“Watch the Screen”: Biofeedback Can Improve Mindfulness for Chronic Pain

Biofeedback ◽  
2018 ◽  
Vol 46 (1) ◽  
pp. 15-20
Author(s):  
Saul Rosenthal
Keyword(s):  
Chronic Pain ◽  
Daily Life ◽  
Behavioral Therapy ◽  
Medical Intervention ◽  
External Signal ◽  
Chronic Pain Management ◽  
Internal Process ◽  
Optimal Approach ◽  
Over Time

Chronic pain has a significant impact on the quality of lives for millions of people. Because it is resistant to traditional medical intervention, the optimal approach to chronic pain management relies on a biopsychosocial understanding of health and treatment. To date, cognitive behavioral therapy (CBT) has been the treatment of choice. However, CBT's emphasis on active control can prove counterproductive because the cognitions, behaviors, and emotions related to pain are difficult to directly confront. More recently, CBT has begun to integrate mindfulness, shifting toward paradigms of accepting sensations rather than trying to change them. This is difficult for individuals with chronic pain, who frequently spend significant resources avoiding and trying to minimize sensations. Biofeedback can be a useful tool for shaping mindfulness because it allows a focus on an external signal that in fact reflects the internal process. Over time, individuals can learn to integrate mindfulness techniques in their daily life that minimize the influence of pain, allowing them to focus on other aspects of their lives.

scholarly journals Views of patients suffering from Failed Back Surgery Syndrome on their health and their ability to adapt to daily life and self-management: A qualitative exploration

PLoS ONE ◽  
2020 ◽  
Vol 15 (12) ◽  
pp. e0243329
Author(s):  
Tanja E. Hamm-Faber ◽  
Yvonne Engels ◽  
Kris C. P. Vissers ◽  
Dylan J. H. A. Henssen
Keyword(s):  
Quality Of Life ◽  
Chronic Pain ◽  
Daily Life ◽  
Failed Back Surgery Syndrome ◽  
Personal Health ◽  
Positive Health ◽  
Failed Back Surgery ◽  
Back Surgery ◽  
The Web

Background The clinical outcomes of Spinal Cord Stimulation (SCS) therapy in patients with a Failed Back Surgery Syndrome (FBSS) is mostly done by standardized pain and quality of life measurements instruments and hardly account for personal feelings and needs as a basis for a patient-centred approach and shared decision making. Objectives The objective of this study is to explore perspectives on personal health and quality of life (QoL) in FBSS patients concerning their physical-, psychological and spiritual well-being prior to receiving an SCS system. Methods We performed face-to-face, semi-structured, in-depth interviews to obtain descriptive and detailed data on personal health, guided by the Web diagram of Positive Health (Huber et al.) and a topic list. The following main topics were assessed qualitatively: 1) Bodily functioning, 2) Mental function and perception 3) Spiritual dimension, 4) Quality of life, 5) Social and societal participation and 6) Daily functioning. Results Seventeen FBSS patients (eight male, nine female) were included from April–November 2019 at the department of pain medicine in the Albert Schweitzer Hospital in the Netherlands. Median age 49 years; range 28 to 67 years, and patients underwent between one and five lumbar surgical operations. The duration of their chronic pain was between four and 22 years. After analyzing the interviews, three themes emerged: 1) dealing with chronic pain, 2) the current situation regarding aspects of positive health, and 3) future perspectives on health and quality of life. These themes arose from eleven categories and a hundred ninety codes. Conclusion This qualitative study explored FBSS patients ‘views on their health and the ability to adapt to daily life having complex chronic pain, and showed that patients experienced shortcomings in daily life within the six dimensions of the Web diagram of Positive Health before the SCS implant.

scholarly journals Reward Processing under Chronic Pain from the Perspective of “Liking” and “Wanting”: A Narrative Review

2019 ◽  
Vol 2019 ◽  
pp. 1-8
Author(s):  
Xinhe Liu ◽  
Ning Wang ◽  
Lijia Gu ◽  
Jianyou Guo ◽  
Jinyan Wang ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Chronic Pain ◽  
Animal Studies ◽  
Daily Life ◽  
Reward Processing ◽  
Neural Mechanisms ◽  
Incentive Salience ◽  
Therapeutic Goals ◽  
Relieve Pain

The therapeutic goals of patients with chronic pain are not only to relieve pain but also to improve the quality of life. Chronic pain negatively affects various aspects of daily life, such as by decreasing the motivation to work and reward sensitivity, which may lead to difficulties in daily life or even unemployment. Human and animal studies have shown that chronic pain damages reward processing; the exploration of associated internal mechanisms may aid the development of treatments to repair this damage. Incentive salience theory, used widely to describe reward processing, divides this processing into “liking” (reward-induced hedonic sensory impact) and “wanting” (reward-induced motivation) components. It has been employed to explain pathological changes in reward processing induced by psychiatric disorders. In this review, we summarize the findings of studies of reward processing under chronic pain and examine the effects of chronic pain on “liking” and “wanting.” Evidence indicates that chronic pain compromises the “wanting” component of reward processing; we also discuss the neural mechanisms that may mediate this effect. We hope that this review aids the development of therapies to improve the quality of life of patients with chronic pain.

