Most professionals who work with people with chronic pain recognize
a predictable pattern known as chronic pain syndrome, which
develops when a person with pain pursues medical interventions with
little or no success, leading to a cycle of frustration and a sense
of despair, hopelessness, and worthlessness.
The following are 3 illustrations of how the cycle
starts and is maintained:
1. If a person who pursues medical treatment is continually
treated with acute pain methods, pain worsens. For example, while
chair or bed rest is an appropriate interventional measure immediately
following an injury during the healing phase, over time, muscles
quickly become atrophied or weakened and the person loses stamina.
Loss of range of motion and muscle atrophy also occurs with prolonged
traction and bracing, measures meant to immobilize an area only
during the healing phase. As a result, pain increases. Stress, frustration
and anger from increased pain increase muscle tension, leading to
more pain, leading to more anger. Chronic anger, stress, muscle
tension and atrophy lead to feelings of fatigue, which in turn decreases
motivation, which in turn leads to passivity, more depression and
a sense of hopelessness and helplessness.
2. After trying a number of treatment options and
medication trials with little or no success, the person with chronic
pain often concludes that something must be terribly wrong and that
doctors are "missing something." As a result, the person
experiences increased emotional distress, which increases muscle
tension, which in turn increases pain. Increased pain is then further
misinterpreted as "proof" that doctors have missed something
and/or that further damage is occurring. Additionally, because of
fear that s/he might cause even more damage to him/herself, s/he
may avoid activity and assume a sedentary lifestyle, which results
in further deconditioning and pain, leading to more anger, stress,
muscle tension, increased pain, and so on.
3. Another tendency of chronic pain patients is to
overdo activities (during periods when their pain level is lower
or in-between "flare-ups") resulting in increased pain
later on, or to perform activities until the pain forces them to
stop. They begin to associate activities that were previously pain-free
with pain exacerbation and thereby avoid activity altogether, or
they persist in this "reduced activity-overactivity" pattern.
These cycles are often maintained by hopeful thoughts that "maybe
the pain is going away" or self-expectations that one will
or should overcome the pain and thereby avoid feelings of "defeat."
In a larger sense, however, chronic pain patients may prolong the
self-destructiveness of overdoing that leads to more pain, fatigue,
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