Physical Treatment

For purposes of this discussion I have chosen to define physical treatment as any process involving movement or external stimulation of the body that may be able to reduce pain. This covers everything from acupuncture to physiotherapy to soaking in a hot spring at a spa. Generally speaking physical treatments can be classified as active […]

Psychological Treatment

If your doctor suggests psychological treatment for pain it does not mean she thinks your complaints are crazy. Of course pain can make you crazy when it persists and/or hasn’t been explained. But such treatment is not just about psychological symptoms. Cognitive behavioral psychotherapy (CBT) deals directly with thoughts and behaviors related to one’s problems. […]

What Pain Is

We may not know much about pain but we sure know what we feel. And that is really what it comes down to. Pain is a feeling that only the person experiencing it can really know. In this series I’ve attempted to show that pain is the result of complex neurological processes triggered by injury […]

Pain and Fear

I believe that for most of us pain and fear are closely linked. Are they locked together? All recent attempts by scientists to define pain include reference to emotion. Imaging studies of the brain have shown a very close anatomical connection between parts of the brain activated by fear and those by pain. Fear and […]

Fear and Pain

As a child I had no fear of going to the dentist until I had a tooth pulled without local anesthetic. Afterward it took years before I stopped flinching at the mere thought of going to the dentist. Getting me to go, even for a check up, became a trial. The point of telling you […]

Weakening the Bond

If we accept that pain and fear interact with each other in a vicious cycle, each magnifying the other, it follows that whatever may reduce one may also reduce the other. One might even say that it is the very strength of their bond that allows us to weaken it. This is not so paradoxical […]

Increasing Performance

Increasing Performance (#4-Pain and Fear) Repeated practice of imagining oneself successfully performing a task leads to improvement in task performance. Mental rehearsal of physical movements alone can actually increase strength. Combined with repeated physical practice of performing the same task, mental rehearsal may greatly enhance an individual’s ability. For best results, training to improve strength, […]

Multi-modal Treatment

Drugs, injections and even surgery can be used to directly attack the pain side of the pain-fear equation and should therefore not be ignored despite their potential for short or long term side effects. In fact any treatment that can provide sustained pain relief may be useful if it facilitates reducing the fear of pain. […]

Non-organic Pain

In our pain group sessions there are sometimes people who can barely participate or who say they cannot sit or stand with biomechanically correct posture because of pain. Although the postures we teach are those that put the least amount of stress on the neck, back and other parts of the body, these individuals persist […]

Practice Makes Better

Let me summarize this series: the neurological and physiological changes caused by pain and fear bond them together. Fear and pain magnify each other. The fear of pain leads to avoidance of activity that is self-reinforcing. So-called pain behavior and non-organic signs, common in chronic pain patients, are indicators of significant distress associated with pain. […]