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Counselling, Psychotherapy, CBT & Mindfulness in Central London & Online

Chronic Pain Treatment: Psychotherapy, Physiotherapy and CBT in London and Online

COVID-19 notice: Online and Telephone Chronic Pain, Psychotherapy, Physiotherapy and CBT are now provided for continued care, support and safety. Get a free 15min consultation or book a session here.

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Around two fifths of the UK population suffer from chronic pain and many may benefit from chronic pain treatment. Living with chronic pain can change dramatically the way you live. We understand that it can feel that you are alone with your struggles. However, you do not have to battle through on your own. At Therapy Central we have Physiotherapists and Psychologists who specialise in working with people with chronic pain and each has over ten years of experience in the field. Our therapists offering chronic pain treatment can help you to learn strategies to cope with your chronic pain, to find ways to adjust and to gain control back enabling you to improve your quality of life.

What is Chronic Pain?

In chronic the intensity of physical pain can range from mild to severe. Chronic pain symptoms may increase and decrease or they may be constant. The pain may have begun following an injury or illness and then remained many months, and even years afterwards. For others there is a more gradual onset. The chronic pain itself can be unpleasant and challenging. However, what compounds the issue is that life adjustments may have to be made and people may not be able to do some of the things they used to. Understandably, this can be difficult to accept and can lead to individuals feeling frustrated, angry, irritable, anxious, stressed and upset. Relationships with loved ones and others can be affected which can become another source of stress.

What Causes Chronic Pain?

The day-to-day functioning of our nervous system and immune system is something most of us probably won’t think much about. However, in the background, every second of every day, these systems are working hard to protect us and ensure our survival. Thousands of miles of nerve “wiring” and hundreds of thousands of connections between different nerves in the brain and body, are constantly receiving and transmitting information about our environment, the internal state of our body, our thoughts, emotions and actions. This huge volume of information is constantly being sorted through and acted upon by the brain, which then makes necessary adjustments to the functions of different areas of the body as required. The brain uses information from the present as well as calling on our experiences from the past, to fine tune these adjustments.

Chronic or persistent pain involves a major shift in the functioning of the nervous and immune systems: they become more sensitive to all stimuli (meaning activities or experiences that weren’t painful before may now be painful) and in addition the brain uses bigger “protective” reactions, such as pain, muscle spasm, muscle weakness, fatigue and brain fog, which may limit what you can do and take a long time to subside after you do it. This is a hardwired, automatic evolutionary response possible in all humans, intended to protect us, but unfortunately can negatively impact our quality of life and function.

There is proven “rewiring” occurring in the nervous system to bring these changes about and the key message is that it can happen without the presence of damage to the body, or occur even if an injury has healed successfully. Chronic pain treatment is there also to help you make sense of where your struggle might come from.

What does Physiotherapy Treatment for Chronic Pain involve?

Physiotherapy for persistent pain uses up-to-date neuroscience education to aid you in making sense of your symptoms, where they come from, how it all started and how it has progressed in the way it has since. Then you will together with your Pain Specialist Physiotherapist to initiate and encourage a new “rewiring” of the nervous system, one where we “turn down” the level of sensitivity in our inbuilt protective systems. This is entirely possible, as the human nervous system is constantly learning and can be moulded (like clay) by the inputs we give it. Our nervous system is as individual as our fingerprints, therefore your physiotherapy treatment program will be tailored to you. An overview of techniques that can be helpful to cover in physiotherapy for chronic pain include:

  • Nerve mobility exercises: These promote blood flow and oxygen and good lubrication of nerves that pass down our spine and into our limbs
  • Breathing exercises: Can be used to program and promote the restful and restorative functions of our nervous system
  • Sleep quality and relaxation: Because all body and brain housekeeping and repair jobs happen when we sleep
  • Working together to reclaim enjoyable or valuable activities and connect with others as these actions trigger the brain to restock and release endorphins and neurotransmitters which we need for pain relief, a sense of calm and wellbeing and to help our concentration, memory and reasoning.
  • Muscle strengthening, cardiovascular fitness and flexibility: because even day to day jobs like changing a bed require these
  • Managing stress: Because the level of stress we experience can have a direct biological effect in heightening the sensitivity of our nervous system, which can increase existing pain or provoke new symptoms
  • Diet: Certain eating habits or foods can provoke or perpetuate pain symptoms due to how they influence our nervous system

Please note that this is not an exhaustive list of topics that can be covered in your therapy with our physiotherapist.

What does Psychological Treatment for Chronic Pain involve?

In the early stages of therapy for chronic pain it can be helpful to spend time with your therapist gaining a deeper understanding of your difficulties, their impact and how you are coping. It can be helpful to use the therapeutic space to unload and share your difficult experiences in a safe and non-judgmental environment. You may benefit from learning coping strategies to help you manage and gain more control of your chronic pain. There is good evidence to suggest that Cognitive Behavioural Therapy (CBT) and Acceptance and Commitment Therapy (ACT) are helpful for many people suffering from chronic pain. Therefore, your therapist is likely to introduce you to concepts and coping strategies drawn from such therapeutic approaches. These approaches have a wealth of evidence supporting their effectiveness [1].

Coming for Psychological Therapy for your struggles around your chronic pain does not mean for one moment that we think “it’s all in your head”. We believe that they are very much real and have a physiological basis. As can be seen above, chronic pain does not just affect a person physically but can affect various aspects of their lives. Psychological Therapy can provide the space and support to explore this, to help you find ways to cope better with both the physical symptoms and the impact that they have upon your life. We hope to help you to gradually take steps towards activities that are valuable to you, thus broadening your life once more whilst doing this in a manageable way. See below an example of a CBT vicious cycle for Chronic Pain.

