{"id":1041,"date":"2016-10-23T16:39:44","date_gmt":"2016-10-23T16:39:44","guid":{"rendered":"https:\/\/blogs.bmj.com\/ebn\/?p=1041"},"modified":"2016-10-23T16:39:44","modified_gmt":"2016-10-23T16:39:44","slug":"chronic-pain-management-moving-beyond-pharmacotherapy","status":"publish","type":"post","link":"https:\/\/blogs.bmj.com\/ebn\/2016\/10\/23\/chronic-pain-management-moving-beyond-pharmacotherapy\/","title":{"rendered":"Chronic Pain Management: Moving Beyond Pharmacotherapy"},"content":{"rendered":"<p><strong>By Roberta Heale, Associate Editor EBN, @robertaheale @EBNursingBMJ<\/strong><\/p>\n<p>Pain is an essential part of life.\u00a0 It tells us when and where we\u2019ve sustained an injury.\u00a0 This acute pain ensures that we seek out and address the problem at hand.\u00a0 However, some pain continues for much longer than necessary. Pain signals remain active, muscles tense in response, energy is lowered and there are changes in appetite.\u00a0 People often experience depression, anxiety or anger as a result of living with these ongoing effects.<\/p>\n<p>Treatment of chronic pain can be complex. There are a whole host of medications ranging from opioids to antidepressants to medications addressing neuropathic pain.\u00a0 Although useful in many cases, medications are not without side effects and there can be negative outcomes, including addiction.\u00a0 More and more we see alternative therapies being implemented to help in the management of chronic pain such as yoga, massage and acupuncture.\u00a0 In recent years, attention has turned to treatments that address mental and psychological coping of patients, such as cognitive behavioural therapy (CBT).<\/p>\n<p>One such therapy is acceptance and commitment therapy (ACT).\u00a0 ACT is a form of therapy that falls into the umbrella of CBT.\u00a0 ACT is defined by the Association for Contextual Behavioural Science as:<\/p>\n<p><em>\u2026a unique empirically based psychological intervention that uses acceptance and mindfulness strategies, together with commitment and behaviour change strategies, to increase psychological flexibility. Psychological flexibility means contacting the present moment fully as a conscious human being, and based on what the situation affords, changing or persisting in behaviour in the service of chosen values.<\/em>1<\/p>\n<p>EBN published a commentary on research that explored the use of ACT for chronic pain management in older adults and the small study showed some promise.\u00a0<a href=\"http:\/\/ebn.bmj.com\/content\/19\/4\/123.full.pdf+html\">http:\/\/ebn.bmj.com\/content\/19\/4\/123.full.pdf+html<\/a><\/p>\n<p>Chronic pain is ubiquitous in health care and in life. \u00a0Given this, we, ourselves, need to make a commitment to continue in this trend of exploring alternative, non-pharmacological methods to help our patients cope with and thrive despite chronic pain. \u00a0Encouraging them to try CBT or ACT may be a first step.\u00a0 Conducting research to better understand the complexity of chronic pain and viable treatment options is another essential step.<\/p>\n<p>1.\u00a0 ACBS. (n.d.)\u00a0 ACT. Acceptance and Commitment Therapy.\u00a0 Retrieved from: \u00a0<a href=\"https:\/\/contextualscience.org\/act\">https:\/\/contextualscience.org\/act<\/a><\/p>\n<p>&nbsp;<\/p>\n<p>&nbsp;<!--TrendMD v2.4.8--><\/p>\n","protected":false},"excerpt":{"rendered":"<p>By Roberta Heale, Associate Editor EBN, @robertaheale @EBNursingBMJ Pain is an essential part of life.\u00a0 It tells us when and where we\u2019ve sustained an injury.\u00a0 This acute pain ensures that we seek out and address the problem at hand.