How Mental Health Therapy Can Help Manage Chronic Pain

Pain is your body’s way of telling you that something is wrong. Maybe you sprained your ankle or are coming down with a cold. Usually, the pain goes away once you’ve recovered. However, sometimes it lasts for months or even years. This is called chronic pain — pain that lasts longer than 3 months. 

About 50 million people in the U.S. have chronic pain. Many turn to medication for relief. But did you know that therapy may also help? 

If you’ve been dealing with chronic pain, read on. We explain how therapy can help, three effective types of chronic pain therapy, what to expect, and how to find a therapist to help you manage chronic pain. 

How can therapy help with chronic pain?

“Therapy can help folks avoid and/or reduce thought processes that typically make their pain worse, such as focusing on how bad their pain is (pain catastrophizing) or focusing on their fears around their pain getting worse (fear of pain),” says Dr. Elena Welsh, a licensed clinical psychologist based in Los Angeles, California. 

She adds, “Think of therapy as a part of your larger pain management treatment plan that will likely still include some form of medical monitoring and/or intervention.”

But does getting therapy mean your chronic pain is all in your head?

“Not at all,” says Welsh. “Chronic pain is a real medical condition. However, there are many things we can do with our thoughts or behavior that can make things worse and/or better.”

That said, chronic pain can take a toll on your mental health. This is because chronic pain is not just a physical sensation. It also has psychological and emotional aspects. Chronic pain can lead to mental health issues, such as anxiety and depression.

The good news is that therapy can improve your mental well-being and help you manage chronic pain. Welsh says that if you’re feeling depressed, therapy can help you learn new skills to live with chronic pain. 

You might work with a therapist to identify ways to distract yourself from pain with activities that make you laugh, for example. “Therapy can help teach tools like activity pacing to help someone stay as active as they can, despite their pain,” says Welsh.

What types of therapy are recommended for people with chronic pain?

When seeking therapy for chronic pain, you may come across different approaches. Below are three types of therapy that research shows can help people with chronic pain. 

Cognitive behavioral therapy (CBT) for chronic pain

CBT is a form of psychotherapy. It can help you recognize and change thoughts and behaviors that make it difficult to cope with chronic pain. 

For example, you may have thoughts during a pain flare-up like, “I will never survive this pain.” This thought will probably make you feel even worse. A CBT therapist can help you shift your thinking. Then, it may be a little easier to manage whatever chronic pain throws at you. 

CBT can help you in other ways too. Welsh says, “You will also learn pain management techniques, such as activity pacing and distraction.” She adds that you “will work collaboratively with your therapist to identify ways you can enrich your life, despite your pain.”

Several studies conclude that CBT can help people manage chronic pain associated with various health conditions. For instance, one study showed that CBT helped reduce pain and depression for people with multiple sclerosis (MS). 

Acceptance and commitment therapy (ACT) for chronic pain

ACT is a modern type of therapy that uses mindfulness. It can help you accept your thoughts and experiences as they are rather than trying to change them. 

With ACT, your therapist will guide you through six principles:

• Connecting with the present moment

• Keeping a balanced view of your thoughts and feelings

• Clarifying what really matters to you — such as your values and goals

• Making a commitment to your values and goals

• Accepting discomfort as part of the process of changing your behaviors

• Recognizing that thoughts are not always factual

Welsh says, “Although we have less research on [ACT], it is showing promise so far in regards to reducing pain ratings, improving depression, and reducing the use of opioid pain medications.” 

Mindfulness-based therapies for chronic pain

Besides ACT, there are other mindfulness-based therapies that can help with chronic pain. For example, mindfulness-based stress reduction (MBSR) uses yoga and meditation. It can help you become more in tune with your body and reduce pain and stress. 

It can be hard to know which chronic pain therapy to choose. You can ask your healthcare provider for suggestions on what they might recommend. 

Welsh suggests that most people would benefit from starting with CBT. “CBT has the most evidence base for pain management,” she says. “I would start here if this is someone's first time seeking therapy for chronic pain.”

What to expect from chronic pain therapy

So what can you expect from therapy for chronic pain? Though it won’t make your chronic pain go away, it can provide other benefits. 

“[Therapy] can reduce your level of pain sensation and give you tools to manage it, such as relaxation or distraction techniques,” says Welsh. “Therapy can also help you feel less hopeless or defeated in regard to your pain.”

The number of therapy sessions your provider might recommend will depend on the type of therapy. For example, Welsh says, “A typical course of CBT therapy is weekly for 10 to 20 weeks. However, you should expect to have new tools for pain management and reducing the emotional burden of your pain within three sessions.” 

Welsh says that you can ultimately expect the following benefits from chronic pain therapy:

• Knowledge of how to manage your pain

• Reduced depression and anxiety levels related to chronic pain

• Tools to catch thought patterns that worsen pain 

• Strategies to live a full, meaningful life despite chronic pain

“In turn, this can help you reduce your need for prescription medications and reduce your risk for long-term physical disability,” she says.

Additional ways to manage chronic pain 

Keep in mind that therapy is just one aspect of chronic pain management. To understand all of your options, you can speak with your healthcare provider. They may refer you to a pain management specialist who can help determine the best ways to manage your pain.

Examples of other chronic pain management options include:

• Non-steroidal inflammatory drugs (NSAIDs) and acetaminophen (Tylenol)

• Antidepressants or anti-seizure medications (for nerve pain)

• Nerve blocks, ointments, or creams

• Alternative treatments like acupuncture and massage therapy

• Electrical nerve stimulation

• Physical or occupational therapy

Where to find a therapist for chronic pain

Your healthcare provider can refer you to a mental health professional who specializes in chronic pain. You can also look for a chronic pain therapist by:

• Searching the internet 

• Asking friends and family

• Reaching out to your insurance provider

• Checking with your local community health center

Before your first session with a therapist, consider asking them certain questions to see if they’re a good fit for you. These questions may include:

• Do you specialize in chronic pain?

• Which chronic pain therapies do you offer?

• When can I expect to see results?

• Is there homework involved?

• How many sessions will I have?

In the end, dealing with chronic pain is your journey. For this reason, it’s important to choose a therapist who will support you and help you set realistic goals. With their help, you can face the emotional challenges that can come with chronic pain. 

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Written by:

Kara-Marie Hall, RN, BSN, CCRN

Kara-Marie Hall, RN, BSN, CCRN, is a registered nurse who specializes in writing health content that connects with everyone — no matter where they are in their health journey. She has over 10 years of clinical experience in a variety of specialties, including critical care, surgery, and hospice.

Edited by:

Renée Fabian, MA

Renée Fabian is the senior pet health editor at GoodRx. She’s worked for nearly 10 years as a journalist and editor across a wide range of health and well-being topics.

Reviewed by:

Mona Bapat, PhD, HSPP

Mona Bapat, PhD, HSPP, has 15 years of clinical experience providing therapy. She is a licensed clinical psychologist in Indiana and Illinois with treatment experience in individual, couples, family, and group therapy modalities.

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