Management of chronic pain in EDS – Part 3 – Nov 2018
This post continues from the first part & second part, and delves into the varied options for management of pain.
Most cases of chronic pain in EDS are a mix of nociceptive and NP. [Neuropathic Pain]
As symptoms vary based on the diseases phase and in individuals of EDS, broad recommendations in a patient with EDS or JHS include: Continue reading
Chronic pain treatment: Psychotherapy, not opioids, has been proven to work – Vox – By Brian Resnick @B_resnick firstname.lastname@example.org – Aug 16, 2018
When pain settled into Blair Golson’s hands, it didn’t let go.
What started off as light throbbing in one wrist 10 years ago quickly engulfed the other. The discomfort then spread, producing a pain much “like slapping your hands against a concrete wall,” he says. He was constantly stretching them, constantly shaking them, while looking for hot or cold surfaces to lay them on for relief.
But worse was the deep sense of catastrophe that accompanied the pain. Working in tech-related startups, he depended on his hands to type. Continue reading
Unwanted Events and Side Effects in Cognitive Behavior Therapy – Cognitive Therapy and Research – June 2018
Side effects (SEs)are negative reactions to an appropriately delivered treatment, which must be discriminated from unwanted events (UEs) or consequences of inadequate treatment.
One hundred CBT therapists were interviewed for UEs and SEs in one of their current outpatients.
Therapists reported 372 UEs in 98 patients and SEs in 43 patients. Continue reading
Psychotherapy is not harmless: on the side effects of CBT | Aeon Ideas | Christian Jarrett – Oct 2018
The structured nature of cognitive behavioural therapy (CBT) and its clearly defined principles (based on the links between thoughts, feelings and behaviours) make itrelatively easy to train practitioners, ensure standardised delivery and measure outcomes.
Being easy to learn, easy to standardize, and easy to measure nails the trifecta of cheap and widely scaleable medical treatment, making this quick and profitable therapy an instant hit among medical “providers” and insurance companies.
Consequently, CBT has revolutionised mental-health care, allowing psychologists to alchemise therapy from an art into a science.
What it has revolutionized is the impersonal standardization of medical mental healthcare. Continue reading
Here is What Clinicians Should Know About Side Effects of Psychotherapy – Dr Sanil Rege MBBS, MRCPsych, FRANZCP – July 24, 2017
In conditions such as depression and anxiety, the beneficial effects of psychotherapy are often comparable with evidence-based pharmacotherapy options in terms of symptom reduction and protection against relapse.
While discussion about side effects, risks and benefits are an important part of psychotropic medication prescribing, the same cannot be said for psychological treatments.
All pharmacological medications come with relevant or absolute contraindications, and yet the common assumption is that talking therapies are risk-free or come with little risk at all. Continue reading
Learning and Unlearning of Pain – free full-text article /PMC6027134/ – Biomedicines. 2018 Jun
This review provides an overview of learning mechanisms and memory aspects for the development of chronic pain.
Pain can be influenced in important ways by an individual’s personality, by family, and by the sociocultural environment in which they live. Therefore, learning mechanisms can explain why pain experience and pain behavior can increase or decrease.
Linking pain with positive consequences or removing negative consequences can contribute significantly to the chronification of pain.
If pain were linked with positive consequences, we wouldn’t mind having it, but I find it impossible to imagine how to link even moderate pain with anything positive. Continue reading
Nora Volkow on prescription opioids, chronic pain and ‘hype’ – Opioid Watch – Nonprofit News from The Opioid Research Institute – July 2018
Research psychiatrist Nora Volkow, MD—the director of the National Institute on Drug Abuse for the past 15 years—is one of the world’s foremost authorities on addiction. Her pioneering work with brain imaging has changed society’s understanding of the phenomenon.
By showing how addictive drugs alter the brain’s chemistry, she helped prove that addiction was a chronic disease rather than a moral failing.
What follows is part 1 of a two-part interview, which was conducted by email. All links in her answers are to supporting references Volkow provided. Continue reading
CBT for Chronic Pain and Insomnia Needs More Research – by Angie Drakulich – April 2018
The Sleep/No Sleep Pain Cycle
Most are familiar with the vicious cycle of insomnia, depression, and increased pain.
Finding the right mix of CBT—including patient education, self-regulation, behavioral activation, and cognitive reframing—may help to break this circle. Continue reading
Why Psychotherapy Helps the Patient in Chronic Pain – Psychiatry (Edgmont). 2008 Dec – Linda J. Griffith, MD – free full-text /PMC2729621/
Psychiatrists frequently see patients in their practices who struggle with issues of chronic physical pain. This can present diagnostic and therapeutic dilemmas.
These patients require an approach that allows them to talk about their pain and feel supported while simultaneously being nudged to develop a meaningful life alongside their pain.
This article addresses an approach to accomplish this difficult balancing act over the course of time and includes case examples. Continue reading
Patient action: as means and end for chronic pain care: PAIN – August 2017
Historically, pain has been understood as a sensory problem. Even the IASP defines pain as “an unpleasant sensory and emotional experience….”
This aversive sensory experience can prompt a protective motor response, which can include reflexive withdrawal, splinting and resting of the painful body part, and avoidance of activities that can increase pain.
This sensory understanding of pain implies that the pain experience must be reduced to reduce motor reactions. Continue reading