Chronic Pain CBT Vicious Cycle shown visuallyHow long does Physiotherapy and Psychological Therapy Last for Chronic Pain?

This really depends upon the severity of your struggles. Some people can benefit from around six sessions of Physiotherapy or Psychological Therapy, whereas others benefit from support over a long period of time. Usually it can be helpful to have between six to twenty four sessions of Physiotherapy or Psychological Therapy, again, depending upon the severity of your struggles.

What are the benefits of Physiotherapy and Psychological Therapy For Chronic Pain?

Research and clinical experience shows that Physiotherapy and Psychological Therapy for chronic pain can bring a range of benefits, including:

  • Reduced Pain Levels
  • Improved level of functioning
  • Improved confidence in ability to manage physical symptoms
  • Reduced detrimental impact upon a person’s life
  • Improved quality of life
  • Improvements to emotional wellbeing, such as anxiety, depression, anger, stress levels
  • Better relationships
  • Ability to engage in more meaningful activities whilst minimising physical symptoms

When Should I Get Chronic Pain Treatment?

It can be helpful to receive help to manage your chronic pain at any stage given that they can be highly challenging to experience both physically and emotionally. However, many people seek therapy when they feel relatively hopeless, when they have exhausted the medical route, when they are struggling to manage, they do not feel in control and it is having a large negative impact upon their lives. These are signs that certainly indicate that therapy can be helpful. It can also prove helpful to reach out for support in the earlier stages of your condition.

The Challenges of Living with Chronic Pain

“It’s All In Your Head”

A common problem that people may experience with chronic pain is that their difficulties are not believed or understood by Doctors, family, friends and colleagues. Perhaps you’ve received the message that “it’s all in your head”. This may partly be due to the fact that your pain cannot be seen and, in some cases, Doctors struggle to find the cause of the pain and provide a diagnosis. This can be extremely frustrating and you may then not get the support you need.

Pressure To “Keep Up Appearances”

People with chronic pain may feel that they are a burden and they should be “strong”, perhaps not asking for help from others when needed, or even, not telling others altogether about their struggles. This can contribute to added pressure to “keep up appearances” which can be stressful and may lead you to take on too much. In some cases this can exacerbate your physical symptoms.

Lack of Diagnosis

You may have been given a definitive diagnosis or perhaps you are yet to receive a diagnosis. Many people experience debilitating pain that medical Doctors struggle to diagnose. There can be various reasons for why some conditions can be hard to diagnose, for example, the human body is highly complex and several bodily systems may be involved. Also, sometimes no abnormalities can be detected to account for physical symptoms even after a battery of physical investigations (which doesn’t mean that the physical symptoms are not real!). This can be incredibly frustrating for those suffering from chronic pain. You may find yourself attending many appointments and feel disappointed each time a cause is not found.

Vicious Cycles

It can be difficult coming to terms with chronic pain and knowing how best to manage it. It can feel like things are out of your control. Chronic pain can lead to various emotional difficulties, such as depression, anxiety, stress, frustration, low self-esteem and anger. Chronic pain, sometimes together with the resulting emotional difficulties, may go on to have a detrimental impact upon all aspects of your life including relationships, leisure activities and work. Life can sometimes, and understandably, become restricted which further negatively affects an individual’s emotional wellbeing. In turn, some chronic pain conditions, such as fibromyalgia, can worsen in response to higher levels of distress (which doesn’t mean at all that the physical health problems are “all in your head”, they are very much real and have a physiological basis).

Lowers Confidence

Chronic pain can have the potential to lower peoples’ confidence. For example, chronic pain can affect mobility and can lower confidence in a range of situations, such as visiting places and socialising. People may worry about how they will manage when they are in unfamiliar settings, particularly if their symptoms increase, and if they do, how they will manage getting home.

Chronic Pain Treatment in Central London

If you are looking for Chronic Pain Treatment in London and online, including either physiotherapy or psychological therapy, at Therapy Central we can help you learn the strategies you need to start managing your pain effectively and reducing its impact on all areas of life. As a result, you’ll be enabled to make the crucial changes to bring balance and fulfilment back into your life. No one should face chronic pain alone.

Start Dealing with Chronic Pain in London and Online Today

Get professional help with Chronic Pain in London and Online today. Contact us for a free 15 min consultation with a Chronic Pain Specialist to see if our help would fit your needs. You can also get in touch via email at info@therapy-central.com or call us at (+44) 020 348 82797.

Our comfortable and confidential therapy rooms (with lift) are conveniently located 3 min walk from Oxford Circus station, in Central London (see map below). Change starts with Talking!

 

 

Authors:

Dr Amy Smith, Counselling Psychologist

Dr Raffaello Antonino, Counselling Psychologist

 

Learn more:

Other issues we work with at Therapy Central

NHS: Understanding Fibromyalgia

YouTube Video: “Understanding pain and what to do about it in 5 minutes”

Learn more about how CBT works

 

References:

[1] Vowles, K. E., McCracken, L. M., & O’Brien, J. Z. (2011). Acceptance and values-based action in chronic pain: a three-year follow-up analysis of treatment effectiveness and process. Behaviour research and therapy49(11), 748-755.

 

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