Yoga and Chronic Pain Management—Telling Our Story

2004 ◽  
Vol 14 (1) ◽  
pp. 59-67
Author(s):  
Ginger Wood
Keyword(s):  
Quality Of Life ◽  
Chronic Pain ◽  
Pain Management ◽  
Psychological Health ◽  
Emotional Health ◽  
Body Awareness ◽  
Chronic Pain Management ◽  
Subjective Quality Of Life ◽  
Yoga Therapy

Purpose: To examine the effects of an 18-month period of Yoga therapy on a single student suffering from chronic pain, specifically fibromyalgia, and to determine what measures are needed to report improvements. Improvements documented over a specific time period in a controlled setting can further the case for using Yoga as a primary means for managing fibromyalgia and chronic pain and also provide a background to establish a working dialogue with practitioners of Western medicine. Study Design: Using case-study research methods, an 18-month period of gentle Iyengar-based Yoga was implemented 1–2x/week in a woman suffering from fibromyalgia and chronic pain. Findings: The findings showed that the student steadily improved in many measures, including pain, body awareness, medications dose/type, body weight, cholesterol, hypertension, bone density, and subjective quality of life measures(increased confidence, improved body image). Conclusions:The information collected during this study provides positive evidence that can assist in the future development of chronic pain management with Yoga therapy. As Yoga therapists, we have a professional obligation to document the changes and improvements our Yoga students are experiencing in a controlled Yoga studio environment. Collecting this information is vital to establishing an open dialogue between practitioners of Western and Eastern medicine. Future case studies and research should include more diverse populations of chronic pain sufferers as well as the use of tools that quantify a student's intangible concerns and complaints(i.e., pain level, quality of life, psychological health,emotional health, ease of daily activity completion, etc.).

Chronic pain in multiple sclerosis: A10-year longitudinal study

2017 ◽  
Vol 16 (1) ◽  
pp. 198-203 ◽  
Author(s):  
Jamie Young ◽  
Bhasker Amatya ◽  
Mary P. Galea ◽  
Fary Khan
Keyword(s):  
Quality Of Life ◽  
Multiple Sclerosis ◽  
Chronic Pain ◽  
Longitudinal Study ◽  
The Mean ◽  
The Impact ◽  
Over Time

AbstractBackground and purposePain is a common symptom associated with multiple sclerosis (MS), and has lasting effects on an individual’s functional capacity and quality of life. A wide range of prevalence rates of pain (between 23% and 90%)have been reported in MS and this is mainly due to the methodological differences amongst the studies such as variability in patient sources, method of sampling and the definition of pain used. Chronic pain in MS, defined as pain lasting for greater than 3–6 months, can have a significant impact on their biopsychosocial health, including negative impact on activities of daily living, relationships and social participation. The long-term course of MS-related pain and its impact in an Australian cohort over a 7-year period has been investigated earlier. The aim of this longitudinal study was to describe the impact of chronic pain, pain-related disability and carer burden in persons with MS over a 10-year period. The aim of this longitudinal study was to describe the impact of chronic pain, pain-related disability and carer burden in persons with MS over a 10-year period.MethodsThis was a prospective longitudinal study conducted at the Rehabilitation Department of Royal Melbourne Hospital (RMH), a tertiary referral hospital in Victoria and Australia. The source of participants was from the RMH MS database and contains detailed MS patient information including demographic data, diagnosis details (using McDonald’s criteria), pain characteristics. Structured face-face interviews and validated measures were used, which include the visual analogue scale (VAS); chronic pain grade (CPG); the assessment of quality of life (AQoL) and the carer strain index (CSI). The mean age of the participants (n = 70) was 55.3 years and majority (70%) were female.ResultsThe mean age of the participants (n = 70) was 55.3 years and majority (70%) were female. The findings show that over time (10 years), participants report having greater bilateral bodily pain and greater description of pain as ‘worse as it could be’. Pain types were similar to 7-years follow-up but remained higher than baseline. There was a significant deterioration in quality of life in those with more severe CPG over time. Almost half of the participants 31 (44%) required care either from a private carer, institution or from a family member. Although fear of taking medications and side effects were common barriers to treatment for pain, there was an increase in the use of pharmacological treatment over time and an increase in the use of healthcare services, mainly neurologists and general practitioners.ConclusionsThe pain measures reported by the participants were similar to those at the 7-year follow-up except there was a greater representation of bilateral pain locations (limb, trunk and facial pain) compared to baseline and 7-year follow-up. At 10-year follow-up, more participants used medications compared tc 7-year follow-up and there was an increase in the use of health professionals at the 10-year follow-up At the 10-year follow up QoL of the participants deteriorated significantly and more participants had progressed to higher CPGIII and CPGIV. This study demonstrates that chronic pain is a significant issue over time in MS, with clinical and health implications, impact on quality of life, disability and healthcare utilization.ImplicationsGreater awareness of chronic pain in pwMS, cognitive classifications and an interdisciplinary approach is required to improve long-term patient outcomes and well-being.Crown Copyright © 2017 Published by Elsevier B.V. on behalf of Scandinavian Association for the Study of Pain. All rights reserved.

