Chronic Pain

Pain is usually considered a physical phenomenon that signals a bodily disorder or injury.  However, pain is actually a complex experience that includes not only physical, but mental and behavioral aspects. Acute pain, or pain that has occurred as the result of an injury or disease, functions to limit movement and avoid re-injury so that proper healing can take place.  However, when pain continues beyond the normal time it would take tissues to heal and recover, the result is chronic pain.  In persistent chronic pain, psychological factors contribute to the bulk of pain-related suffering.  Such psychological factors often include fear of worsening pain, fear of re-injury, and other dysfunctional thoughts and behaviors that interfere with an individual's ability to return to a normal life.  Also, individuals taking opioid medications have typically increased their medication over time and have become dependent on it.  They feel too afraid to reduce or to stop the medication, despite side effects that may contribute to mental slowness, sedation, or disinterest.

Pain management psychologists have specialized training and experience in helping people manage chronic pain and guiding their return to a more normal life.  Pain psychologists usually provide an initial evaluation of an individual's perceptions of and responses to pain.  The pain evaluation typically consists of a comprehensive interview and additional

questionnaires designed  to assess how an individual thinks about and responds to pain.  Assessment of depression, anxiety, personality, and pain medication or other substance use is often part of the psychological pain evaluation. Based on the evaluation findings, a psychotherapeutic pain management program is tailored to the individual's symptoms, personality, social environment, and expressed goals and values.

Evaluations may also be done to assess whether an individual would benefit from spinal surgery or surgery with implantable pain treatment devices, such as opioid infusion pumps or spinal cord stimulators.  Such pre-surgical screening evaluations yield information about how the individual is likely to adapt to the device over time and whether psychological and behavioral treatment interventions would be helpful or necessary as an adjunct to medical treatment.





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