Because you believe that you’re going to hurt, you can activate your physiological pain system just by thinking about doing something that you believe will cause you to hurt.  This is called anticipatory pain.  You anticipate that something will make you hurt, which in turn activates the physiological pain system.  You start hurting even before you begin doing whatever it is that you believe will cause you to hurt.  All you have to do is to start thinking about doing that thing. 

Once the physical pain system is activated, the anticipatory pain reaction can actually make the pain symptoms worse.  Whenever you feel the pain, you interpret it in a way that makes it worse.  You start thinking about the pain in a way that actually makes it worse.  You tell yourself that my pain is “awful and terrible,” and that “I can’t handle the pain.”  You convince yourself that “it’s hopeless, I’ll always hurt, and there’s nothing I can do about it.” 

This way of thinking causes you to develop emotional reactions that further intensify or amplify your pain response.  The increased perception of pain causes you to keep changing your behavior in ways that create even more unnecessary limitations and more emotional discomfort.  This can make you feel trapped in a progressive cycle of disability.
 
My Pain Is Horrible, Awful, Terrible! AKA I’m Suffering!

Your expectations—what you believe it will be like when you experience pain—does affect your brain chemistry.  Your brain chemistry can either intensify or reduce the amount of physical pain that you experience.  What you think and how you manage your feelings in anticipation of feeling pain can make your pain either more severe or less severe.  In other words, you usually get the level of pain and dysfunction that you expect—a self-fulfilling prophecy.

You Get The Level Of Pain And Dysfunction That You Expect!

The anticipation of an expected pain level can influence the degree to which you experience pain.  When your self-talk is saying, “this is horrible, awful, terrible,” your brain tends to amplify the pain signals.  When this occurs, the level of distress increases—you suffer, remaining a victim to your pain.

Using A Two-Part Approach: Physiological & Psychological

Because of the two parts—pain and suffering—pain management must also have two components: physical and psychological.  The way you sense or experience pain—its intensity and duration—will affect how well you are able to manage it.  Anticipatory Pain (which was covered earlier article) is also a major psychological factor that must be addressed.  The research on recovery from chronic pain is very clear.  The people that are most likely to successfully manage their pain do so by becoming proactively involved in their own treatment process.  The chances of success go up as you start learning as much as possible about your pain and effective pain management.
 
Breaking the suffering pain cycle involves addressing the physiological as well as the psychological/emotional components of the pain.  Stress also plays a role in keeping a pain cycle going.  Stress causes muscle tension, which then leads to increased pain sensation.  At the same time your cognition (thinking) and emotions can also amplify this cycle.  Breaking this cycle requires concurrent treatment of the physiological and psychological/emotional condition.
 
Using the Addiction-Free Pain Management® System

Because of the two parts—pain and suffering—pain management must also have two components: physical and psychological.  The way you sense or experience pain—its intensity and duration—will affect how well you are able to manage it.  The Addiction-Free Pain Management® System can help you if you’re living with chronic pain and want to better manage your pain; thus leading to a better quality of life. 

To learn more about chronic pain management please check out our website at www.addiction-free.com and go to our Publications page and check out my latest book The Addiction-Free Pain Management® Recovery Guide: Second Edition. If you want to learn more about dealing with suffering for chronic pain management you can find my article Pain versus Suffering that you can download for free on our Ariticles page.

To check out our July Chronic Pain Solutions Newsletter please click here.

There is now an effective medication for both opiate addiction treatment and/or maintenance pain management that is FDA (Food and Drug Administration) approved. The medication is buprenorphine, which is an opiate agonist/antagonist and a very effective pain medication for appropriate patients. It has been used in pain management for many years—mostly in its injectable form. Buprenorphine is now available in the United States as sublingual (dissolved under the tongue) medication and is many times more potent than injected morphine. Buprenorphine is different from other opiates in that the patient usually feels more “clear headed” when taking it.

Being the first oral medication that has been approved in the U.S., physicians can now prescribe buprenorphine in their offices for people who are dependent or addicted to opiates such as opiate pain medication, heroin, or methadone. Buprenorphine is an effective medication for opiate addiction which does not require daily or weekly visits to a clinic. Buprenorphine blocks the effects of other opiates; it eliminates cravings and prevents withdrawal symptoms such as pain and nausea. Patients can be maintained on buprenorphine or go through detoxification.

