Using Cognitive-Behavioral Therapy to Control Your Chronic Pain

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Treatment Overview
Cognitive-behavioral therapy (CBT) teaches relaxation techniques, stress management, and other ways to help you cope with pain. Physical, psychological, and social factors all play a role in pain management.

Cognitive-behavioral therapy is based on the idea that thought and behavior patterns can affect symptoms and disability and may be obstacles to recovery. For example, when you feel a familiar type of pain starting or getting worse, you probably have a sense of how it will progress. If you are used to the pain being severe or long-lasting, you may expect the pain to become more intense. This thinking may make you feel out of control or helpless. A stress response like this can trigger physical changes in your body, such as a rise in blood pressure, the release of stress hormones, muscle tension, and more pain.

You can expect to attend several sessions with a therapist, each lasting an hour. Sometimes therapy takes place in a group setting. You will be taught specific exercises that increase your ability to cope and your feelings of control. Your therapist will give you homework to encourage you to change the way you respond to your symptoms. You will then be taught how to practice changing a certain behavior until the next session.

What To Expect After Treatment
Cognitive-behavioral skills can change the way your mind influences your body. When you shift your thinking away from the pain and change your focus to more positive aspects of your life, you change the way your body responds to the anticipated pain and stress.

Why It Is Done
The goal of cognitive-behavioral therapy is to change the way you think about the pain so that your body and mind respond better when you have episodes of pain. Therapy focuses on changing your thoughts about illness and then helping you adopt positive ways of coping with illness. For cognitive-behavioral therapy to be most effective, work together with your counselor toward common goals.

How Well It Works
CBT can be helpful for chronic pain by changing the way you think about pain. It also teaches you how to become more active.1 This helps, because pain can also improve with appropriate physical activity, such as walking or swimming.

Risks
There are no risks associated with cognitive-behavioral therapy.

What To Think About
Whatever the reasons for improvement, it is clear that cognitive-behavioral therapy can be helpful for some people who have persistent pain. It has virtually none of the side effects that other treatments, such as medications, can cause.

Complete the special treatment information form (PDF) (http://www.health.com/health/static/hw/media/pdf/hw/form_zm2258.pdf) to help you understand this treatment.

References
Citations Max MB (2004). Pain. In L Goldman, D Ausiello, eds., Cecil Textbook of Medicine, 22nd ed., vol. 1, chap. 29, pp. 138–145. Philadelphia: Saunders.

Last Updated: April 20, 2008