Welcome to Act for Pain

Acceptance & commitment therapy is a psychological technique which is used to deal with a struggle that an individual may face in their life.

It has been widely used to deal with the people suffering with pain.

ACT based on the idea that trying to get rid of a trauma or distress can often make the problem bigger and make you feel worse, more anxious and depressed.

The “Act for Pain” program shows you how you can make room for the chronic pain you experience but still live a life that is true to you.

You’ve probably heard a lot about mindfulness. Mindfulness simply teaches you how to be more in the present and it’s a way of observing or experiencing the moment.

However, before we go any further, it is important to say that mindfulness is but one component of this program and we recognise it is not for everyone. You will see that all the participants struggle with it. The program offers many other choices, options and strategies to help you understand and manage your pain better.

Now, back to mindfulness- the reason it is useful in chronic pain is that often we develop a whole range of unpleasant thoughts and emotions in relation to the ongoing pain. These emotions can magnify the issues surrounding your chronic pain and it becomes all encompassing. This in turn can increase the perception of pain and the whole scenario snowballs.

By learning to be more mindful, we find that people became more able to see their pain in a different way and are able to live with that unpleasant experience and not let it cause so much emotional distress. This in turn in helps them put more the time and energy into things that they really care about and they say that their life becomes more fulfilling and their pain doesn’t impact on their day to day actions as much as it used to.

This leads to another important part of the course which is about identifying what is really important to you and how you can move towards those values. So, we talk about living a “Valued Life”.

Overall, ACT is proving to be very useful using these simple principles.

“ACT for Pain” is not designed to reduce your pain intensity but directed to helping you cope with the mental anguish it causes everyday- fear, anxiety, low mood and depression. However, there is a growing evidence base that this type of program can actually lead to significant reductions in pain levels (e.g., see Digging Deeper, entry 6th October 2021- a review of a recent scientific paper relating to chronic back pain). By reducing the emotional distress, in a very real organic, neurotransmitter level, pain transmission can be reduced.

Watch the videos on how pain is generated in the chronic pain pathway- pay special attention to what happens with the descending pathways. The animation talks about how the psychological state can impact on pain nerve transmission. You may find it helpful to understand what is being said here.

The animation explains the current theories about how pain neurotransmission and the psychological state are interlinked.

“Act for Pain” is pretty much suited to anybody with chronic pain.

There are some simple questionnaires that you can take which will tell you whether you are suitable for the program.

If you are feeling very depressed or suicidal, the questionnaires will identify that the programme is not for you and you will be provided some additional information about how to access help and support.

The program neatly fits in around other treatments such as tablets or injections you may be receiving for your pain.

The next few questions go through different categories of chronic pain and there will be a comment and advice given for each.

Nociceptive and neuropathic pain are two main categories of chronic pain which we talk about.

There is another type of pain which is often referred to called centralised pain condition. This usually refers to widespread body pain often referred to as fibromyalgia.

Nociceptive pain usually refers to ongoing pain from soft tissues such as ligaments, tendons, and muscles. It also relates to pain from joints where there is wear and tear or arthritis. Alex, one of the participants in the program has nociceptive pain from wear and tear of his lumbar spine.

Neuropathic pain occurs as a result of damage to any part of the pain pathway. This leads to the nerves behaving abnormally and this in turn can lead to changes in the way that the pain signals are processed in the spinal-cord and the brain. There are animations such as the one on chronic pain pathway which will help you understand neuropathic pain better.

Examples of neuropathic pain are post herpetic neuralgia, diabetic neuropathy, trigeminal neuralgia (facial pain) post-surgical wound pain or scar pain, pain after amputation of a limb, multiple sclerosis.

Another category which is often overlooked is neuropathic pain after a spinal cord injury- if you become paralysed or partially paralysed from the waist, chest or from the neck down.

Complex regional pain syndrome is also widely considered to be a type of neuropathic pain condition and Kamal, one of the participants in the program is living with this condition.

