만성통증과 일상Living with Persistent Pain

1. Who this series is for

When pain persists, planning a day can change. Work, household tasks, time with other people, and rest may all require more thought. On a day when pain is lighter, you might catch up on everything and then need much more rest the next day.

This series is for adults whose daily lives have become harder because of persistent pain. It offers information to help you understand pain, notice patterns in daily life, and choose approaches to discuss with your therapist.

Chronic pain usually means pain that persists or recurs for longer than three months. Its causes and course vary. A condition or injury that needs medical treatment may be present, so it is important to understand your medical assessment and treatment plan.

2. What we will look at

We consider pain intensity separately from how much pain interferes with daily life. We also look at sleep, mood, tension, and patterns of activity and rest. Alongside changes in pain, we pay attention to how much you can participate in things that matter to you.

For example, a goal might include reducing pain and also joining a family meal more comfortably, or dividing household tasks so you can continue your routine the following day. The size and pace of a goal should fit your current health and your medical team's recommendations.

3. What happens in psychological treatment

Cognitive behavioral therapy for chronic pain, or CBT-CP, addresses thoughts, emotions, and behaviors related to pain. It includes learning to pace activities and plan breaks, notice tension, respond to worries about pain, and care for sleep and daily routines.

A review of research in adults with non-cancer chronic pain, excluding headache, found small average benefits of CBT over usual care or a waiting list for pain intensity, disability, and emotional distress at the end of treatment. Differences were very small when CBT was compared with other active treatments. Individual responses vary. These findings concern clinician-delivered treatment; they do not establish that reading this series will produce the same effects (Williams et al., 2020).

4. How to use the series

Start with Part 01 to explore persistent pain and Part 02 to make brief observations about your own daily life. Then choose the topic you need most. Part 03 covers pacing, Part 04 tension, Part 05 thoughts about pain, Part 06 sleep, and Part 07 pain flare-ups.

You can choose the topic you need first. The article sequence does not prescribe treatment sessions or their order. Individual activity levels and exposure plans are set with your therapist and medical team.

5. When to speak with your medical team first

If pain suddenly changes from your usual pattern, or you develop new changes in sensation or strength, seek medical assessment rather than assuming it is your familiar chronic pain. If you have had recent surgery or a new injury, have a condition under active treatment, or have been given activity restrictions, check with your medical team before changing your activity plan.

In particular, low back pain with new loss of bladder or bowel control, numbness in the saddle area, or severe or progressive leg weakness needs immediate emergency assessment. These are examples especially relevant to low back pain. Chest pain, trouble breathing, or pain that worsens quickly with a high fever may also need immediate emergency care. This list does not cover every emergency. If pain brings thoughts of ending your life or urges to harm yourself, please reach out now. In the U.S., you can call or text 988 (Suicide & Crisis Lifeline), or call 911 if your life is in danger.

The series

1. 01 When Pain Persists
2. 02 Tracking Pain and Daily Life
3. 03 Pacing Daily Activities
4. 04 Pain and Tension
5. 05 Working with Thoughts About Pain
6. 06 Pain and Sleep
7. 07 When Pain Flares

PADO independently developed this series using VA resources and related research. It is not an official VA translation or endorsed treatment program, and its clinical effects as a web series have not been established.