Cognitive Behavioural Therapy (CBT)
CBT is a method of pain management used by many musculoskeletal medicine practitioners. There is good evidence that it is an effective form of treatment for chronic pain sufferers, especially when combined with other treatments, such as physical therapy and medication.
It is based on an understanding that pain is real (and not just “in the head”) and that there is triggering of specific emotions, thoughts, memories and behaviours (many of which are negative) when pain signals are processed by the brain. Similarly, negative thoughts, beliefs and emotions can influence the way pain is felt by people, often increasing muscle tension and activating more pain signals, and leading people to behave in a way that reduces their enjoyment of life.
CBT involves talking with a practitioner to develop skills to identify and change these negative thoughts and behaviours and to think more realistically and healthily about pain. This can help people gain a greater sense of control of their pain, reducing pain levels and use of pain medications and improving their overall functioning.
CBT can be performed as part of a pain management consultation or by referral to a psychologist. To learn more about this worthwhile approach, the book “Manage Your Pain: Practical and Positive Ways of Adapting to Chronic Pain (3rd Edition)” by Dr Michael Nicholas is an excellent starting point.