Barriers to Overcoming Chronic Pain

There are three main reasons why people have such a difficult time overcoming pain. They are:

1. Fear of making the injury or condition worse.

2. Fear avoidance behavior that keeps us from using the injured body part or parts.

3. Many healthcare professionals are afraid to advise patients to do more because they don't want to be blamed for an increase in pain level.

I want to discuss each of these in more detail.

At first glance, it may seem reasonable to avoid pain because it can be an indication that the injury is being worsened. In the early stages after a traumatic injury, there is a period of time during which it is helpful to immobilize the injured area. But at a certain point, movement and function have to be restored and that requires us to gently challenge the injury to promote healing.

Fear avoidance behavior refers to the habit that people in pain often develop. It refers to when all movements or activities which bring out pain are strictly avoided for fear of making things worse and creating more pain. The result is a sedentary, unproductive lifestyle where muscles get tighter and more painful and then atrophy producing weakness. Joints stiffen and lose range of movement. Pain cannot be overcome without regaining flexibility, strength and joint mobility.

Finally, healthcare practitioners feed into patient fears by instructing them to avoid anything that causes pain. They may understand that the patient has to exercise to get better but because they are afraid of being blamed for a worsening of pain and possibly being sued for malpractice, they tend to baby patients more than is necessary. In the end, they create more of a problem than the one they are trying to avoid.