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Are you a healthcare provider or someone living with pain? Get Trained in Pain Science
Teen Workbook

Resources

Access to affordable, high-quality information about pain and its treatment can make a major difference for patients and providers alike.

Articles

Journal articles + books for healthcare professionals and patients on everything to do with pain.

Pain Science

Pain is Biopsychosocial
• What you don't know about pain WILL hurt you (Zoffness    + Kevin MD)
• Gatchel & Howard’s user-friendly guide to the    biopsychosocial model of pain
Pain treatment is biopsychosocial (Bevers et al
Psychosocial contributions to chronic pain outcomes (Meints    & Edwards)
•  Psychosocial processes affect the development &    maintenance of chronic pain (Edwards et al 2016)
• A biopsychosocial formulation of pain communication - great    academic paper
• Biopsychosocial assessment and formulation of pediatric    pain (Liossi & Howard)
• Evidence-based psychosocial interventions for pediatric pain    management (Coakley & Wihak)
• Psychological pain treatments change neurophysiology (Flor)
• Pain is NOT biomedical: An expose of the opiate epidemic    and Big Pharma (NPR, Lembke)
Moseley's take on the biopsychosocial model (podcast    + article)
Research Uncovers Potential Treatment for Chronic Pain    (Zoffness)
•  Why is my doctor sending me to a Psychologist for    PAIN? (Harvard Health)
•  Evidence for Psychological Treatments for Pain (Vox)

Central Sensitization
What is Central Sensitization? (Institute for Chronic Pain)
How does pain become chronic? (J of Pain)
The neurobiology of Central Sensitization (J Applied Beh Res)
Explaining central sensitization to patients (Manual Therapy)
• Central sensitization occurs in fibromyalgia, migraine,    arthritis + other pain conditions (Lancet)
Understanding CRPS  (Mayo Clinic)
• Understanding amplified pain (AMPS)
•  Pediatric CRPS: background, treatment options, CBT
The link between anxiety, sensitivity, and pain
Amplified pain, CRPS + CBT
• How CBT can desensitize and re-train your brain:    neuroplasticity video
How Pain Works // Pain Neuroscience
•  Think Pain is Purely Medical? Think Again (Psychology     Today)
•  A Tale of Two Nails: What Changes Pain? (Psychology     Today)
•  What is pain? (Moseley)
•  Why we need to target the brain in pain treatment: Evidence     from neuroscience (Moseley & Flor)
•  Neuroimaging pain: A guide to pain neuroscience (Martucci     & Mackey)
•  Pain & the brain (U Wisconsin, brief handout)
•  Neuromatrix theory of pain (Chronic Pain Institute)
•  Pain control techniques (article)
Distraction strategies for pain (Journal: PAIN - PDF article     download)
•  Mood & attention regulate the experience of pain (NPR)
•  Pain catastrophizing: Negative mood states and negative     thoughts affect pain (Journal: Expert Review of     Neurotherapeutics)
•  The power of "brain training" (HA magazine)
•  The impact of mood on pain: Laughter as Medicine     (Scientific American)
•  The Neuroscience of pain (The New Yorker) - A great read!
•  A list of pain education websites
•  NIH's update on the opioid epidemic (2021)
•  A seriously great handout on how pain works (VA.gov)
•  The funniest ever version of the pain scale, in case you need     to laugh.

Treatments That Work

Mindfulness
•  Mindfulness-Based Stress Reduction: Free course for     patients + providers, evidence-based and awesome
Research Uncovers Potential Treatment for Chronic Pain    (Zoffness, 2020)
Mind-Body Therapies for Opioid-Treated Pain (JAMA, 2019 -    full article)
Mindfulness for managing chronic pain (PsychCentral)
Mindfulness-Based Stress Reduction (MBSR): How    mindfulness changes pain processing in the brain
Mind-Body approach to pain (Communitas: Osher Center for    Integrative Medicine, UCSF)
Nonpharmacological approaches to pain management  (NY    Times)
Mindfulness & distraction are effective for pediatric pain (Int    Assoc for the Study of Pain)
Biofeedback
• Find a biofeedback provider near you: BICA (enter zip code    only for best results)
Biofeedback and relaxation therapy: definition (MHNI)
Biofeedback for headaches (Amer. Migraine Foundation)
Efficacy of biofeedback for headaches (journal article)
• Underpinnings of biofeedback: The Skin You're In (Dr. Erik     Peper)
• Articles on biofeedback for pain
Cognitive Behavioral Therapy (CBT)
• What you don't know about pain WILL hurt you
•  Research Uncovers Potential Treatment for Chronic Pain     (Zoffness)
•  The neuroscience underlying CBT for pain (one of my favorite     nerdy journal articles, by Flor & Moseley)
•  CBT for chronic pain: A review (Edhe)
•  What everyone with chronic pain should know about     CBT (Curable podcast)
•  Mind-body therapies for opioid-treated pain (Garland)
•  CBT can improve quality of life for people with pain
•  CBT reduces depression in patients with pain

