Case-Studies: 1-2-1 Injury and Pain Psychology Support
Alice started to have frequent and excruciating lower, back pain whilst working long hours at her computer to meet an important contract deadline. She made adjustments to her workstation, took over-the-counter pain meds, stretched when the pain become too intense, and often put hot water bottles behind her back. After a few weeks, the pain also came when she was in restaurants/pubs or travelling for long periods.

On seeing a physiotherapist, she was given several exercises to complete which she did as instructed. After a few sessions, the physio said that her pain had no physical cause and that she ‘needed to change her life’. Feeling angry and abandoned, she didn’t know what to do. The pain had to go, but she was happy with her life and proud that she’d achieved a good work-life balance.

The daily pain stopped when the important contract finished, but it returned a couple of times a week. She became wary of meeting up with friends in pubs and restaurants, playing with her child, and dreaded, the unpredictable and painful ‘bad work days.’ Worrying of the pain’s potential to have long-term affect on her life, she decided to see whether psychology might help.

When we started to talk, Alice realised the unhelpful pain beliefs that led her to think and act in ways that made the pain worse. With a few hours of support, she had a better general and personal understanding of what causes pain and what to do to prevent and manage it. Helped by being able to talk more confidently about her pain and needs, she started to make small adjustments at work and within her personal life.

Now, Alice has pain very occasionally. When she feels it coming on, she acts quickly to stop it. In essence, she is continuing life as normal, and no longer fears that pain will affect her future life.

James’s physio suggested we might be able to help him. 10 months after being diagnosed with Achille’s tendonitis, his Achilles was strong, but nerve-type symptoms persisted.

Prior to injury, James’s active life was an important part of his identity and his physical, mental and social health. He regularly ran 10k races and trained 5-8k, 3x/week. A small niggle, became worse, until James was no longer able to exercise or complete normal life activity. This, the continuing pain, and lock-down, left James feeling very low. Eventually, he saw his doctor who prescribed a low dose of medication to reduce his anxiety.

When our support started, James had carefully progressed to an easy, 20-minute jog on the flat. His mental health had to some extent improved, but he remained low in energy, deeply frustrated by the ‘unfairness’ of the injury, and saddened by his inability to live life as he wanted and its effect on others. He felt unable to move freely and wary of doing any normal life activity that might overload the Achilles or that required quick or certain movements: When he did so, the pain remained for a number of days.

Over 5 sessions (3 months) of our support, James worked hard to:
• Understand the causes of his pain and how to prevent and manage a flare-up.
• Cope better with the ‘unfairness’ of the injury and with the ‘not so good days.’
• Overcome his fear of movement and to have a more flexible approach to exercise that satisfied his exercise motives.

By the end of our support, James rarely had ‘bad days’. He felt more positive, more energetic – especially in the mornings, and better able to cope: He was also confident enough to stop his medication. He was able to enjoy training without fear and increased his training load to successfully complete a 10K race.

A few months later, James got back in touch to say that he’d completed a ½ marathon. Although slow in comparison to previous times, he saw it as one of his best ever races and proud for what he had overcome. He was also delighted that his new mental approach and coping strategies had enabled him to run better than he had thought possible.