Many pains are a combination of both nociceptive and neuropathic. Paula, another one of the participants has both neck and arm pain which is a combination of both these types of pain.

Also, if you have fibromyalgia, this program would be suitable for you. Lucy another participant has this condition and like many others has found that the treatments available haven’t worked for her.

So if you experience chronic nociceptive pain or you have been diagnosed with neuropathic pain or fibromyalgia, this program would be suitable for you but the important thing is- you should have discussed your pain condition with your doctor, GP or family doctor or had treatment with a specialist.

It is important in all these pain conditions that you’ve tried physiotherapy, pain medication or tablet optimisation and you may have had or have ongoing injection treatments.

Many pain conditions, no matter what we try to do to reduce the intensity unfortunately still continues to have a daily intrusive impact and causes emotional distress.

If your pain changes and takes on a different character, you should tell your doctor and discuss it with them.

Cancer pain is usually caused by both nociceptive and neuropathic pain.

“ACT for Pain” is suitable for you but it is important that your doctor and your cancer specialist are informed if you decide to go on this program.

Again, your cancer specialist (and the associated pain clinic) should have tried to reduce your pain by optimising your pain tablets and possibly they would have tried some injection treatments as well.

If your pain changes significantly, you should obviously discuss it with your treating doctors.

Generally speaking these are considered nociceptive chronic pains. Usually antibodies which your body produces have attacked your joints, ligaments, muscles, and other soft tissues in your body.

Most likely you will have seen a specialist called a Rheumatologist or that’s what we call them in the UK.

You will have probably had at some point oral steroids, injections of steroids, immunosuppressant treatments.

“ACT for Pain” should help you with the emotional and psychological distress that these painful conditions cause.

It’s important to continue to have treatment with your Rheumatologist and inform them that you are embarking or taking on this program.

We believe “ACT for Pain” neatly fits around your ongoing treatments for these types of conditions.

One of the unique benefits of this program is that you can put your queries directly to the pain experts who will provide a personalised response.

However, you should understand that this program is not designed to give any specific advice about your tablets or changing doses etc. But we can offer some general advice and guidance which you can take back and discuss further with your family doctor or specialist.

We will ensure that you feel fully supported throughout your journey with 'ACTforPAIN'.

We anticipate that you will re-visit the program from time-to-time after completing it and again we will be on hand to provide all the support you need.

The program is online and you can access it any time.

We have written the program in such a way that you should feel part of the group session that you are watching. When the expert asks the participants a question – you can press the pause button and think how this applies to you.

There are worksheets to guide you through each session, clearly explaining the:
i) Aims of each session
ii) Questions to ask yourself as you are watching

You can join in with the mindfulness exercises. They are also edited out and available for you to add into your “Favourites section” so you can access them quickly.

Whether you choose to do it by yourself or with someone else is really down to you. It might be helpful to do the course with a friend or a family member (perhaps someone who is being impacted on by your pain) or somebody else who you know has chronic pain.

We think you will do better taking the time to ask yourself and thinking about the questions that are put the participants, taking part in the mindfulness exercises and doing the homework.

All the home work sheets given to the participants are available to view and download.

You may also just benefit from just watching the program a few times and gradually learning the techniques involved.

We should say however that the program requires thought and reflection.

Generally, we would advise you to do one session or module per week. We think it takes that time to assimilate the ideas and concepts that are discussed. It should take eight weeks to complete from start to finish.

It is difficult to predict when you should see the benefits but you should at least leave a month after completing the entire program and you should apply the techniques that you learn about.

You can track your progress by the taking the questionnaires again. It acts as a kind of dashboard.

The beauty of having an online program is that you can go back and watch certain sections again. We think you will see something new with re-visiting it in this way.

Actual pain management programs which you might attend once a week over 2 months cost from £2000 upwards (in the UK) and so we feel our program represents good value for money.

Further, it is also the case that actual programs offer only one or two follow up appointments. With 'ACTforPAIN' you have a lifetime of access to support via email or for as long as you wish to subscribe.