scholarly journals Daily Life Benefits and Usage Characteristics of Dynamic Arm Supports in Subjects with Neuromuscular Disorders

Sensors ◽  
2020 ◽  
Vol 20 (17) ◽  
pp. 4864
Author(s):  
Johannes Essers ◽  
Alessio Murgia ◽  
Anneliek Peters ◽  
Kenneth Meijer
Keyword(s):  
Social Life ◽  
Daily Life ◽  
Contextual Information ◽  
Neuromuscular Disorders ◽  
Activities Of Daily Life ◽  
Self Reports ◽  
Actual Use ◽  
And Performance ◽  
Over Time

Neuromuscular disorders cause progressive muscular weakness, which limits upper extremity mobility and performance during activities of daily life. Dynamic arm supports can improve mobility and quality of life. However, their use is often discontinued over time for unclear reasons. This study aimed to evaluate whether users of dynamic arm supports demonstrate and perceive quantifiable mobility benefits over a period of two months. Nine users of dynamic arm supports were included in this observational study. They had different neuromuscular disorders and collectively used four different arm supports. They were observed for three consecutive weeks during which they were equipped with a multi-sensor network of accelerometers to assess the actual use of the arm support and they were asked to provide self-reports on the perceived benefits of the devices. Benefits were experienced mainly during anti-gravity activities and the measured use did not change over time. The self-reports provided contextual information in domains such as participation to social life, in addition to the sensor system. However self-reports overestimated the actual use by up to three-fold compared to the accelerometer measures. A combination of objective and subjective methods is recommended for meaningful and quantifiable mobility benefits during activities of daily life.

Chronic pain-related patient-provider communication: The significance of health related quality of life and satisfaction

2015 ◽  
Vol 8 (1) ◽  
pp. 50-50 ◽  
Author(s):  
T. Jonsdottir ◽  
S. Gunnarsdottir ◽  
H. Jonsdottir
Keyword(s):  
Health Care ◽  
Chronic Pain ◽  
Daily Life ◽  
Demographic Variables ◽  
Provider Communication ◽  
Related Quality ◽  
Health Related ◽  
Patient Provider Communication ◽  
And Control

Abstract Aims To investigate patients’ perception of chronic pain related patient-provider communication in relation to socio-demographic and pain-related variables. Methods Apostal questionnaire measuring socio-demographic variables, pain characteristics, health-related quality of life (HRQoL), pain-related health care utilization and perceived patient provider communication, was sent to a sample of 4500 individuals randomly drawn from the national population of Iceland. Relationships between patient perceived patient-provider communication and perceived outcome, satisfaction with care as well as sociodemographic and pain-related variables were tested by using bivariate and multivariate statistical analysis. Results The prevalence of chronic pain (≥3months) among respondents was 47.5%. Among participants reporting chronic pain, 53.2% had consulted a health care provider for pain during the previous six months. Patients’ perception of providers’ behaviour and control in the communication was mostly related to pain impact on daily life and physical components of HRQoL as well as to patients’ satisfaction with health care providers. The more pain interfered with daily life and impaired patients’ physical health, the more they felt that the provider did not spend time to listen to their concerns and discuss symptoms and treatment options. Patients’ perception of own activity and control in the patient-provider communication and participation in care was related to socio-demographic variables but not with pain related variables. Conclusions To be understood as an individual and having their concerns legitimized by the health care provider is crucial for patients when consulting health care for chronic pain. The more pain interferes with daily life and impairs HRQoL, the more important this is. Patients’ perception of own control in patient-provider communication and participation in care is more related to socio-demographics than pain related variables.

