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Chronic Pain Management
Pain is a natural human experience that can occur due to injury, chronic stress, or medical complications. When this pain stays with us longer than expected, we may become distressed and further physical or psychological issues can develop. Managing and living with chronic pain is always a challenge though working with a chronic pain psychologist can equip you with psychological and practical strategies to manage pain and help us live a meaningful and fulfilling life despite the pain. Our chronic pain psychologists in Melbourne (who also have lived experience with chronic pain) use a holistic evidence-based approach which integrates a range of different therapeutic techniques that can help us cope with and manage chronic pain.
What's the difference between Acute Pain and Chronic Pain?
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Acute pain happens suddenly and is often directly due to an injury, illness, or medical procedure. It starts out as intense and is short-term and temporary.
The experience of acute pain is our brain’s way to warn us of a threat, injury, or disease and serves to motivate us to check what is wrong, protect ourselves, or to seek help.
When we experience acute pain, our brain is typically getting us to:
(1) pay attention to the painful area to protect the injury or seek help,
(2) reduce our activity with rest to allow the body to recover, or
(3) seek pain relief with medication or other relief strategies like ice or heat treatment.
Over time, these strategies can help us manage the initial injury or illness and the pain subsides as we recover.
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Chronic Pain, on the other hand, is pain that has lasted longer than medically expected (e.g. >10-12 weeks with a typical broken limb) or has an unknown origin but lasting >3-6 months.
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When pain is short-term and temporary, the strategies for acute pain can help give us relief until we recover. But when pain is chronic, the strategies we use for acute pain may not be as effective and can even increase the intensity of our pain long term. We may even fall into a cycle that makes it harder and harder to manage our pain and fatigue.
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How many people are affected by Chronic Pain?
According to Pain Australia, in 2018, 3.24 million Australians lived with chronic pain. 44.6% of these Australians also lived with depression and anxiety.
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Rates of depression are 4x higher for people with chronic pain than those without pain.
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How does chronic pain affect our mental health?
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Chronic pain can significantly impact our quality of life and daily functioning in every aspect of our lives. Our chronic pain psychologists Jess Suetsugu and Austin Chu (who both live with chronic pain) can tell you firsthand how chronic pain can affect ​the way we think, feel, and cope with different situations.
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The long-term experience of pain, the uncertainty about the future, the intense flare ups, and the randomness of flares can cause us to fall into "thinking traps" and get us stuck in cycles that can ultimately make the pain harder and harder to cope with. Chronic pain can put us at a much higher risk of developing ​other mental health issues that make living with chronic pain even harder. Some examples include:
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Depression, low mood, and loss of motivation or fun in activities.
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Beating ourselves up, low self-worth, and feelings of hopelessness.
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Anxiety, rumination, and hypervigilance about getting worse, experiencing more pain, or triggering a flare up.
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Social anxiety such as having a flare up in public or what other people might think.
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Anxiety about using medications or things that can help us manage pain (e.g. anxiety about using mobility aids, or anxiety about more pain from going to the physio or exercising).
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Anxiety and stress about the future, what living with chronic pain means for our work, social life, goals, or family.
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Feeling more irritable or on edge and lashing out in anger at our friend and loved ones.
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Sleep disturbances.
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Difficulty concentrating, with memory, and starting and finishing tasks.
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Feelings of loneliness, isolation, and withdrawal from our friends.
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Grief and loss about what our life was like before, and also about the future.
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Turning to alcohol and other substances as a way to temporarily avoid the pain.
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Trauma and PTSD.
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If you've experienced or noticed any of these signs, please remember that you're not alone and that support is out there. Our team of psychologists are trained in a range of evidence-based therapies for chronic pain management in Melbourne. Our chronic pain psychologists can equip you with the skills and strategies to help you live a meaningful life despite the pain in a safe, sustainable, holistic, and evidence-based way.
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How can a chronic pain psychologist help with chronic pain management?
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The gold standard for chronic pain management involves a multidisciplinary approach with a chronic pain psychologist on your team. This approach is helpful because it takes into account the fact that chronic pain can impact every part of our body from head (i.e. our mind) to toe.
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Our chronic pain psychologists take a holistic approach to chronic pain management and work with you on different psychological, social, and practical strategies to manage chronic pain. We integrate a range of different therapeutic techniques, research evidence, and insights to help support our clients living with chronic pain.
Our chronic pain psychologists use a range of evidence-based strategies that ultimately aim to reduce the duration, frequency, or intensity of chronic pain so that we can leave a meaningful life despite the pain. More on this below!
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Psychological Wellbeing
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As chronic pain can significantly impact our quality of life and daily functioning, it's important to build protective psychological coping strategies that help us manage chronic pain in a sustainable way.
A chronic pain psychologist can help by addressing other mental health concerns that impact our wellbeing and our experience of pain. As an example, this might involve working on addressing depression, social anxiety, pain anxiety, or grief and loss.
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Helping People Feel Seen and to Self-Advocate
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Because chronic pain is often “invisible”, others may not fully understand our experience which can cause us to feel alone and invalidated. This may lead to us being more likely to feel hurt and misunderstood, to withdraw from our loved ones and responsibilities, and ultimately stuck in a cycle that makes it harder to cope.
