Conventional wisdom suggests that chronic pain is a medical problem and that medical doctors
are the best at treating pain? This may be true. However, decades of research have shown that an
“interdisciplinary” approach to treating a chronic pain condition is superior to any single
intervention (to be clear, chronic pain is not the same as acute pain. Acute pain = being in pain
for under 6 months; Chronic pain = 6+ months of pain). The best long-term outcomes occur
when patients work with many doctors across specialties and, in the best case scenario, these
doctors actually talk to each other regularly and coordinate treatment plans, recommendations,
information, etc. Specialties that may be involved in the treatment of chronic pain include:
orthopedics, sports medicine, pain medicine and rehabilitation, physical therapy, acupuncture,
massage therapy, and psychology.
Many people are confused about the role that a psychologist would play in the treatment of
someone with chronic pain. There are several reasons for this. One reason is that many people
with chronic pain don’t know the extent of the neuroanatomy behind chronic pain, regardless of
where it is felt in the body. For instance, we know that lower back pain doesn’t begin and end in
the lower back or the spinal cord. Pain registers in multiple parts of the brain, including the
thalamus, limbic system, cerebral cortex, and somatosensory cortex. The limbic system and
cerebral cortex do many things, including shaping our emotions and thought process. Activity
that happens in these areas of the brain directly influences pain signals. Simply put, emotions
and thoughts shape the experience of pain. And since psychologists are experts in the domains
of emotions and thoughts, they play a pivotal role in improving the outcomes of those with
chronic pain, especially when it appears that medical interventions aren’t helping.
Psychological approaches to chronic pain aren’t mysterious or random. And the positive
outcomes aren’t simply due to a placebo effect. Neuroscience studies show that psychological
approaches actually reverse the neural changes associated with chronic pain. Effective treatment
combines a variety of techniques (cognitive-behavioral, psychoeducational, mindfulness-based
stress reduction, biofeedback/relaxation, and pacing) to help patients self-manage their pain and
require less medical intervention(s) and medication.
If you are interested in learning more about psychological treatment for chronic pain at NRS|Lifespan,
please call 732-988-3441 to schedule a consultation appointment.
Lauren Gashlin, PsyD
Clinical Psychology