Stomachaches + GI Symptoms

There is more serotonin in your gut than in your brain! Your GI tract contains 80-90% of the serotonin in your body. This means that your stomach is highly sensitive to emotions. No wonder you get "butterflies," stomachaches, and nausea when you're stressed or anxious, why you "trust your gut instincts," and have a "gut feeling."
• Stomachaches are one of the MOST COMMON signs of stress    & anxiety in kids. This scientific article helps explain why.
•  The gut-brain connection (Harvard)
•  Your gut is your "second brain": Your enteric nervous system     (Johns Hopkins)
•  Relationship between your gut and depression/anxiety     (Journal: Molecular Psychiatry)
•  How your gut and mood influence each other (Scientific     American)
•  How stress & anxiety cause GI pain & diarrhea (article)
•  "Gut Feeling" (UCLA Health, great article on gut-brain     connection)
•  What causes IBS? (International Foundation for GI Disorders)
•  Psychological interventions for IBS (article)
•  IBS and RAP (video)
•  Enteric Nervous System (GI tract) and serotonin (CalTech)
•  IBS and serotonin (Canadian Society of Intestinal Research)


Anxiety, Depression & Trauma

Stress & Anxiety:
Stress and anxiety trigger pain, and also result from it.
ACES = Adverse Childhood Experiences: studies indicates that early exposure to TRAUMA + stressors is associated with the development of chronic pain & illness.
CDC ACES report: how stress & traumatic experiences in childhood lead to health issues later in life
• Relationship between stress and pain (VMC)
• Link between anxiety and pain tolerance (NY Times)
• Relationship between chronic pain and anxiety: Institute for Chronic Pain
Anxiety and catastrophizing mediate the experience of adolescent pain (journal article)
Physical effects of stress on the body (APA)
Sources of childhood stress that can trigger/maintain pain (KidsHealth)
Stress and time management tips for teens (Sutter Health)
Anxiety and stress negatively affect pain: 50 signs of stress in the BODY
Anxiety in children (AACAP)
Explaining anxiety to kids (Dr. Angoff)
School refusal is often a sign of anxiety (ADAA)
Try CBT before drugs for childhood insomnia (American College of Physicians)
Child Mind Institute (CBT effective for childhood anxiety)
Mayo Clinic (CBT for anxiety explained)
• Why are more American teenagers than ever suffering from anxiety? (NYT magazine)
Mindfulness & distraction are effective for pediatric pain (Int Assoc for the Study of Pain)
Depression: 
Up to 85% of patients with chronic pain live with depression.
• The relationship between Depression + Pain (Mayo)
•  Pain amplifies depression, and depression amplifies pain (J     of Neural Plasticity)
•  The link between depression and physical symptoms (J     Clinical Psych)
 Depression and pain comorbidity (JAMA)
•  Symptoms of depression in youth (Mayo Clinic)
• Serotonin & endorphins: increase "happy hormones" to    improve mood
Parent guide to teen depression & suicide warning signs    (Help Guide: Harvard health)
Exercise, nature & being social  can improve mood and self-
   esteem (journal)
CBT for childhood depression  (Society of Child & Adolescent    Clinical Psych)
Self-injury: Why do people cut? (Mayo Clinic)
Trauma:
Trauma and chronic pain go hand-in-hand. If you've experienced any type of trauma, including abuse or sexual assault, pain treatment MUST include trauma treatment.
Adverse Childhood Experiences Studies (Felitti et al, 1998)
   This seminal series of studies report that adverse childhood    experiences (ACES) are major risk factors for chronic illness,    pain, depression, and disability. ACEs include: physical    abuse, sexual abuse, emotional abuse, physical neglect,    emotional neglect, parental mental illness, parental    substance abuse, witnessing violent crime.
Childhood trauma is vulnerability factor for developing    chronic pain (Harvard Health - great article)
•  Book: The Body Keeps the Score (van der Kolk)
•  Dr. Sarno's take on the Mind-Body Connection

Sleep (do not take meds for sleep!)

