Chronic pain affects many people in the UK. Pain is a uniquely individual and subjective experience that depends on a variety of biological, psychological, and social factors. For many patients, treatment of pain has been inadequate not just because of uncertain diagnoses and societal stigma, but also because of shortcomings in the availability of effective treatments and inadequate patient and GP knowledge.
Pain’s occurrence, severity, duration, response to treatment and disabling consequences vary from person to person because pain, like other severe chronic conditions, is more than a biological phenomenon and has profound emotional and cognitive effects. Pain can be mild and managed with over-the-counter remedies, it can be acute and recede with treatment, it can be recurrent over a long period, or it can be chronic and debilitating, requiring constant management.
Stress is a significant contributing factor to pain. Stress is a physical and mental feeling of helplessness or uncertainty in the face of challenging or life-threatening circumstances. It involves a range of feelings including anxiety, sleeping issues, decreased immune function, mood swings and memory problems. One of the most common and harmful types of chronic stress is childhood abuse, abandonment and neglect.
Stress can also result from experiencing life-threatening situations such as physical or sexual abuse, rape, assault, and even being diagnosed with a life-threatening illness. This is known as post-traumatic stress disorder (PTSD) and involves severe symptoms, including nightmares, intrusive thoughts, flashbacks and avoidance. PTSD can also involve re-experiencing symptoms, wherein the sufferer actually re-lives the traumatic event in their body. This re-living may incorporate physical pain, making PTSD a significant type of stress in terms of pain generation.
After physical injury, stress is the leading contributing factor to chronic pain. Extensive studies have shown that those who have experienced severe stress are more than twice as likely to develop a range of significant health problems. They experience greater levels of pain and respond less well to normal, usually effective medical interventions. They are more likely to be injured at work and experience greater levels of disability. Distress and traumatic experience not only cause pain, they exacerbate injury and inhibit recovery.
Recent developments in neuroscience and brain imaging techniques have radically changed the ways pain can be effectively managed. Although it usually begins in the body, all pain involves the brain, with research showing an 80% overlap in the areas of the brain involved in physical and emotional pain.
Increased understanding of the brain has led to the development of new strategies for overcoming pain, aimed at changing the patterns of brain activity which maintain pain. These include innovative approaches such as EMDR. These methods target the deeper areas of the brain where sensory-emotional aspects of pain are stored. Because they are designed to work with how the brain works, they are both more efficient and more effective.