Pain stems from visible causes, a wound or break, but when the reason is less obvious a health psychologist can help.
Dr. Valeria Martinez-Kaigi, trained in clinical health psychology and behavioral medicine, adds unique expertise to address chronic pain for patients at the Hartford HealthCare Ayer Neuroscience Institute Spine Wellness Center.
“Health psychology understands the psychological, biological, social and environmental factors that all contribute to health, illness and disease prevention,” she said. “Pain is sensory like touch, sight and smell, and an emotional experience reflecting mood state and anxiety. Mood and anxiety can influence one’s sensory pain experience and vice versa.
“This bidirectional nature, especially with chronic pain, reflects dynamic biopsychosocial processes.”
The neuroscience of pain, she added, is complex, with many parts of the brain contributing to the experience of pain, including the limbic system and anterior cingulate cortex.
“These regions of the brain store pain memories and are responsible for the emotional processing of pain,” Dr. Martinez-Kaigi said. “This means that treating pain is not one-dimensional or solely from a biological perspective. It is biopsychosocial and needs to be assessed and treated accordingly.”
Patients can also suffer psychological symptoms of these chronic conditions:
- Stroke.
- Digestive disorders.
- Movement disorders.
- Diabetes.
- Cancer.
- Heart disease.
- Kidney disease.
- Seizures.
- Sexual dysfunction.
As a health psychologist, Dr. Martinez-Kaigi evaluates and treats the common psychological symptoms such as change in mood, increased anxiety, sleep difficulties, weight gain and problems with memory that are associated with chronic health conditions.
Her job is to help patients understand the relationship between physical and psychological symptoms and adopt techniques to minimize the negative impact of pain or medical condition on their overall quality of life and well-being.
Together, she and patients come up with tailored care plans that might include treatment for mental health disorders like depression or sleep disorders, or behavior modification therapy to adopt healthy habits. Behavioral weight loss, in which she provides an evidence-based treatment program for weight management and promotes a healthier relationship with food and physical activity, is among the available lifestyle change recommendations.
As part of the Spine Wellness Center multidisciplinary medical team, Dr. Martinez-Kaigi works with Melissa Keeney, a registered dietitian, to educate patients about nutrition.
There has always been a need to address behavioral health’s impact on pain treatment, but Dr. Martinez-Kaigi said it’s only recently that many physicians accept the concept.
“The medical system is beginning to understand that health is biopsychosocial in nature and we are able to provide more comprehensive and compassionate care,” she said.
Spine Wellness Center patients heading for surgical intervention will also meet with Dr. Martinez-Kaigi for a presurgical psychological evaluation. She assesses everything from existing cognitive deficits that might mean patients won’t be able to follow through with post-surgical care instructions to their level of anxiety.
“We figure out their strengths and weaknesses, and then put supports in place so they achieve the best surgical outcomes,” she said.