As a Chiropractor I regularly see people in neuromuscular skeletal pain, that is why they came to my practice in the first place. But how dose a person in my profession help a patient in Chronic Pain? Let me first define Chronic Pain. Chronic Pain has been defined as pain that has lasted longer than three to six months.
In the case of pain there are times I prescribed either an MRI or X Ray to help with my diagnosis
of the cause of pain. The best outcome, the test results show why the pain exists, and that the cause of the pain I can correct, eventually eliminating the patient of thier pain. Sometimes the answers are not the ones that help either myself, their Chiroprator or the patient. Somtimes the continuance of pain can not be explained. Or there is not a treatement during this time to correct the cause of the pain. So where does this leave my patient, and how can I best direct my patient?
As a clinicain I keep an open mind and always research, investigate in the sensible pursuit of
managing chronic pain as I want to provide the best care for my patient or direct them.
Here is what I have learned in my sensible pursuit of answers in managing chronic pain thus so far. First and foremost I never give my patient the "it's all in your head" speech if the pain can not be explained. I take my patients expressed concern for the pain they are experiencing, genuine. Jean-Martin Charcot who was a French neurologist and professor of anatomical pathology, stated in De l'expectation en médecine, that, "it is we who change as we learn to recognize that which was formerly imperceptible." Was there ever a more true statement? Therefore I keep an open mind!
Approach to managing musculoskeletal pain is with Analgesic medication. When medication is not enough to control the chronic pain provided by a pain management physician, whom I do refer some of my patients too, where do we go from there? Lately I've been researching Cognitive behavioral therapy (CBT) which has been shown through various studies can help many people deal with chronic pain, including chronic back pain.
CBT is a form of psychological therapy. It usually involves 10 to 20 meetings with a therapist. Focusing on your thoughts makes up the cognitive part of CBT. CBT, is a way to help you stay well or cope with a health problem by changing how you think. CBT works because “The perception of pain is in your brain, so you can affect physical pain by addressing thoughts and behaviors that fuel it,” And how you think affects how you feel. Focusing on your actions are the behavioral part.
In the Vanderbilt Pain Management Inventory those particpant with chronic pain who were Active Coping was associated with reports of less pain, less depression, less functional impairment, and higher general self-efficacy. Praying, yoga and walking are some of the active coping, and we know that physical exercise helps reduce pain. However we also know that there is power in prayer, and these are all active coping methods with CBT.
CBT can be helpful for chronic pain by changing the way you think about pain. It also teaches you how to become more active.
I also suggest a Pet-Scan, Imaging study finds first evidence of neuroinflammation in brains of chronic pain patients.
Active Coping should involve in educating yourself!
Dr. Donald Berry DC SFMA
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