Visit 2: Integrative Medicine & Mind - Body Practices for the Management of Fibromylagia- Frank's Slides

Transcript

3. Pain Management • Easing suffering • Improving quality of life • Beyond analgesia • Not always eradication of all pain • Achieving adequate quality of life in presence of pain • Lessening the pain • Understanding pain better • Being able to live happily despite pain
4. Common Pain Misconceptions • 1. If you cannot find the exact cause of your pain, then it must be in your head. • 2. Chronic pain isn’t that bad because you get used to it after a while. • 3. If you take opiates, you must be or will be an addict. • 4. Chronic pain is forever. • 5. Living with chronic pain eliminates the possibility of a fulfilling life.
5. Common Pain Myths and Misconceptions • 6. Chronic pain is an inevitable part of growing older. • 7. The best treatment for chronic pain is bed rest. • 8. Weather has no impact on “real” pain. • 9. Alternative treatments are ineffective. • 10. If a person has “real” physical pain, then psychological treatment is not needed.
6. Behavioral Approaches • Acceptance and Commitment Therapy (ACT) • Cognitive Behavioral Therapy • Hypnosis • Mindfulness Meditation • Mindfulness-based Pain Management
7. Chronic pain • Biochemical • Psychological • Treatment needs to address • How we think about it • How we feel about it
8. Transition from Acute to Chronic Pain • Our perception of pain • Our fear of pain • MRI does not help us figure out what hurts and what doesn’t • Study: • 5% of MRIs for backpain were appropriate • 65% resulted in potentially harmful advice
9. Reasons Why Pain Becomes Persistent • Those who fear pain or are anxious about it are twice as likely to develop chronic pain • After spinal surgery • 26% returned to work • Versus 67% who didn’t • Small study: • The strongest predictors of back pain turning chronic • Are past traumatic events: being robbed, bullied or sexually assaulted
13. Recent Clinical Trial • JAMA: Psychiatry, Asher and Wager • Three conditions: • Usual care • Pain medications • Physical therapy • Placebo • Pain reprocessing therapy (twice weekly for a month) • Results (pain-free for one year): • Pain reprocessing therapy – 52% • Placebo – 27% • Usual care – 16%
14. Coping 1. Soften yourself to pain rather than fighting it. 2. Find the gray areas rather than thinking in ‘black or white’. 3. Try using the natural breath: slowly breathe in for 5 seconds and then slowly breathe out for 5 seconds.
15. Coping 4. Try moving your attention back onto the things you need to do. 5. Ease back into doing the things pain pushed out of your life. 6. Set small goals that you can achieve now: TODAY is important.
16. Coping 7. Enjoy the small things – set goals. 8. The slower you go the faster you will get there. 9. Setting goals for today is a good start. 10.You can also start to think ahead to where you will be in a few weeks or a few months.
17. Coping 11.Pushing too hard, too soon isn’t smart. 12.Be gentle with yourself. 13.Go easy and congratulate yourself on one achievement each day.
18. Coping 14.Be your own best friend. 15.Cracking the whip over yourself when you are already struggling is punishing. 16.Be gentle with yourself. 17.Go easy and try and congratulate yourself on one achievement each day