Whether it's back issues, migraines, nerve damage or arthritis, chronic pain affects millions of people. In fact, more than 100 million Americans suffer from chronic pain, according to WebMD. The average yearly cost across the United States of medical treatment for chronic pain is $600 billion. Around the world, more people are affected by chronic pain than diabetes, heart disease and cancer combined.
Chronic pain can be debilitating in a variety of ways. There's the pain, of course, and pain simply hurts; for many, it means they are unable to partake in the activities they enjoy, and many are unable to work. But, it’s more than just perpetual aches and discomfort. There's also an accompanying mindset that’s as debilitating as the pain itself.
Those who experience chronic pain often think they're powerless. This mindset of powerlessness comes from pain catastrophizing, which explains the way individuals feel and process pain. Pain catastrophizing is when a person unintentionally exaggerates or magnifies the extent of their pain to the point that the individual feels helpless and afraid, which results in many aspects of life to be controlled by chronic pain.
During pain catastrophizing, individuals experience thoughts such as "I can’t stop thinking about how much this hurts," "There’s nothing I can do about the pain" or "This is only going to get worse." Essentially, an individual experiences dread and worry in tandem with physical pain, and this makes the pain even more unbearable.
When you consider the anxiety that comes with chronic pain, it makes sense that many people depend on medication to quell the experience of pain and the fear of it.
Medications are certainly helpful for temporary pain relief, but in the case of prescription opioids, continual use can be problematic. Medications simply aren’t able to do much for long-term pain, and they don't reduce the problem of pain catastrophizing.
Overcoming pain catastrophizing
Brain-imaging research has shown that Cognitive Behavioral Therapy (CBT) can effectively combat chronic pain and pain catastrophizing by helping patients relearn the way they deal with pain, giving the patient a sense of empowerment as opposed to a sense of helplessness.
Additional research has shown that after 11 weeks of group CBT, patients reported less pain, less anxiety, greater control over the way they experienced pain, and an increase in volume in the regions associated with pain control.
By drawing from the research, pain psychologist Beth Darnall of Stanford University created a two-hour pain relief mindset class and subsequently developed an online program called My Surgical Success. (The video above is a short lecture by Darnall on the subject.)
As described by Scientific American, the program can be accessed online before a patient undergoes surgery, and it teaches patients the skills needed to reduce pain catastrophizing and their overall experience of pain.
My Surgical Success has been tested in women who have undergone breast cancer surgery, and Darnall wants to see if the program can effectively reduce chronic pain and opioid dependence in individuals who have undergone orthopedic surgery.
New possibilities for pain management
For many individuals who have been taking opioids for an extended period of time, they fear that weening themselves off their medication will result in an increase in pain. This fear is understandable, but if Darnall’s theories and research prove successful, then patients should have the skills needed to face and overcome their fears. Of course, facing fears means you have to be willing to do so, and Darnall’s latest research suggests that when patients voluntarily agree to slowly taper opioid use while adopting a positive mindset, they are able to successfully taper without any increase in pain.
In 2017, Darnall and her team were awarded almost $9 million from the Patient-Centered Outcome Research Institute to continue this research. About 1,000 patients who have been taking opioids long-term have been participating in studies.