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    When Your Pain Medication Isn't Working

    What your next steps might be in treating your chronic pain.

    Putting Your Mind to Work

    "Most people with chronic pain are never 'cured' [of their pain], and that's a difficult thing to be told. Our society tells us if you're in pain, you shouldn't be," says Beverly Thorn, PhD, of the University of Alabama.

    She's a psychologist who works with people in chronic pain to help them find new ways to think about it. The brain can be a powerful ally -- or enemy -- during chronic pain. That's because:

    • Your brain filters the pain signals coming from your body. Your thoughts and emotions play a role in this filtering. The brain can dampen the strength of these pain signals or ramp them up, Thorn tells WebMD.
    • Over time, the brain can become more sensitive to chronic pain. It may overreact to even less intense pain signals.

    Cognitive-behavioral therapy (CBT), an approach that Thorn uses with patients, can address both issues, she says. CBT helps people:

    Change their pain-related thoughts. "If the thought of a pain flare-up makes you say things to yourself like, 'I'll have to go to the ER for sure,' or, 'I can't stand this anymore, this is ruining my life,' it can really dig a hole for you," Thorn says.

    Pain control involves noting negative self-talk and replacing these thoughts with factual, positive options, like focusing on the good parts of your life.

    Change their behaviors. "When they have a pain flare-up, many people go to bed, pull the covers up, and withdraw. This makes them more susceptible to pain, and it can make them depressed," Thorn says. CBT can help people follow their usual routines even during flares.

    A psychologist can also help you deal with your pain with a related technique: mindfulness. Instead of reacting when pain grabs your attention, mindfulness involves observing the pain with a neutral attitude. "When that reaction isn't there anymore, pain is easier to manage," Thorn says. "What people start to realize is that there's a lot of variability in their pain. If they really pay attention to their moment-to-moment experiences, they realize that sometimes they're pain-free."

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