\u00a0 However, some pain continues for much longer than necessary. Pain signals remain active, muscles tense in [&#8230;]<\/p>\n<p><a class=\"btn btn-secondary understrap-read-more-link\" href=\"https:\/\/blogs.bmj.com\/ebn\/2016\/10\/23\/chronic-pain-management-moving-beyond-pharmacotherapy\/\">Read More&#8230;<\/a><\/p>\n","protected":false},"author":169,"featured_media":0,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[],"tags":[3643],"class_list":["post-1041","post","type-post","status-publish","format-standard","hentry","tag-pain-management"],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v27.5 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>Chronic Pain Management: Moving Beyond Pharmacotherapy - Evidence-Based Nursing blog<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/blogs.bmj.com\/ebn\/2016\/10\/23\/chronic-pain-management-moving-beyond-pharmacotherapy\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Chronic Pain Management: Moving Beyond Pharmacotherapy - Evidence-Based Nursing blog\" \/>\n<meta property=\"og:description\" content=\"By Roberta Heale, Associate Editor EBN, @robertaheale @EBNursingBMJ Pain is an essential part of life.\u00a0 It tells us when and where we\u2019ve sustained an injury.\u00a0 This acute pain ensures that we seek out and address the problem at hand.\u00a0 However, some pain continues for much longer than necessary. Pain signals remain active, muscles tense in [...]Read More...\" \/>\n<meta property=\"og:url\" content=\"https:\/\/blogs.bmj.com\/ebn\/2016\/10\/23\/chronic-pain-management-moving-beyond-pharmacotherapy\/\" \/>\n<meta property=\"og:site_name\" content=\"Evidence-Based Nursing blog\" \/>\n<meta property=\"article:published_time\" content=\"2016-10-23T16:39:44+00:00\" \/>\n<meta name=\"author\" content=\"rheale\" \/>\n<meta name=\"twitter:card\" content=\"summary_large_image\" \/>\n<meta name=\"twitter:label1\" content=\"Written by\" \/>\n\t<meta name=\"twitter:data1\" content=\"rheale\" \/>\n\t<meta name=\"twitter:label2\" content=\"Est. reading time\" \/>\n\t<meta name=\"twitter:data2\" content=\"2 minutes\" \/>\n<script type=\"application\/ld+json\" class=\"yoast-schema-graph\">{\"@context\":\"https:\\\/\\\/schema.org\",\"@graph\":[{\"@type\":\"Article\",\"@id\":\"https:\\\/\\\/blogs.bmj.com\\\/ebn\\\/2016\\\/10\\\/23\\\/chronic-pain-management-moving-beyond-pharmacotherapy\\\/#article\",\"isPartOf\":{\"@id\":\"https:\\\/\\\/blogs.bmj.com\\\/ebn\\\/2016\\\/10\\\/23\\\/chronic-pain-management-moving-beyond-pharmacotherapy\\\/\"},\"author\":{\"name\":\"rheale\",\"@id\":\"https:\\\/\\\/blogs.bmj.com\\\/ebn\\\/#\\\/schema\\\/person\\\/4d6c0669182b39dd438efb3fe94d7f64\"},\"headline\":\"Chronic Pain Management: Moving Beyond Pharmacotherapy\",\"datePublished\":\"2016-10-23T16:39:44+00:00\",\"mainEntityOfPage\":{\"@id\":\"https:\\\/\\\/blogs.bmj.com\\\/ebn\\\/2016\\\/10\\\/23\\\/chronic-pain-management-moving-beyond-pharmacotherapy\\\/\"},\"wordCount\":383,\"commentCount\":1,\"publisher\":{\"@id\":\"https:\\\/\\\/blogs.bmj.com\\\/ebn\\\/#organization\"},\"keywords\":[\"Pain Management\"],\"inLanguage\":\"en-US\",\"potentialAction\":[{\"@type\":\"CommentAction\",\"name\":\"Comment\",\"target\":[\"https:\\\/\\\/blogs.bmj.com\\\/ebn\\\/2016\\\/10\\\/23\\\/chronic-pain-management-moving-beyond-pharmacotherapy\\\/#respond\"]}]},{\"@type\":\"WebPage\",\"@id\":\"https:\\\/\\\/blogs.bmj.com\\\/ebn\\\/2016\\\/10\\\/23\\\/chronic-pain-management-moving-beyond-pharmacotherapy\\\/\",\"url\":\"https:\\\/\\\/blogs.bmj.com\\\/ebn\\\/2016\\\/10\\\/23\\\/chronic-pain-management-moving-beyond-pharmacotherapy\\\/\",\"name\":\"Chronic Pain Management: Moving Beyond Pharmacotherapy - 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