Whether or not you know the specific cause of your pain, research has shown that stress, anxiety, or depression contribute in some way to most cases of chronic pain. That’s actually good news, because treatments are available to help.

The biggest stumbling block for most patients with chronic pain is accepting the suggestion that there could be a psychological component to their pain.

For many people, this may be due to the stigma still prevalent in our U.S. society that being depressed means you have a mental illness. Sometimes, it helps to understand that feeling stressed out or down due to pain is a natural reaction; it doesn't mean you have a mental illness or are weak.

Another common problem is that the pain is so real that it's hard to imagine it comes from anywhere other than where it actually hurts. But our brains are incredibly powerful, and that power can make us feel better or worse, depending on how it is used. Just think about the placebo effect — almost any treatment for any problem works to some degree on at least some people, for at least a while.

Here are some psychological approaches that may help you to better manage your pain:

Try to understand your pain experience.
We know that stress and anxiety worsen pain. If your underlying diagnosis is known, that may bring some relief. If you still don't have a diagnosis, take comfort knowing that you've had a thorough evaluation.

If nothing else was found, chances are your problem is only as severe as the pain, fatigue, and other symptoms you already have. If you accept and trust the idea that there's nothing else about to happen to you, that will reduce your suffering.

Set appropriate goals.
Unfortunately, it's very hard to cure chronic pain. A goal of reasonable pain control is much easier to achieve than trying to be completely pain free. And if you achieve your pain-control goal, you'll likely feel less stressed — thus reducing your pain even further.

Reduce stress.
There are many physical and mental treatments that can reduce both stress and pain. Consider biofeedback, aromatherapy, yoga, massage, acupuncture, Tai Chi, or hypnosis. This list is far from complete — anything that helps you to relax counts!

Consider counseling.
A psychologist or social worker, especially one with training and experience in treating people who have chronic pain, can be immensely valuable in helping you to understand your situation and reduce your stress.

Many people, even after they've accepted the idea that there is a psychological component to their pain, still have difficulty taking that mental step to psychotherapy. If you're not ready for formal counseling, remember that clergy, support groups, telephone or Internet hotlines, or even just a good friend can all be helpful.

Ask about medication.
There are several antidepressant and anti-anxiety medications available, including some over-the-counter and "alternative" or "natural" products. Some even have direct pain-reducing qualities, independent of their psychiatric effects.

I've never had a patient walk into my office asking for more pills to take — often the only thing tougher than convincing someone to seek counseling is getting them to take one of these medications — but if something can reduce your pain without causing significant side effects, why wouldn't you consider it?

These techniques probably aren't going to get rid of your pain entirely, but you're likely to achieve a much greater degree of comfort if you treat your mind in addition to your body!

Howard Levy, M.D.