Persistent pain influences individuals differently. When a person experiences pain, it affects their physical being, thought patterns as well as their emotions and relationships. Behaviour and cognitive responses such as fear, anxiety and perceptions about the future becomes part of their pain experience. 

Tackling persistent pain with short term solutions and traditional strategies can result in further frustration and hopelessness. Modern pain science tells us that a different approach is imperative when addressing ongoing pain. We are complex beings and pain is a multi-faceted emergent experience which therefore warrants an approach that looks beyond our tissues.

We need to reframe pain. Instead of giving it a negative connection, what if we perceive it as an alarm that prompts action? When we experience PAIN, the brain is sending us an alarm or warning, alerting us to change how we are feeling, thinking and behaving, so we can protect our well-being. Our nervous system is then on alert and sensitised. Pain is thus a protector and not an accurate indicator of damage.

The first step towards reversing your pain experience is a commitment to change. Pain is a complex  phenomenon influenced by a great number of things. Thus, there are many avenues for positive change and opportunities for recovery. Our bodies are designed to heal itself, provided that we give our bodies the right tools to do so. 

On your journey to heal, consistency and daily positive habits lead to small improvements that will turn into bigger improvements. The power lies in switching paths from a downward spiral of PAIN and SUFFERING to a slow and steady road to recovery.  There are usually no QUICK fixes, but there are management strategies that require patience, persistence, perseverance, courage and coaching. 

This tried and tested route to recovery is centred around threat identification and graded exposure with the assistance of an interdisciplinary team of clinicians that will coach you while you are on your journey to recovery.

Our practice embraces an individually tailored active approach to assist this client group. The type of coaching that will best suit an individual with complex pain, is determined by a baseline consultation. This consultation comprises of an interview and a bio-pshyco-social assessment. The aim is to identify the pain mechanisms invovled as well as possible contributing factors. Following the assessment, an individualised, tailored program will be designed to suit the individual’s goals and challenges.  

PAIN NEUROSCIENCE EDUCATION

This is a cognitive intervention based on the work of various pain scientists which aims to purposefully shift patients’ understanding away from the traditional biomedical and anatomical models. It equip patients with a better knowledge and understanding of how pain works. Both research and our personal experience have demonstrated the effectiveness of this approach in improving a person’s pain and management thereof. This important clinical tool is often overlooked in other medical approaches.

PROGRESSIVE GOAL ATTAINMENT PROGRAM

This programme is a uniquely evidence based programme, which are usually administered over a ten week period (involving one to one sessions) with the client. The primary aim is to assist the client to resume previous interests (where and if possible), provide strategies to implement adjustments by pre-determined specific goals and bridge the gap to resume working or stay at work (if possible). This program uses the principles of activity scheduling in order to facilitate moving away from under-activity patterns. This is centered around realistic and achievable goals to ensure success.

GRADED MOTOR IMAGERY

In most persistent pain conditions, the brain develops changes in its neural representation of the affected body part. This can be likened to a map that has become smudged and difficult to interpret. Specific ‘brain training’ techniques can be helpful to restore the clarity of the map. This includes, left/right discrimination training, imagined movements and mirror therapy.

GRADED EXPOSURE AND PACING STRATEGIES

Our bodies thrive on variability, movement and physical activity. A magnitude of research studies have revealed that physical activity and exercise is one of the most effective strategies to improve well-being and reduce pain. With complex pain conditions, however, participating in physical activity can prove to be challenging as pain often gets in the way. 

Graded exposure to physical activity and exercises involves designing a program that is based on realistic and achievable goals for the individual. The aim is to gradually condition the body’s ability to cope with exercise and to retrain the sensitised nervous system and ultimately the pain response associated with physical activity. This then allows the individual to make use of this powerful tool to self-manage their well-being without being inhibited by pain.

SLEEP HYGIENE

Sleep hygiene refers to practises and habits that influence the quality of our night time rest. Poor sleep hygiene can negatively influence our mental and physical health, and specifically also our pain experience. Various strategies can be implemented to improve the likelihood of effective, good quality sleep.

MINDFULNESS, RELAXATION AND STRESS MANAGEMENT

Persistent pain is physically and emotionally stressful, and stress in turn can have a negative effect on our pain experience. Structured and purposeful relaxation or mindfulness techniques can break the stress-pain cycle. These strategies include breathing techniques, muscle relaxation, guided imagery and mindful focus on pain.

COGNITIVE FUNCTIONAL THERAPY AND RESTRUCTURING

Cognitive restructuring is a process of learning to identify and dismiss irrational or maladaptive thoughts. In the context of persistent pain, these thoughts are challenged during functional training.

Pain is experienced when the brain perceives more ‘threat’ messages than ‘protective’ messages. We can therefore influence our pain experience by restructuring our thought processes to become more protective. Our brains have the wonderful ability to form new pathways with the right input. Cognitive restructuring involves challenging our negative thoughts associated with specific functional tasks, and replacing them with new protective processes. 

MULTIDISCIPLINARY PAIN MANAGEMENT

Pain is a complex multifaceted experience. It therefore often requires input from various disciplines in health care. As part of an individualised management plan, it will be determined whether referral to other professionals could be beneficial

These could include: