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I suffer from chronic low back pain. I notice that I've started saying things to myself like, "I can't do that because my back won't let me" instead of ignoring it like I used to. I think I'm losing ground and I don't know why. How can I get back to a more positive frame-of-mind?

Many people who suffer from chronic pain of any kind share your experience. Pain can be tiring. Over time, the effects of chronic pain can wear down even the most positive, optimistic folks. But the good news is there are ways around this and trained professionals to help you. Counselors, psychologists, and behavioral specialists have techniques they use and can teach patients to use to improve thoughts and coping strategies when dealing with chronic pain. For example, cognitive therapy teaches people to be aware of their inner thoughts and replace the negative ones with more positive, helpful thinking. The concept is that "thoughts are not necessarily the truth, they are just thoughts" that can be changed to affect how we live and function. Coping skills along with time and activity management (including scheduling pleasant activities) is another type of cognitive therapy. Accepting pain in a way that allows patients to live based on goals and values rather than on feelings, thoughts, and pain falls under the category of acceptance-based cognitive-behavior therapy. A slightly different approach using hypnosis involves suggestions for ways to think about and experience pain. Many people who try hypnosis report decreased pain intensity. Studies show that combining hypnosis with cognitive therapy yields even better results. Not too different from hypnosis are the self-relaxation procedures used by some patients. Relaxation techniques usually involve contracting and relaxing muscles, biofeedback, or listening to instructions (suggestions) to train the body to relax. Research has shown that this approach works by changing patients' beliefs about what they can do for themselves. Reducing the stress response and experience of pain results in less perception of pain. You may find one technique works well for you while others do not. Some patients combine two or more approaches for the best results. It may take a bit of time but with trial and error, you should be able to find the method(s) that work best for you. Recognizing there's a problem is the first step. You are already well on your way!

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