Tips for improving sleep when you have pain (Govt of W AU)
•  The interrelationship between sleep + pain (PPM)
•  Sleep hygiene: 5 tips for sleeping well, with or without pain    (Palermo & Law)
•  Over-the-counter sleep meds are BAD for you (Harvard     Health)
•  Why sleeping pills do more harm than good (TIME)
 Risks of sleeping pills include early death, outweigh     benefits (TIME)
•  The association between sleep and pain (J Pain)
Screens disrupt sleep cycles: melatonin & sleep (Scientific    American) - good read!
 TREATMENT for sleep issues = CBT-i (Cognitive Behavioral     Therapy for insomnia)
 CBT-i is better than pills for sleep (NPR)
How CBT for insomnia works
•  How to find a CBT-i provider near you (1)
How to find a CBT-i provider near you (2)
• APP for phones: CBT-i Coach

For Kids, Teens, & Parents

School
Should my child go to school with pain? (Harvard)
Getting kids in pain to school (Darling)
Helping kids with pain get out of bed (Darling)
Returning to school helps the brain recover from pain, headaches and concussions (getschooledonconcussions.com)
School Refusal (ADAA)
How missing school makes anxiety, stress and pain worse: Why are more teenagers than ever suffering from severe anxiety? (NY Times)
Books
The Chronic Pain & Illness Workbook for Teens, by R. Zoffness
• Be the Boss of Your Pain: Self-Care for Kids, by Kajander & Culbert
• Treating Somatic Symptoms in Children & Adolescents, by Williams & Zahka
• Imagine a Rainbow: A Child’s Guide for Soothing Pain, by B. Miles
• GrrrOUCH!: Pain is Like a Grouchy Bear, by C. Morgan
Screentime
• How screens are hijacking your dopamine-reward-pathway (Harvard)
What screens do to the brain (Psychology Today)
• Social media use increases anxiety and decreases self-esteem (Child Mind Institute)
Kids and smartphones (TIME mag)
Tips for taking control of smartphones (Humane Tech - this website is GREAT!)
• The LIKE movie (show it to your kids)
Apps ranked by how happy/unhappy they make people feel

Websites + Apps for Youth
•  ComfortAbility: Boston Children's Hospital
•  Seattle Children's Hospital: Dr. Tonya Palermo's lab
•  ChildKind (resources)
•  APP for kids with pain: WEBMap Mobile (found in your     phone's "app store")
  Solutions for Kids in Pain (SKIP)
• Creative Healing for Youth in Pain (CHYP @ UCLA)

Treatment Books + Workbooks

The Pain Management Workbook (Zoffness)
Why Do I Hurt? (Louw)
Managing Chronic Pain: A CBT-Approach Workbook (Otis)
Managing Pain Before It Manages You (Caudill)
A Mindfulness-Based Stress Reduction Workbook (Stahl)
The Chronic Pain and Illness Workbook for Teens (Zoffness)
CBT for Chronic Pain in Children and Adolescents (Palermo,    for providers)
Managing Your Child's Chronic Pain (Zeltzer, for parents)
(ALSO SEE: "Books" tab on this Resources page)

Videos

Free, easy-to-understand videos about pain science and pain management for healthcare providers + people living with pain.
Healing our pain pandemic: How pain works + how to treat it     (Zoffness + ZDoggMD)
• The Truth About Managing Chronic Pain (Zoffness    + ZDoggMD)
• Tame the Beast: How the brain learns pain (5 mins, Moseley)
 Why Things Hurt (Moseley, TED talk - I love this dude)
•  The science of pain (5 min video, Pate)
•  The psychology of pain (Beth Darnall)
•  Understanding pain (5 min, Hunter Integrated Pain Service)
•  How to explain pain to kids (4 min, BC Children's Hospital
•  Melzack on the Gate Control Theory of Pain (12 mins.     Warning: nerdy.)
•  Pain Bytes (video series) - Pain Management Network, Australia
•  Learning how to manage pain (12 min video) - Stanford Children's Health
Mindfulness-Based Stress Reduction: A training for patients + providers
•  Collection of pediatric pain resources & videos: The Meg Foundation

