The Therapy Room: Chronic Pain

Posted on 17 August 2017 by LeslieM

The United States of America is experiencing a national opioid addiction crisis; the use of opioid pain medications has reached epidemic proportions! Those who suffer with chronic pain, defined as any pain lasting more than 12 weeks, and who take opioid medications, are monitored more than ever before by medical professionals who prescribe and dispense them. Monitoring those taking pain medications is important to prevent overdosing and opioid side effects, such as drowsiness, nausea and vomiting. It is important to also look for signs of drug misuse, the development of intolerance and addiction.

Opioid medications include codeine, fentanyl, hydrocodone, hydrocodone/acetaminophen, hydromorphone, meperidine, methadone, morphine, oxycodone, oxycodone/acetaminophen and oxycodone/naloxone. Many medical experts today debate if opioids effectively treat chronic pain and recommend non-opioid pain medications to their patients, such as acetaminophen, ibuprofen, anticonvulsants, serotonin and norepinephrine reuptake inhibitors, tricyclic antidepressants and topical NSAIDs.

How can someone realize they are becoming dependent or addicted to pain medication? Here are questions to help and, if the answer is “yes” to one or more of these questions, it is recommended one contact a medical professional for further help:

Do you take more pain medication than prescribed?

Do you get pain medications from friends and family versus your pharmacist?

Do you get pain prescriptions from more than one doctor?

In addition to taking pain medication for your chronic pain, do you also take same medication to treat a bad mood, anxiety or to sleep?

Do you spend more time than you should worrying about running out of your pain medication?

Psychotherapy is an excellent collaborative treatment for anyone with chronic pain and/or taking pain medications. As a clinical psychotherapist, I see many patients with chronic pain and after I attain details on the type of chronic pain they experience and medications used I focus on how they respond to their pain. Do they respond to their pain with distressing thoughts that ruminate and magnify pain, along with feelings of helplessness about their chronic pain.  This response to chronic pain is defined as pain catastrophizing and it relates to any depression and anxiety being experienced. Studies show that people who catastrophize have more severe pain, require more pain medication and have reduced response to multidisciplinary pain care. 

Psychotherapy can provide much needed education and relief to a person’s experience with chronic pain.

In addition to psychotherapy, other treatments for chronic pain include chiropractic care, nutritional counseling, weight management, acupuncture, pressure point therapy, salt therapy, biofeedback, meditation, oga, Pilates and various exercise and wellness programs.

A psychotherapy client of mine experiences physical pain from multiple sclerosis and diabetes. If her workday starts in pain, she focuses on making it to lunch time and then maybe treating herself to a frozen yogurt. The simple act of getting through the day by taking small steps and rewarding herself with a treat helps her to manage her chronic pain.

Another psychotherapy client chooses to get off his reclining chair and go for a walk on the beach and breathe in the salt-filled ocean air. He believes that modifying his surroundings and physically moving are solutions to managing his chronic pain and he wants others to know that change is possible.

Dr. Julia Breur is a Licensed Marriage and Family Therapist with a private clinical psychotherapy practice in Boca Raton. Further Information available at

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