Conceptualization and Management of Chronic Pain in an Over 65 Using an ACT Lens—A Single Case Study

2020 ◽  
pp. 153465012097829
Author(s):  
Rebecca Campbell ◽  
Podugu Sai Durga Vara Prasadarao ◽  
Mary Morris
Keyword(s):  
Physical Activity ◽  
Chronic Pain ◽  
Older Persons ◽  
Single Case ◽  
Medical Intervention ◽  
Single Case Study ◽  
Psychotherapeutic Research ◽  
Acceptance And Commitment

This single case study illustrates the application and utility of Acceptance and Commitment Therapy (ACT) for a 72-year-old Australian male presenting with chronic pain and complex health conditions. Chronic pain often entails complexity among older adults and can impact the patient’s life across a range of domains. Psychological approaches, as stand-alone or adjunct to medical intervention, are widely acknowledged as potentially beneficial to older persons experiencing pain. ACT has been supported as a viable psychological approach for chronic pain and especially suitable for older persons with chronic pain. This study describes an ACT treatment approach for an older person with chronic pain informed via development of an extension of the existing ACT conceptualization of chronic pain. The development of the ACT based model is in keeping with recommendations to seek out mechanisms of change in psychotherapeutic research. Measures of Quality of Life, Depression, Physical Activity, and Acceptance/Avoidance were taken at pre and post treatment, as well as across treatment phases. Improvement was noted in self-reported measures of QOL, depression, and physical activity.

Erector spinae plane block in chronic pain management: a scoping review

2021 ◽  
pp. 030089162098593
Author(s):  
Dmitriy Viderman ◽  
Antonio Sarria-Santamera
Keyword(s):  
Chronic Pain ◽  
Clinical Practice ◽  
Pain Management ◽  
Scoping Review ◽  
Case Series ◽  
Erector Spinae ◽  
Chronic Pain Management ◽  
Efficacy And Safety ◽  
Erector Spinae Plane Block

Chronic pain is reaching epidemic levels. Chronic pain represents a significant burden for patients, healthcare systems, and society, given its impact on quality of life, increased disability, and risk of hospitalization and mortality. Unmet needs of chronic pain management are also significant as only a small percentage of patients respond to medical (drug) therapy. Erector spinae plane block (ESPB) was rapidly adapted in clinical practice and numerous cases have been published assessing its effectiveness, but no systematic review of evidence on ESPB in chronic pain management is available. The purpose of this scoping review is to perform a comprehensive overview of existing evidence on ESPB in chronic pain management. We analyzed cases and case series reporting 43 patients. ESPB was performed in patients with severe pain and in all cases resulted in some degree of pain relief. However, because there was heterogeneity in mechanisms and underlying causes of chronic pain, preprocedural analgesic therapy, and pain assessment in reporting the cases, with the information currently available (case reports) we cannot make a definitive conclusion regarding efficacy and safety of ESPB in chronic pain management. Lack of homogeneity was present in medication use before the procedure, indicating a significant variation in how patients with chronic pain are managed. Variation in clinical practice can indicate the need to improve the quality of care to alleviate the chronic pain burden. Randomized controlled clinical trials are warranted to establish efficacy and safety of ESPB in chronic pain management.

scholarly journals Management of fibromyalgia syndrome

2018 ◽  
Vol 87 (1) ◽  
pp. 34-37
Author(s):  
Joshua Y Lee ◽  
Stacey D Guy ◽  
Michael J Lukacs ◽  
Zoe A Letwin ◽  
Mohamad F Fakhereddin ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Chronic Pain ◽  
Emotional Response ◽  
Fibromyalgia Syndrome ◽  
Behavioral Therapy ◽  
Exercise Program ◽  
Thought Processes ◽  
Chronic Pain Condition ◽  
Maladaptive Thought

Fibromyalgia syndrome is a chronic pain condition that affects 440,000 Canadians above the age of 12. People with fibromyalgia report lifelong biological, emotional, cognitive and social complications. Recent clinical practice guidelines indicate management of symptoms is limited outside of analgesics. Cognitive-behavioral therapy (CBT) is one emerging treatment that displays promise for these individuals. CBT helps individuals to realize their maladaptive thought processes and how these can affect their own emotional response as well as the significance they attribute to potentially noxious stimuli. In conjunction with a physical exercise program, CBT shows promise in both the management of pain, and an improvement of quality of life.

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