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It can also make it harder to reach out for support and we may even start to question our own experiences. A psychologist trained in chronic pain management will advocate for you and be there in your corner with compassion, empathy, understanding, and respect. We empower our clients to self-advocate and to build confidence in their ability to live a meaningful life despite the pain.
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Learning Chronic Pain Management Strategies
When pain becomes chronic, our first response is often to use the pain management strategies that are helpful for acute pain. We might pay attention to the pain, spend more time resting and not moving, or take pain relief medication to help. This can ultimately cause us to fall into thinking traps or boom/bust cycles that can make the experience of pain more intense.​
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Our chronic pain psychologists can help you identify these chronic pain cycles and build a toolkit of pain management strategies.
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Pain Medication and Alternate Management​ Strategies
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Historically, pain and chronic pain has been treated with painkillers which can be problematic (particularly with opioids) as an addiction and tolerance can be developed and withdrawal symptoms are common. This can lead to an overreliance on medication in lieu of other treatments. Medications may also come with side effects, which over time, may lead to other health issues and the need to take other medications to counter those side effects.
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We can also become stuck in a cycle of taking pain medication, having temporary relief from our pain symptoms, overdo things because we are feeling better and potentially injure ourselves and cause more pain.
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On the other hand, some people may constantly rest because they worry the pain means something is wrong. Too much rest will lead to muscle deterioration and postural problems which will make everything physically feel harder and the body generally weaker. This can also lead to an increased sensitivity to any experience that may remotely resemble pain because our brain becomes used to us not moving at all (e.g., in the case of Complex Regional Pain Syndrome).
A chronic pain psychologist can help by identifying and shifting these patterns and cycles.
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Living a Rich and Meaningful Life Despite the Pain
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Our chronic pain psychologists can help by working with you on different strategies that can empower you to live a rich and meaningful life despite the pain. This could involve a combination of reflecting on your values and thinking about ways you can still live life accordingly despite the pain.
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What's the goal of chronic pain management?
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The aim of chronic pain management is not to get rid of the pain per se, as this may not be realistic for lifelong or “incurable” (that we know of) conditions. Rather, it is to reduce one or more of three factors that we can measure and can improve our quality of life. These can include:
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Duration: How long a pain flare up lasts for, or how long the better days last.
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Frequency: How often a pain flare up happens, or how often the better days happen.
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Intensity: How intense the pain feels during a flare up or the average on the best days.
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If we can change any one of these factors, then that will translate into a noticeable change in the person’s quality of life and functioning.
For example, let’s say someone was averaging 5/10 pain, with 3/10 as their best days, and 8/10 their flare ups. These flare ups would have once/week and last for the whole day, which would in turn, knock them out physically, mentally, and emotionally, for at least 3 days following.
If the duration of the flare up only lasted half a day, then perhaps they would only need 2 days to recover from it. If the frequency was reduced from once/week to once/fortnight, then suddenly, the person has more energy and time on their hands where they are feeling better. And finally, if the intensity changes from 8/10 maximum to 7/10 maximum, that can make it more manageable emotionally which means the bounce back will be less distressing.
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It's always important to remember that everyone's experience of chronic pain is different. Our chronic pain psychologists will always work with you to tailor a treatment plan and to find the strategies that can work best for you.
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What approach or techniques will a chronic pain psychologist use?
Psychologists with experience in chronic pain management can help as our brain plays a very key part in how our bodies experience the impact of pain. It’s very important to note that it is not “all in your head” (as some people might tell us), but rather, the science tells us that "your mind has something to do with it".
That’s where chronic pain psychologists (like Jess Suetsugu or Austin Chu) come in as we are very interested in the impact that our thoughts can have on our physical experiences. We come equipped with evidence-based strategies to reduce the intensity of chronic pain by identifying and managing triggers, chronic pain cycles, unhelpful thoughts, and much, much more.
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Chronic pain psychologists may use approaches like Cognitive-Behavioural Therapy or Acceptance and Commitment Therapy to help change the relationship we have with our thoughts around pain. We may also integrate techniques from other evidence-based approaches (such as Schema Therapy or Solutions Focused Therapy).
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Our chronic pain psychologists (who also have lived experience of chronic pain) can support you by creating an empathetic, understanding, and compassionate space to navigate chronic pain. Together, we can help proactively build strategies to manage the experience of chronic pain so that we may lead meaningful and fulfilling lives despite the pain.
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If you'd like to read more about chronic pain management and how we can help, we've put together some resources from our chronic pain psychologists here.
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Ready to get started?
Chronic pain is a common health issue that not only affects people’s physical but also mental health. Many Australians experience some form of chronic pain in their lives but may not seek treatment. Psychology can provide a significant benefit from those who suffer from chronic pain, especially if received in the context of a multidisciplinary team.
​For more information or to book an appointment with one of our chronic pain Psychologists, call the team at Reimagine Psychology Melbourne on (03) 8330 5588 or email us on hello@reimaginepsychology.melbourne.