Addressing Chronic Pain

Video by Dr. Dawn Elise Snipes on integrative behavioral health approaches to improving mental health and reducing mental illness.

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 Learn about the prevalence of chronic pain (CP)
 Identify the biopsychosocial impact of CP
 Explore some causes of pain
 About 40% of people have chronic pain issues
 Pharmacological treatment is only capable of controlling chronic pain in 30-50% of the cases

BioPsychoSocial Impact of Pain
 Chronic pain has complex bidirectional causal-effect relationships with biological, psychological, and social factors
 Biological (impairs psych & social)
 HPA-Axis: Cortisol, sleep, inflammation, serotonin, gonadal hormones
 Reduced activity
 Weight gain
 Psychological (which worsens bio and social factors)
 Grief/Depression/Anger
 Guilt
 Anxiety
 Impatience/irritability
 Jealousy/Resentment
 Social (worsens psycho & bio)
 Isolation/Withdrawal/Rejection

Causes of Pain
 Threat learning is a major contributing factor in chronic pain and vice versa because cortisol has a significant effect on learning, biasing towards threat information
 Stress increases pain and autoimmune symptoms
 HPA-Axis activation leads to increased inflammatory cytokines associated with increases in anxiety and depression
 People with chronic pain have higher cortisol levels
 Parental low care (emotional unresponsiveness) and high overprotection (enmeshment) during childhood contribute to the future risk of chronic pain and the patients’ need for psychosomatic treatment in adulthood
 Musculoskeletal (scoliosis, TMJ) or neurological conditions (like neuropathy, “phantom pain”)

Causes of Pain
 Autoimmune issues
 Rapid cessation of opioid medications after tolerance is developed
 Cessation of adequate pain treatment as a result of Covid may have unintended consequences in people with chronic pain including increased pain, reduced function, increased reliance on opioid medications, and potential increased morbidity, due to the systemic impact of untreated disease burden
 Also check out our other podcasts, Happiness Isn’t Brain Surgery and Addiction Counselor Exam Review

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