Activities Training: Integrating Behavioral and Cognitive Methods with Physiotherapy in Pain Management

For chronic pain sufferers, the path back to work or to other productive activity can be a long and complex one of overcoming both physical and psychological obstacles. These obstacles can be effectively addressed, and patients enabled to return to their previous activities and to achieve valued goals, by pain management. The major practical components of this are physical retraining, steady increase in range and extent of abandoned and novel activities, and adoption of a realistic model of pain and of its impact on lifestyle. The entire program is underpinned by behavioral and cognitive principles, and these are also used directly to reduce unhelpful beliefs and distress. These components must be integrated, or progress from work in any one area is limited by lack of change in others. This paper describes activities retraining using pain management, based on the work of INPUT, a London-based unit.