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Promoting Healthy Lifestyle Behaviors in Patients with Persistent Pain

  • Patricia RobinsonEmail author
  • David Bauman
  • Bridget Beachy
Chapter

Abstract

Pain avoidance plays a central role in patients with persistent pain. Health-care professionals can help people with persistent pain through various lifestyle approaches, including values clarification and values connection exercises, mindfulness practices, and behaviors that promote commitment to change. Selected interventions should be implemented in primary care and specialty care settings due to the high prevalence of chronic pain. This chapter provides an evidence-based review of conditions associated with chronic pain, interactions between lifestyle behaviors and the experience of pain, and specific psychological interventions that promote lifestyle behavior change. A case example illustrates the deployment of recommended strategies in both individual and group formats.

Keywords

Chronic pain Lifestyle behaviors Acceptance and commitment therapy Primary care behavioral health 

Abbreviations

ACT

Acceptance and commitment therapy

APA

American Psychological Association

BHC

Behavioral health consultant

DDD

Degenerative disc disease

EHR

Electronic health record

NEEDS

Nutrition, exercise, enjoyment, don’t smoke or drink, and sleep

References

  1. 1.
    Buhrman M, Skoglund A, Hussell J, Bergstrom K, Gordh T, Hursti T, et al. Guided internet-delivered Acceptance and Commitment Therapy for chronic pain patients: a randomized controlled trial. Behav Res Ther. 2013;51:307–15.CrossRefPubMedGoogle Scholar
  2. 2.
    Dahl J, Wilson KG, Nilsson A. Acceptance and Commitment Therapy and the treatment of persons at risk for long-term disability resulting from stress and pain symptoms: a preliminary randomized trial. Behav Res Ther. 2004;35:785–802.CrossRefGoogle Scholar
  3. 3.
    Thorsell J, Finnes A, Dahl J, Lundgren T, Gybrant M, Gordh T, et al. A comparative study of 2 manual-based self-help interventions, Acceptance and Commitment Therapy and Applied Relaxation, for persons with chronic pain. Clin J Pain. 2011;27(8):716–23.CrossRefPubMedGoogle Scholar
  4. 4.
    Wetherell JL, Afari N, Rutledge T, Sorrell JT, Stoddard JA, Petkus AJ, et al. A randomized, controlled trial of acceptance and commitment therapy and cognitive-behavioral therapy for chronic pain. Pain. 2011;152:2098–107.CrossRefPubMedGoogle Scholar
  5. 5.
    Wicksell RK, Ahlgvist J, Bring A, Melin L, Olsson GL. Can exposure and acceptance strategies improve functioning and life satisfaction in people with chronic pain and whiplash-associated disorders (WAD)? Cogn Behav Ther. 2008;37(3):1–14.CrossRefGoogle Scholar
  6. 6.
    Wicksell RK, Kemani M, Jensen K, Kosek E, Kadetoff D, Sorionen K, et al. Acceptance and Commitment Therapy for fibromyalgia: a randomized controlled trial. Eur J Pain. 2013;17:599–611.CrossRefPubMedGoogle Scholar
  7. 7.
    Robinson PJ, Gould D, Strosahl KD. Real behavior change in primary care. Strategies and tools for improving outcomes and increasing job satisfaction. Oakland: New Harbinger; 2011.Google Scholar
  8. 8.
    Robinson P, Wicksell R, Olsson GL. Act with chronic pain patients. In: Hayes S, Storsahl K, editors. A practical guide to acceptance and commitment therapy. New York: Springer; 2005.Google Scholar
  9. 9.
    Merskey H, Bogduk N. Part III: pain terms, a current list with definitions and notes on usage. In: Merskey H, Bogduk N, editors. Title: classification of chronic pain. 2nd ed. Seattle: IASP Press; 1994.Google Scholar
  10. 10.
    National Institute of Neurological Disorders and Stroke. Pain: hope through research. http://www.ninds.nih.gov/disorders/chronic_pain/detail_chronic_pain.htm. Accessed 15 Aug 2014.
  11. 11.
    Cherney K. Musculoskeletal disorders. http://www.healthline.com/health/musculoskeletal-disorders#Definition1/health/musculoskeletal-disorders#Definition1. Accessed 15 Aug 2014.
  12. 12.
  13. 13.
    Ullrich PF Jr. Lumbar degenerative disc disease. http://www.spine-health.com/conditions/degenerative-disc-disease/lumbar-degenerative-disc-disease-ddd/conditions/degenerative-disc-disease/lumbar-degenerative-disc-disease-ddd. Accessed 15 Aug 2014.
  14. 14.
    NIH. Joint disorder. http://www.nlm.nih.gov/medlineplus/jointdisorders.html. Accessed 15 Aug 2014.
