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Column: Behavioral health and chronic pain

Provided by UCHealth

Chronic pain can be a devastating condition. But with an integrative approach that involves both physical and behavioral health treatments, people can find relief.

Amy Goodwin, a licensed professional counselor and behavioral health specialist UCHealth Behavioral Health Clinic in Steamboat Springs who also sees patients at UCHealth Primary Care in Craig, describes how behavioral health is an important part of treating chronic pain.

First steps first

When treating chronic pain, it’s important to first calm down overactive nerves that continually message there’s pain, even after the injury or illness has healed.



“There’s a physical issue, in that the nerves are on and hyper-firing, but the off-switch is still in the brain,” Goodwin said.

Interventional procedures can help disrupt the hyperactive nerve, so that further treatments — such as physical therapy, meditation, massage and acupuncture — can help.



After problem nerves are quieted

When the brain is no longer receiving constant signals of pain, behavioral health treatments come into play.

“It’s my job to take advantage of that so people can enhance their physical functioning by quieting their mind and their central nervous system,” Goodwin said.

Patients are invited to choose behaviors that help their overall health and functioning: for instance, following a healthy diet and committing to regular exercise.

“The more people are building muscle and maintaining a certain level of health, the better their body can recover,” Goodwin said.

And, Goodwin helps patients identify how their pain affects their overall thoughts.

“When we have a pain response that’s turned on in our body, we increase our brain’s focus on other worrisome issues and ideas,” Goodwin said.

The importance of thought patterns

Slowly, patients are able to think about their situation in a more positive or accepting way.

For instance, if someone is struggling with wanting to be at the same physical level they were before their injury or illness, they can learn to accept their functional level at that moment.

“We have to accept where we are and be mindful of that, instead of being in a rush to get back to where things were before the accident or surgery,” Goodwin said.

Goodwin can also help patients identify and address beliefs that may actually be preventing healing and recovery. That includes “all or nothing” thinking such as, “If I can’t be a top athlete, then it’s not worth it to do anything,” which can create a sense of defeat or helplessness and undermine recovery.

Dispelling pain myths

Though we feel pain in our physical bodies, pain itself isn’t just a physical issue. “Pain is always an interplay between the injury and the body and brain’s interpretation of the injury,” Goodwin said. “It’s like a dialogue between the brain and body. It’s not just in your head, but it’s not just in your body.”

And even with treatment, chronic pain may not simply go away.

“Our pain awareness is not like an on/off switch — it’s like a dimmer dial,” Goodwin said. “We might not ever be able to turn pain off entirely, but we can definitely teach people strategies to dim it.”

When to seek help

A lot of healing can take place within three to six months of an injury or illness. But if there isn’t substantial change after that, people should get help.

“If people are starting to experience chronic pain, the quicker they respond by getting the support and information they need, the better their outcomes,” Goodwin said. “It’s more important than ever for people to seek help when they need it.”


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