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Apart from causing musculoskeletal disorders, chronic pain starts affecting the well-being of many patients psychologically, their quality of sleep, social interaction, and general ability to carry out their daily duties. While the pain continues for days or weeks, patients experience depression and anxiety, and feel isolated, frustrated and hopeless. At times, patients end up being dependent on prescription pain medications and other forms of substances in order to deal with the pain.

Current healthcare practice recognizes that chronic pain is not solely a physical condition and its management requires taking care of both aspects of pain – the physical and psychological. If there are mental health issues and/or addiction problems along with chronic pain, it means that treatment needs a comprehensive approach in order to give patients the best chance to get back to life and function properly.

Pain and Mental Health Connection

There are different ways in which pain and mental health interact with each other. Persistent pain triggers production of stress hormones, disrupts sleeping patterns and lowers activity level thus making patients’ activities more challenging. As a result, there are certain changes occurring which could contribute to the emotional state of patients.

On the other hand, patients’ psychological state also influences how they experience pain and perceive it. Anxious or depressed patients report experiencing pain intensively, having problems with recovery and being unwilling to engage in physical rehabilitation programs. There is a circle in which physical and emotional state are reinforcing each other. Modern healthcare providers have understood the importance of treating not only the physical cause but also other factors that play role in patients’ perception of pain.

The Need for Comprehensive Care

Usually, patients with chronic musculoskeletal conditions require the intervention of several healthcare professionals. Physicians, physical therapists, pain specialist and psychologists provide coordinated treatment to address all the aspects of patients’ health.

If patients are dealing with opioid dependence, alcohol abuse or any kind of addiction together with chronic pain, the treatment becomes even more complicated. Such patients usually need programs that allow them to improve mental health status and dealing with addiction problems along with physical issues. The Aura Recovery Center offers personalized programs, which could involve medically assisted detoxification, residential care, treatment for dual diagnosis, medication-assisted treatment (if required), individual and group therapy, family therapy, holistic services, and aftercare.

Role of Opioids in Chronic Pain Management

While there is still some space left for opioids in treatment of chronic pain, especially after surgery, injuries or other medical conditions, regular use of these drugs needs to be controlled because of some risks associated with these drugs, like tolerance, dependence and OUD.

Not everyone who takes opioids gets addicted to these drugs; however, regular use of these drugs increases the risk of development of physical dependence. Therefore, it is important for the patients to visit their doctors to ensure safety and efficiency of prescribed medications.

Healthcare specialists may also suggest the use of these drugs along with physical rehabilitation, psychotherapy or other non-pharmacological therapies for pain management.

Psychological Issues and Their Influence on Rehabilitation Process

Successful recovery from orthopedic injury or any other chronic diseases of musculoskeletal system requires active involvement. Physiotherapy exercises, gradual activity, visits to the doctor are all necessary elements of recovery process.

However, psychological issues may complicate this process. Patients suffering from depression feel unable to make movements because of lack of motivation. Patients with anxiety issues fear exacerbation of the condition and some patients just refuse to make any actions that may hurt them.

Thus, considering these psychological issues, rehabilitation specialists may develop a strategy helping patients not only recover physically but also feel confident about their movements.

Not Only Physical Aspects of Rehabilitation Process

Today, healthcare professionals take into consideration many aspects in addition to pain level when they develop the plan of treatment for patients.

For example, people with chronic pain suffer from such issues as:

• Disturbances in sleep;
• Depression or other negative emotions;
• Stress;
• Occupational issues;
• Difficulties with socialization;
• Lifestyle.

This information enables healthcare specialists to develop an individual program, which considers all aspects of patient’s health.

Approaches to Chronic Pain Treatment

Usually treatment of chronic pain involves several treatment techniques in addition to one. As chronic pain influences physical health, patient’s emotional state, ability to sleep, communication with other people and ability to perform daily activities, treatment of this condition should be multifaceted as well.

Depending on the patient’s diagnosis and his or her personal characteristics, healthcare specialists may prescribe physiotherapy, exercises, occupational therapy, cognitive behavioral therapy, use of pain killers, relaxation techniques, meditation skills, proper nutrition, changes in lifestyle, etc. These approaches can be used together to help the patient recover, relieve pain, regain mobility and improve his or her quality of life. When the patient suffers from substance use disorder, addiction medicine specialists also become an important part of the therapeutic team.

Therefore, the close cooperation of doctors, psychologists, physiotherapists and addiction medicine specialists makes it possible to adjust the pain management strategy and prevent exacerbation of these conditions. Moreover, it enables changing the therapeutic plan according to the patient’s needs without any additional risks.

Multidisciplinary approach also acknowledges the interaction between physical and psychological aspects of patient’s health. Therefore, improvement in stress management, emotional state and coping abilities can influence the reduction of pain, and pain relief can improve patient’s sleep, mobility and general state.

Prevention through Early Intervention

An efficient way to prevent any complications is the early diagnosis of the problems connected to the course of treatment of chronic pain. Emotional distress, depression, social isolation, and anxiety are the problems that appear quite often in the patients with chronic pain but are often overlooked due to the focus on physical pain only.

Patients should not be afraid to talk about the changes in mood, motivation, sleep, and emotional state since it can mean not only that they have to deal with the chronic pain but there is also something else that requires proper treatment. Early diagnosis can help healthcare providers find out what kind of problems a patient has and how to deal with them.

The intervention can be based on such techniques as individual counseling sessions, stress reduction, mindfulness, peer support group, consultation with a psychologist or psychiatrist. Patients will be able to learn some techniques to cope with chronic pain and reduce the emotional strain caused by it.

It is also very important to detect the early signs of maladaptive coping strategies. The use of some substances, prescription drugs, or alcohol in order to cope with physical pain or emotional distress means that there is a need for intervention. Otherwise, it can become a serious problem for patients.

The early diagnosis of any mental problems requires regular screening of anxiety, depression, PTSD, and substance abuse by healthcare providers during the treatment of chronic pain.

They will have a chance to monitor the changes, adjust the treatment and provide constant assistance to patients during the rehabilitation process. Early intervention and collaboration are crucial for the improvement of the physical and mental well-being of patients.

Assistance beyond the Clinics

The rehabilitation of the patients with chronic pain is not over when the person leaves the rehabilitation center. In order to achieve successful results, it is necessary to maintain a healthy lifestyle that can help to manage both physical and psychological aspects of chronic pain.

According to the Centers for Disease Control and Prevention (CDC), the effective pain management requires individualized treatment that will involve various therapies that will contribute to the recovery of patients, their health, life quality, and will reduce the unnecessary prescription of opioids.

Regular physical activity, visits to the healthcare provider, participation in counseling sessions, maintenance of social support network, etc., can help patients to continue recovering.

The patients that regularly communicate with the healthcare provider after the completion of the rehabilitation program usually can deal with difficulties that may come along during the recovery process.

Patient Education Contributes to the Successful Recovery Process

Education is one of the important components of the rehabilitation of the patients with chronic pain. The information on the development of chronic pain, the influence on the mental condition of patients, and the mechanism of the treatment can motivate patients to take an active role in the process of their recovery.

It will be easier for patients to participate in the treatment process knowing that it is a gradual one. Any changes in mobility, strength, quality of sleep or emotional state will motivate patients to continue making progress gradually.

Positive interaction with the healthcare provider can help to set realistic expectations and make appropriate decisions regarding the treatment process.

The management of chronic pain involves numerous aspects. The goal of rehabilitation is to help patients to regain their independence, physical abilities, and emotional stability.

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