The Pain Truth program helps patients focus on what they desire (i.e. quality of life) instead on what they don’t want (i.e. pain). Have you ever tried hard to not think about something? Imagine if every day you attempted to eliminate the thought of ‘flying elephants’ from your head. From the morning when you woke up, all through the day and just before you went to bed, you tried to get rid of ‘flying elephants’. Every day, you go on the internet and search, “How to get rid of flying elephants.”
The primary focus of the 6-week Pain Truth program is not to eliminate pain, but to teach patients to experience and savour daily life activities. When patients with chronic pain are taught to savour various experiences using their five senses, a reduction in their pain hyper-vigilance may occur. – Garland et al 2013
The second focus of the 6-week Pain Truth program is on gradual/graded exposure to patient-led goals and movements, for reversing a conditioned response.
Perhaps sometimes, the reason some of our patients feel pain when they sit and feel better when they stand has little to do with mechanical factors of the spine but everything to do with sitting being a conditioned response to experiencing pain. When standing and walking feel better, it may be due to the fact that they are simply avoiding the conditioned response.
Standing and walking may not be taking strain off the spine but may feel better as the postures make the brain feel safer. This excellent review paper summarizes the studies supporting the hypothesis that pain may sometimes not be mechanical, but a conditioned response. We make repeated futile attempts to fix muscles, joints and tendons which may actually be worsening the condition, further fueling into the pain experience.
Pain is stressful, but when it is sensed it is unpredictable and uncontrollable, the associated stress response and the perceived severity of the pain will be amplified. The third focus of the Pain Truth program is make patients once again feel in CONTROL of their body and their life; a sense of empowerment that THEY can control their symptoms.
“When the person gains control of situations through their own actions, anxiety diminishes.” –Boeke et al 2017
If you have a patient with persistent pain who is just not responding to PT and other medical interventions, please consider having them complete the Pain Truth program. You may find a Pain Truth Certified (PTC) healthcare provider on the website, or you may become one.