  15. 15.
    Weingarten TN, Moeschler SM, Ptasynski AE, Hooten WM, Beeebe TJ, Warner DO. An assessment of the association between smoking status, pain intensity, and functional interference in patients with chronic pain. Pain Physician. 2008;11:643–53.PubMedGoogle Scholar
  16. 16.
    Hooten WM, Shi Y, Gazelka HM, Warner DO. The effects of depression and smoking on pain severity and opioid use in patients with chronic pain. Pain. 2011;151(1):223–9.CrossRefGoogle Scholar
  17. 17.
    Arnow BA, Hunkeler EM, Blasey CM, Lee J, Constantino MJ, Fireman B, et al. Comorbid depression, chronic pain, and disability in primary care. Psychosom Med. 2006;86(2):262–8.CrossRefGoogle Scholar
  18. 18.
    Gureje O, Von Korff M, Simon GE, Gater R. Persistent pain and well-being: a World Health Organization study in primary care. JAMA. 1998;280(2):147–51.CrossRefPubMedGoogle Scholar
  19. 19.
    Arvidsson S, Arvidsson B, Fridlund B, Bergman S. Health predicting factors in a general population over an eight-year period in subjects with and without chronic musculoskeletal pain. Health Qual Life Outcomes. 2008;6:98.CrossRefPubMedPubMedCentralGoogle Scholar
  20. 20.
    Janke EA, Collins A, Kozak AT. Overview of the relationship between pain and obesity: what do we know? Where do we go next? J Rehabil Res Dev. 2007;44(2):245–62.CrossRefPubMedGoogle Scholar
  21. 21.
    Society of Clinical Psychology. Acceptance and Commitment Therapy for chronic pain. http://www.div12.org/PsychologicalTreatments/disorders/pain_general.php. Accessed 15 Aug 2014.
  22. 22.
    Hayes SC, Strosahl KD, Wilson KG. Acceptance and Commitment Therapy: the process and practice of mindful change. 2nd ed. New York: Guilford Press; 2012.Google Scholar
  23. 23.
    Johnston M, Foster M, Shennan NJ, Johnson A. The effectiveness of an Acceptance and Commitment Therapy self-help intervention for chronic pain. Clin J Pain. 2010;26:393–402.CrossRefPubMedGoogle Scholar
  24. 24.
    McCraken LM, Vowles KE, Eccleston C. Acceptance-based treatment for persons with complex, long standing chronic pain: a preliminary analysis of treatment outcome in comparison to a waiting phase. Behav Res Ther. 2005;43:1335–46.CrossRefGoogle Scholar
  25. 25.
    Vowles KE, Wetherell JL, Sorrell JT. Targeting acceptance, mindfulness, and values-based action in chronic pain: findings of two preliminary trials of an outpatient group-based intervention. Cognit Behav Pract. 2009;16:49–58.CrossRefGoogle Scholar
  26. 26.
    Vowles KE, McCracken LM. Acceptance and values-based action in chronic pain: a study of treatment effectiveness and process. J Consult Clin Psychol. 2008;76:397–407.CrossRefPubMedGoogle Scholar
  27. 27.
    McCraken LM, Gutierrez-Martinez O. Processes of change in psychological flexibility in an interdisciplinary group-based treatment for chronic pain based on Acceptance and Commitment Therapy. Behav Res Ther. 2011;49(4):267–74.CrossRefGoogle Scholar
  28. 28.
    Vowles KE, McCracken LM, Zhao-O’Brien J. Acceptance and values-based action in chronic pain: a three year follow-up analysis of treatment effectiveness and process. Behav Res Ther. 2011;49:748–55.CrossRefPubMedGoogle Scholar
  29. 29.
    Strosahl KD, Robinson PJ, Gustavsson T. Brief interventions for radical change: principles and practice of focused acceptance and commitment therapy. Oakland: New Harbinger; 2012.Google Scholar
  30. 30.
    Lundgren T, Luoma JB, Dahl J, Strosahl K, Robinson P, Melin L. The Bull’s-Eye Values Survey: a psychometric evaluation. Cogn Behav Pract. 2012;19:518–26.CrossRefGoogle Scholar
  31. 31.
    Parkerson GF Jr, Broadhead WE, Tse CK, Tse CK. The Duke Health Profile. A 17-item measure of health and dysfunction. Med Care. 1990;28(11):1056–72.CrossRefPubMedGoogle Scholar
  32. 32.
    Robinson PJ, Reiter JT. Behavioral consultation and primary care: a guide to integrating services. 2nd ed. New York: Springer; 2015.Google Scholar

Copyright information

© Springer International Publishing Switzerland 2016

Authors and Affiliations

  • Patricia Robinson
    • 1
    Email author
  • David Bauman
    • 2
  • Bridget Beachy
    • 2
  1. 1.Mountainview Consulting Group, Inc.ZillahUSA
  2. 2.Central Washington Family Medicine Residency ProgramYakimaUSA

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