Books

Books for healthcare professionals, adults with pain, parents of kids in pain, and youth.
For youth living with pain
•  The Chronic Pain & Illness Workbook for Teens,
by R. Zoffness
•   Be the Boss of Your Pain: Self-Care for Kids, by Kajander & Culbert
•  Imagine a Rainbow: A Child’s Guide for Soothing Pain, by B. Milesrvice
•  GrrrOUCH!: Pain is Like a Grouchy Bear, by C. Morgan
For parents of children in pain
•  Pain in Children & Young Adults: The Journey Back to Normal, by Zeltzer & Zeltzer
•  Conquering Your Child’s Chronic Pain, by L. Zeltzer
•  Managing Your Child’s Chronic Pain, by Palermo & Law
•  When Your Child Hurts, by R. Coakley
• Drug Dealer MD, by A. Lembke
•  Compilation of resources for parents: ChildKind  
• Book list for parents: Children's Hospital of Eastern Ontario
For adults with pain
•  The Pain Management Workbook, by R. Zoffness
•  Pain: The Science of Suffering, by P. Wall
•  The Pain Survival Guide, by Turk & Winter
•  Why Do I Hurt, by A. Louw
• Explain Pain, by Butler & Moseley
• Managing Chronic Pain: A CBT Approach, by J. Otis
• Drug Dealer MD, by A. Lembke
For healthcare providers:
•  The Pain Management Workbook, by R. Zoffness (adult-focused)
•  The Chronic Pain & Illness Workbook for Teens, by R.      Zoffness (youth-focused)
•  Pain: The Science of Suffering, by P. Wall
•  Why Do I Hurt, by A. Louw
•  Explain Pain, by Butler & Moseley
•  Managing Pain Before it Manages You, by M. Caudill
•  Managing Chronic Pain: A CBT Approach, by J. Otis
•  CBT for Chronic Pain: Therapist Manual, by J. Murphy
•  CBT for Chronic Pain in Children and Adolescents, by T.      Palermo
•  Drug Dealer MD, by A. Lembke
•  Treating Somatic Symptoms in Children and Adolescents, by      Williams & Zahka
 A Child in Pain: What Health Professionals Can Do To Help,     by L. Kuttner

Pain Providers & Programs

•  The American Association of Pain Psychology: psychologists      for adults with pain (mostly in CA)
•  Full list of Pediatric Pain programs around the world is here
•  How to find a Pain Psychologist (Darnall)
•  How to find a Biofeedback Provider (enter only zip code)
•  The American Chronic Pain Association (support groups,      info)
•  Go to Psychology Today and type in "pain psychologist CBT"
•  If you have a therapist you like, give them The Pain     Management Workbook and ask them to go through it with     you!

Apps

Smartphone apps for youth + adults to take with you wherever you go.
For Adults + Youth
•  WebMAP mobile  (Seattle Children's Hospital, for kids)
•  UCLA Mindful (free & awesome)
•  CBT-I Coach (for insomnia)
•  Stop Breathe Think
•  Breathe2Relax
•  Relax Melodies
•  Headspace
•  Rain Rain
•  Curable (for adults)
CBT-i Coach (for SLEEP!)
•  Calm
Additional Recommendations
•  APA Health Psychology recommended apps
•  A collection of pain trackers and apps

Guided Audio + Podcasts

For those who learn by listening, a collection of pain science podcasts - plus guided audio resources to help ease pain and distress.
Podcasts
• ZDogg MD: Healing Our Pain Pandemic
• ZDogg MD: The Truth About Chronic Pain
• ZDogg MD: Anxiety Contagion: Healing Our Kids' Mental       Health Crisis
• Ologies: Dolorology: The Science of Pain
• Curable: Like Mind Like Body Podcast
• Healthy, Wealthy & Smart: The Money & Science of Pain    Management
• The Run Smarter Podcast: Understanding Pain & Injury
• The Run Smarter Podcast: Strategies to Reduce Your Pain
Pain Reframed
Modern Pain Podcast
Healing Pain Podcast
Pedia Pain Focus 
Straight Talk MD
Guided Audio for Pain + Relaxation
•  Audio for pain: The Chronic Pain & Illness Workbook (create an account for free access)
Guided Audio: Mindfulness-Based Stress Reduction (MBSR; under "Practices" on the left)
Guided Audio: Guided Meditations, UCLA
Guided Audio: Dr. Dawn Buse
•  Guided Audio for kids: Bedtime Explorers for sleep
Calm Your Nervous System: free 20-minute guided relaxation audio with binaural technology to deepen the relaxation response.
• Guided Audio: Seattle Children's Hospital (middle of the page)
Guided Audio: The Comfort-Ability, Harvard/Boston Children's Hospital

Podcasts

ZDogg PodcastPain Reframed PodcastCurology PodcastIntegrative Pain Science Institute

"Pain, Explained" Column in Psychology Today

Think Pain Is Purely Medical? Think Again
Pain isn’t simply a medical issue.
A Tale of Two Nails
What changes pain? The science behind why pain is painful.
Ten Evidence-Based Strategies for Pain Relief
Tips and tools for treating chronic pain.
How to Set Boundaries With Family
A guide to maintaining sanity.

“Everyone deserves to understand their pain.”
- Rachel Zoffness, PhD

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