Subutex and Suboxone are the brand names under which buprenorphine is being marketed for the treatment of opiate dependence. Both medications contain the active ingredient, buprenorphine hydrochloride, which works to reduce the symptoms of opiate dependence. Subutex contains only buprenorphine hydrochloride which was developed as the initial product. The second medication, Suboxone contains an additional ingredient called Naloxone to guard against misuse or abuse. Subutex is usually given during the first few days of treatment, while Suboxone is used during the maintenance phase of treatment. Both medications come in 2 mg and 8 mg strengths as sublingual (placed under the tongue to dissolve) tablets.

However, this medication is also being used very effectively by some pain management physicians for people living with chronic pain. It is important to remember that medication is only one modality for effective chronic pain management. It is also crucial to develop non-medication based treatment interventions as well as learning to treat the psychological/emotional components of chronic pain. A multidisciplinary team approach always gives the best treatment outcomes. For someone with chronic pain who has developed an addictive disorder this medication may be the best intervention possible along with concurrent addiction treatment modalities.  In addition, it is important to help people differentiate between the physiological and psychological/emotional components of their pain. Once that is done then cognitive behavioral approaches can help people manage the psychological components more effectively.

To learn more about chronic pain management please check out our website at www.addiction-free.com and go to our Publications page and check out my book Managing Pain and Coexisting Disorders: Using the Addiction-Free Pain Management® System. If you want to learn more about non-medication intervnetions for chronic pain management you can find my article Managing Pain Without Pills that you can download for free on our Ariticles page.

To check out our July Chronic Pain Solutions Newsletter please click here.

In most cases, anxiety about living with pain is more likely in the acute pain stage while depression prevails in the chronic pain stage. A sub-acute stage occurs after the acute stage but before the chronic stage. It usually occurs at about the three- to six-month range. At the acute stage the person in pain generally feels a reasonable sense of hope that the pain will resolve within the near future. In the sub-acute stage and at the beginning of the chronic stage, people’s thoughts and emotions about the pain begin to change.

It is not uncommon for the person to begin to wonder if the pain will ever go away or if they’ll ever get better. These types of thoughts lead to anxiety. Although most people believe that their anxiety will subside when the pain goes away, the anxiety frequently leads to a significant increase in pain perception. This results in a vicious cycle of pain, anxiety, more pain, and more anxiety.  When the pain continues for longer than six months and people haven’t yet learned to manage their anxiety the symptoms will only get worse.

Anxiety can occur at different intensities, all the way from mild nervousness to full blown panic attacks.  Anxiety can be characterized by the following:

1. Muscle tension, including shakiness, jitteriness, trembling, muscle aches, fatigue, restlessness, and inability to relax.
2. Nervous system hyperactivity, including sweaty palms, heart racing, dry mouth, upset stomach, diarrhea, lump in throat, shortness of breath, etc.
3. Apprehensive expectations, including anxiety, worry, fear, anticipation of misfortune.
4. Trouble concentrating, including distractibility, insomnia, feelings of edginess or irritability, and impatience.

Excess anxiety and tension can cause people to experience heightened emotional upset (anxiety, depression, anger), increased pain, slower healing times, and increased side-effects to medications, among other things. An ongoing stress response causes numerous negative problems such as increasing muscle tension and pain while also decreasing the activity of their immune system and blood flow to their extremities.  This in turn worsens a person’s perception of their pain and the pain condition continues to worsen and needs specialized treatment.
 
Psychological treatment for chronic pain focuses on the emotional toll people experience living with pain on a daily basis. The treatment for chronic pain does not include magical interventions; rather, it is a combination of proven psychological treatment approaches in addition to medication management and other non-chemical interventions that addresses all the issues people in chronic pain experience.

To learn more about chronic pain management please check out our website at www.addiction-free.com and go to our Publications page and check out my book Managing Pain and Coexisting Disorders: Using the Addiction-Free Pain Management® System. If you want to learn more about the emotional components of chronic pain you can find my article The Psychological Components of Pain that you can download for free on our Ariticles page.

To check out our July Chronic Pain Solutions Newsletter please click here.