain, for instance – based on a study which examined 412 adult participants from a London-based pain management center – found that 67 percent showed “meaningful improvements” following the completion of acceptance and commitment therapy.
“Research has shown that most of the six ACT processes, all of those so far investigates, correlate with improved daily functioning and emotion well-being in patients with chronic pain,” researchers concluded in similar studies.
As physical therapists, of course, we understand that such psychological treatments alone – regardless of how effective they may be for some – should support a more holistic approach to pain management that involves both functional nutrition and movement-based interventions.
By making ACT part of your professional toolbox as a physical therapist treating chronic pain, however, you’ll not only help your patients achieve greater, longer-lasting success in overcoming chronic pain. You’ll also set your physical therapy clinic apart within your marketplace.
At the Integrative Pain and Science Institute, we’ll show you how to make these services a central part of your practice. Sign up here to be placed on the waitlist for our course “ACT for Pain,” taught by chronic pain experts JoAnne Dahl, PhD and Joe Tatta, PT, DPT.
Click here to learn about the Certification in Functional Nutrition for Chronic Pain!