
- •Other titles in the series include:
- •Overcoming chronic pain a self-help manual using Cognitive Behavioral Techniques frances cole, helen macdonald, catherine carus and hazel howden-leach
- •Isbn: 978-1-84119-970-2 eIsbn: 978-1-47210-573-8
- •Table of contents
- •Acknowledgements
- •Foreword
- •Introduction by Peter Cooper Why cognitive behavioral?
- •Introduction
- •Who might benefit from using this book?
- •What does chronic pain mean?
- •What is Cognitive Behavioral Therapy?
- •How can a book help?
- •How can I get the most out of using this book?
- •What do the chapters cover?
- •How do I start using this book?
- •Four case histories
- •Using the person-centred model
- •Maria and the person-centred model
- •How did the model help Maria make changes for the better?
- •How can the person-centred model help you get ready tomake some changes?
- •Getting started
- •Reducing the impact of pain on your daily life
- •How do you or others see these changes occurring?
- •Understanding chronic pain and pain systems
- •Understanding pain
- •Acute and chronic pain
- •What is acute pain?
- •What is chronic pain?
- •Acute and chronic pain systems
- •The acute pain system
- •The chronic pain system
- •Theories of pain The Gate Control Theory of Pain
- •Other theories of pain
- •Frequently asked questions
- •Understanding investigations for pain
- •Blood tests
- •Waiting for tests and results
- •Understanding the roles of healthcare professionals
- •Healthcare professionals
- •What is the role of a physiotherapist?
- •How do physiotherapists work?
- •What is the role of a specialist pain nurse?
- •What is the role of a pain specialist?
- •What is the role of a psychologist?
- •What is the role of a psychiatrist?
- •Talking therapies
- •Cognitive Behavioral Therapy
- •Pain management programmes
- •Understanding medicines and using them better
- •What types of medicines are used to manage chronic pain?
- •How are medicines used? Analgesics
- •Problems with medicines
- •Making better use of medicines
- •Four suggestions for using medications more helpfully
- •Stopping or reducing your medicines
- •Part two Overcoming Chronic Pain
- •Introduction
- •Setting goals
- •What are goals?
- •Informal and formal goals
- •What are smart goals?
- •Setting goals
- •Using a goal ladder
- •Achieving your goals
- •Giving yourself rewards
- •What are rewards?
- •Creating a ‘fun presciption’
- •50 Mg of fun three times a day (at least) For maximum benefit, use imagination!
- •Understanding pacing skills
- •What is pacing?
- •What are the different styles of pacing?
- •What type of pacing style do you use at present?
- •If pain levels are low, do you:
- •If pain levels are high, do you:
- •How to change your pacing style
- •Experimenting
- •Planning
- •Priorities
- •How to deal with barriers to realistic pacing
- •Getting fitter and being more active
- •How being more active can help you manage your pain
- •Trying to get fitter: What does having more pain mean?
- •Why do these types of activity cause aches and pains?
- •Assessing your present activity level
- •Frequently asked questions about increasing physical activity
- •How to get started on a basic exercise programme
- •Strength exercises – do slowly
- •Stretches for flexibility
- •Understanding problem-solving
- •What is problem-solving?
- •The main steps in problem-solving
- •Putting the problem-solving process into practise
- •Problem-solving guide
- •Understanding sleep and sleep problems
- •What sort of sleeping problems can be caused by chronic pain?
- •What kind of sleep pattern do you have at present?
- •How much sleep do you need?
- •How to use a sleep diary
- •How can you change unhelpful sleep habits?
- •Relaxation
- •What is relaxation?
- •How can relaxation help with chronic pain?
- •What can help you relax?
- •How to practise relaxing
- •Time out relaxation
- •What can make it difficult to practise relaxation?
- •Pain, communication and relationships
- •Part 1: communication and sharing concerns How close relationships can be affected by pain
- •How to manage difficulties in relationships
- •How to change behavior
- •How to communicate and share your concerns
- •Part 2: chronic pain and sexual relationships
- •How to deal with sexual problems
- •How to make sexual relationships easier
- •Managing depression, anxiety and anger
- •What moods can occur because of pain?
- •Part 1: managing depression
- •Why do people become depressed with chronic pain?
