email      DrSooHoo@sequoiacounselingoc.com                                                     
phone     949.337.1034                 
mailing address   340 E. 1st St. #291, Tustin, CA 92781         
Sequoia Counseling & Wellness Services OC offers virtual teletherapy services for California Residents  

Pain Conditions and Non-Drug Interventions to Aid Pain Management 

• Do you often feel like you can't stand the pain anymore? 
• Is your pain frequently so overwhelming that it affects your work or relationships?
• Are you so distracted by your worries that it is hard to focus on where you are or who you are with?

If you identify with any of the above thoughts, you are not alone! One in three people living in the United States suffers from pain. There are several different types of pain such as surgery related pain, burns, injuries, cancer related pain,  arthritis, fibromyalgia, and chronic pain associated with trauma.  When you experience bodily pain, your nervous system alerts you to prevent additional physical harm, as a biological function to ensure your survival. When there is an injury, the nerves send signals to protect the body and the injured area. Once the injury heals, these nerves usually relax and return to a normal level of functioning. If the nerves persist in a heightened sensitivity state, your pain can continue even though the injury is healed. Changes to the brain and nervous system can occur as a result, leading to chronic pain (Thorn, 2017). Retrain Pain offers this brief lesson to help explain why we have pain.   

iasp-pain.org

​In 2020, the International Association for the Study of Pain (IASP) Task Force revised the definition of pain based upon almost 40 years of clinical and research findings. This revision is intended to better reflect the nuances and complexity of pain and to support better pain assessment and treatment. 

   To date, pain is considered "An unpleasant sensory and emotional experience associated with, or resembling that associated with, actual or potential tissue damage."

A Brief Word on the Assessment of Pain

There are different ways to describe and measure pain. Aside from considering the frequency, intensity, and duration of your pain sensations, we also want to consider how it impacts your daily living. When you perceive that your pain is moderate to severe and is affecting your quality of life more than it should, psychological consultation is a necessary aspect for your pain management treatment team. To help you identify ways that pain can impact daily living, I invite you to complete the PROMIS Scale for Pain Interference: 

Available Pain Treatments and Self-Management

​The current opioid epidemic draws attention to the critical need for better pain treatment options. Opioid use risks include suicide and opioid misuse and harm. In 2019, the United States Health and Human Services Department (HHS) released a Pain Management Best Practices document.

The Task Force recommends using treatments from one or more areas which may include:

• medication: Non-opioid options include- acetaminophen, nonsteroidal anti-inflammatory drugs (NSAIDs), antidepressants, anticonvulsants, musculoskeletal agents, or anxiolytics                            
• restorative therapies: PT/OT services, TENS unit, massage, cold/heat
• interventional procedures: minor outpatient procedures such as injections & nerve blocks
• behavioral health: behavioral therapy, cognitive behavioral therapy, acceptance and commitment therapy, mindfulness based stress reduction 
• complementary and integrative health: acupuncture, massage, yoga, tai chi

Here are a couple of images for public health promotion of a multidisciplinary approach to pain treatment: 

I am able to work with most patients living with pain through my psychology residency training, postdoctoral fellowship training, and experience in physical rehabilitation facilities, dialysis center, and primary care community health clinic. I am also a certified Empowered Relief Class Instructor. I believe that a coordinated healthcare team approach is the best way to support you in managing your pain, reducing medication use, and restoring your functioning and quality of life. 

​Pain conditions I treat include:

• Back pain
• Headache & Migraines
• Fibromyalgia
• Musculoskeletal Pain
• Abdominal Pain
• Mood Changes associated with pain conditions (up to 85% of chronic pain sufferers have co-occurring depression)
• Quality of life changes due to pain or disability

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If you don't see your pain condition here, I may still be able to help you.. just ask!

Recommended pain management interventions include:

• education 
• cognitive therapy and changing harmful thoughts/beliefs
• stress management
• communication skills related to stress and pain experience
• relaxation training, mindfulness techniques 
• management of anxiety and depression symptoms 
• cognitive behavioral therapy for sleep 
• support in coping with other pain treatment modalities (OT/PT for example) 
• emotional support and coping with the healthcare system, medical procedures, etc. 

Barriers to a Coordinated Pain Management Approach with Psychological Treatment

Unfortunately, it is not uncommon for healthcare providers to prescribe medication without considering or educating about the emotional or lifestyle factors that may influence your pain levels. Our healthcare system tends to operate in "silos" such that physicians don't have many psychologist referral sources to collaborate with on pain issues. Unfortunately psychologists are more likely to be involved only as a "last resort" when medication/medical interventions haven't worked. There is also undue stigma associated with counseling referrals.
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How Will Counseling/Therapy Help My Pain Condition? 

• Regular practice of coping strategies learned in counseling can reverse any nervous system/cognitive changes associated with pain response. 
• Counseling/therapy can help to decrease your pain levels, improve coping with your condition, and prevent your overall health from declining.  In addition to the information presented in the IASP infographic to the left, other medical providers also emphasize the importance of counseling to address concerns with sleep, stress, and lifestyle behaviors so that the pain and impairment doesn't worsen. Click here or here for more.

I would welcome the opportunity to work with you and consult with your healthcare team to identify new strategies to help with pain
self-management. Call or email for more information.
            - Dr. Melissa Soo Hoo