Chronic pain: a first world pandemic
Chronic Pain is a big health problem. In westernised countries, recent studies estimate that a staggering 20-37% of the general population suffer from chronic pain at some point in their lives: with a higher prevalence among women. It’s a complex biological, psychological, social and existential phenomenon that requires a multidimensional treatment approach.
I have a great interest in Chronic Pain and its relationship to mind-body health, having spent time working in a Pain Management Unit in a multidisciplinary setting.
This year saw the publication of a fascinating study which demonstrates the effectiveness of mind-body interventions for pain conditions The study, by Björnsdóttir et al. (2016), uses a non-randomised controlled trial to compare a traditional multidisciplinary pain management program with mindfulness-based cognitive therapy. The results are very interesting!
A study of two methods
Over an 8-year period, Scandinavian researchers Björnsdóttir et al. studied a group of women with chronic pain, comparing two types of interventions and how they affected quality of life, pain intensity, and sleep.
The study investigated the effectiveness of two intensive, multidisciplinary biopsychosocial rehabilitation approaches:
- A traditional multidisciplinary pain management program (TMP), where the physical training emphasised traditional endurance, strength and flexibility training.
- A neuroscience education and mindfulness-based cognitive therapy (NEM)
Both approaches were compared to a control group who received no intervention.
Truly comprehensive and holistic interventions
There are many interesting aspects to this study, including how comprehensive and holistic both interventions were. Examples of some of the physical activities offered included aqua gymnastics, Tai Chi and individual personal training. Then were was the meditative and relaxation offerings, including relaxation sessions, massage and even mud baths.
All treatment for both groups was delivered by a specialised, professional pain management team, comprising of physical therapists, a psychologist, a psychiatric nurse, a sports therapist, a rehabilitation physician, a medical massage therapist, and a nutritionist.
Both groups were provided with a comprehensive program, including physical therapy sessions to optimise the benefits of movement (in terms of pain control and as a treatment) with emphasis on overcoming limitation and working on fear avoidance behaviour.
Both groups utilised the psychologist, who provided discussion on health promotion with respect to chronic pain and overcoming limitations in daily life. The physician took part in the initial assessment procedure, lead weekly patient education and group discussion sessions and provided medication as needed.
In the traditional multidisciplinary pain management program (TMP), the physical training emphasised traditional endurance, strength and flexibility training. Whereas, in the neuroscience education and mindfulness-based cognitive therapy (NEM) group individuals received their physical training emphasised motor control training in conjunction with neuroscience patient education, and mindfulness-based cognitive therapy.
Truly, both models of intervention are advanced when you compare them with other pain management programs around the world, and certainly would be considered Integrative and Holistic in nature. This ticks a lot of boxes and you would hope with all the effort, the variety of disciplines utilised, the high number of hours the participants had contact with helping professionals, and the group support, that there would be significant improvement in both groups.
So how did they do?
Both groups showed significant improvement in all aspects of the various Quality of Life markers (except financial status) and experienced a decrease in pain intensity, as compared to their waiting list control group.
Interestingly, the TMP group showed improvement in pain intensity to a greater extent than the NEM group. The NEM group, in comparison, improved their sleep more than the TMP and control group.
Implications for sufferers of chronic pain
This study highlights the value of approaching a chronic health condition from many angles, not just with medication. It’s great to see such a comprehensive, truly holistic biopsychosocial pain management program existing and making such a positive difference to women with chronic pain.
The improvement in pain intensity, quality of life and sleep are key indicators that not only show both of those comprehensive approaches work, but that an integrative approach that also utilises a specific mind-body therapy (like MBCT) produces truly positive outcomes.
The future of chronic pain treatment
This study helps us understand two key things. Firstly, using a multidisciplinary approach to chronic health conditions is an effective means of treatment on its own. Secondly, adding mind-body medicine to that mix provides an additional benefit and improvement in health and functioning.
The Mainspring Method has been designed to easily fit into an Integrative Medicine Model: helping you uncover the psycho-emotional root causes of illness, and giving you the tools you need to recover.
If you would like to discuss how Mainspring can help you or someone you love with chronic pain, get in touch today.
Björnsdóttir, SV., Arnljótsdóttir, M., Tómasson, G., Triebel, J., & Valdimarsdóttir, UA. (2016). Health-related quality of life improvements among women with chronic pain: comparison of two multidisciplinary interventions. Disability & Rehabilitation, 38, 828-836