- •How depression affects people’s thinking
- •What factors can contribute to depression?
- •Unhelpful thinking in depression
- •Using anti-depressants
- •Part 2: managing anxiety
- •What is anxiety?
- •What are the effects of anxiety?
- •How does anxiety affect the body?
- •Anxiety and chronic pain
- •Managing anxiety by dealing with unhelpful thinking
- •Overcoming avoidance
- •Changing unhelpful behaviors
- •Part 3: managing anger
- •How anger affects you and your pain
- •How chronic pain and anger are linked
- •How being angry can affect other people
- •How to manage anger better
- •A coping plan
- •Acceptance
- •What is acceptance?
- •How can acceptance help you manage chronic pain?
- •What is attentional control or mindfulness?
- •1. Reasonable (thinking reasonably)
- •2. Emotional (thinking emotionally)
- •3. Wise (being mindful)
- •Mindfulness skills
- •1. Observing
- •2. Being ‘non-judgemental’
- •3. Focusing on one thing now and being in the present
- •4. Doing what works
- •Mindfulness exercises
- •Maintaining progress and managing setbacks
- •How can you maintain progress?
- •Obstacles to progress
- •What is a setback?
- •How can you manage a setback?
- •Looking to the future and managing work
- •How are new ways of life and new roles possible?
- •How can you use a positive data log?
- •Thinking through work, training and other options
- •How can you stay at work or return to work successfully?
- •Useful information
- •Professional organizations
- •Self-help groups and organizations
- •Books and publications
- •Self-help books
- •Tapes and cDs
- •Useful videos
- •Wordlist
Waiting for tests and results
WHAT CAN I DO TO HELP MYSELF WHILE WAITING FOR TESTS AND THEIR RESULTS?
Keep as active as possible every day. This is important in order to prevent your body becoming unfit or out of condition. Lack of fitness can make pain symptoms worse. And pain researchers have discovered that we improve and heal while we move about. Long periods of rest do not help the body to manage persistent pain well.
There will be some days when the pain is severe. But, even on those days, it will do no harm to do parts of your activity programme or stretch-and-strengthen programme (see Chapter 9). If you are not certain what to do, or how to keep active, talk to your doctor or physiotherapist.
HOW CAN I COPE WITH WAITING FOR TEST RESULTS?
Waiting can be very difficult because worrying thoughts go through your mind. Some patients describe the waiting, and the lack of a definite diagnosis or cause, as ‘soul-destroying’.
It is understandable that you and your family may become preoccupied with the pain because it can take over your everyday life. But the downside of this preoccupation is that the pain may then affect you and your activities even more. Generally, if a doctor or specialist has assessed you, they will order a test urgently if your symptoms and the results of a clinical examination suggest that something could be seriously wrong.
So, how do you cope with feelings of fear, anxiety and depression while waiting for test results? Here are some suggestions:
• You could read more about managing your moods in Chapter 14 of this book.
• You could write down your worries in your notebook and check them with your doctor, physiotherapist or hospital specialist.
• You could share your worries with someone you trust. Then ask yourself: did sharing your worries with this person help? If so, how?
• You could contact a self-help group (see the Useful Information section at the back of this book). Then ask yourself: did the group help? If so, how?
WHERE CAN I GO FOR MORE INFORMATION IF I DON’T FULLY UNDERSTAND THE ANSWERS TO MY QUESTIONS?
There are several options. You could:
• Ask the questions of your doctor or specialist again.
• Ask the questions of another member of your healthcare staff, such as your physiotherapist.
• Ask a self-help group for possible solutions (see the list of groups under Useful Information at the back of this book).
• Ask a patient liaison and advice service (PALS) to help. You may find PALS in your local hospital, where you had your tests or investigations.
• Check a reliable, helpful website (see the list of websites under Useful Information).
CHAPTER SUMMARY
• Blood tests are not usually helpful in finding a cause for chronic pain.
• X-rays and scans can sometimes help explain some of the reasons for chronic pain.
• Ask your doctor or specialist about the investigations and exactly what the results mean. This will reduce your anxiety, and help you manage life better, despite the pain.
• Remember to keep physically active while waiting for tests, investigations or results. It’s important to be active, despite the pain, in order to prevent other pains developing from tight, inactive muscles and joints.
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