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Why Are You So Guarded About Your Pain?

That may be a strange question to hear from your therapist who you just told about your pain, but the question still stands. However, instead of guarded meaning secretive, it means why is your body behaviour protecting the painful area.

We all have been through this at one point of our lives where we have injured or sprained some parts of our body like our ankle for example. Whilst the ankle is still painful, we avoid putting weight on it; relying more on the other ankle to carry our weight. This behaviour is known as “guarding”. In this case, we are “guarding” our sprained ankle. This is perfectly alright and makes perfect sense.

Forgetting to Stop Guarding

The problem arises when we forget to “stop guarding” even after the sprained ankle has healed and no longer painful. And since guarding is not a natural in terms of your body’s movement, it tends to place extra strain and stress of some parts of your body. In this example, the “other” ankle continues to bear extra weight.

A very common situation is spraining your lower back. When having the initial episode of low back pain, we tend to be very careful with our movements as our back hurts and the back muscles feel weak. But as time goes by and the pain becomes chronic, our lack of movement at the low back area stiffens up our spinal joints. These stiff joint further aggravate the situation and we become more guarded; perpetuating a viscous cycle.

 

 

Smashing through with Cognitive Behaviour Therapy.

One approach to treating chronic persistent pain of this nature is Cognitive Behaviour Therapy or CBT. Combining cognitive-behavioural interventions with pain reduction strategies is part of a multidimensional approach to managing persistent pain. Once pain reduction strategies have been attended to, there is benefit from an increasing focus on self-management.

Resolving “guarding” type issues is not as simple as just telling someone to stop guarding. There is a wide range of issues interacting that need to be resolved. In contrast to medical interventions targeted at diagnosis and/or pain reduction, CBT is targeted at specific problem areas identified in assessment, such as thought processes, emotions and behaviours that are not helping the person manage/cope as well as possible, for example:

  • Inactivity (activity/work avoidance)
  • Depressed/anxious/negative mood states
  • Unhelpful beliefs or fears
  • Excessive reliance on medication

So be mindful there may not be a specific physical cause for problem but may simply be your body’s movement and behaviour.

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