Psychomental Paincoping Strategies
The biopsychosocial diseasemodell, as a working basis for a longlasting therapy of chronic pain, has established itself over the last 15 years internationally. Every person suffering from pain relatively fast develops ideas and beliefs about possible causes or why all the therapies did not help up to now. These personal beliefs lead to changes in the behaviour - so it is very common that activity is meant to have caused or at least aggravated pain and patients hence avoid movement and prefer to rest or sit. Subsequently the stabilizing muscles get weaker and less coordinated. Patients have a decreasing protection of the soft tissue (ligaments, capsules, tendons, fasciae,...) so that pain increases e.g. in loading postures, where the body weight hangs on the weak muscles and soft tissues. This further increase of pain while moving pretends to confirm the own hypothesis - "activity causes backpain". Therefore patients rest just more!
But not only the physical course of the pain characterizes the chronic paindisease, pain also influences the psychosocial parameters. People tend to stopp going out to the theatre or concert, because they are no longer able to sit for 90 minutes on a wooden chair. So they won't try it again, but prefer to stay at home. After some time of pain the friends won't ask any longer about the health, because they get the same or even worse answer every time - and the patient himself also gives up, informing everyone about the missing success of different therapies. Even the partnership suffers significantly from the pain-"disability". This can even disturb the sexual harmony, because nobody is full of desire while having strong pain!
The permanent failure of the medical system causes a break in the patient's trusts and beliefs. So - patients develop some very typical inner sentences, which come up every time, when strong pain returns: These are e.g. "If I am that disabled and destroyed now, how will I be able to live my life with wife and children in 10 years?" or "When I get one other acute painattack, my boss will fire me and my wife will leave me!"
50% of the chronic painpatients develop a depression and 50% of depressiv people suffer from chronic pain as well.
Another amplifier for a depressive mood can be, that most painpatients have sleep problems also - pain wakes the patient up repeatedly and delays to fall asleep again. But just in the deep sleep phase the storage of the important neurotransmitters serotonin and noradrenalin is filled up again. Pain, depression and anxiety - all three lack of these transmitters - so with unregular sleep, the risk to get or worsen one of these conditions increases significantly.