Living well with chronic pain

March 29, 2015, 10:23 pm

Posted by Rachel Mallory

Pain is a common issue. Pretty much all of us have had a sore back at some point or another, or a bad headache. Often that pain just goes away by itself, or with some physiotherapy, or with a couple of acetaminophen or ibuprofen pills.

But what about chronic pain? This isn’t the pain that comes from breaking a leg, for example – that’s acute pain and is treated differently. Chronic pain can be caused by a wide variety of problems, including illnesses such as fibromyalgia, or arthritis, or migraine. Or perhaps there was an injury that may have happened quite a while ago but still causes pain, in the back or shoulder or knee or somewhere else. Chronic pain is pain that has been around for a while, and is causing problems. Often people report that they cannot do activities with friends or family, or basic tasks like cooking or gardening or washing the car. Particularly for people who have physical jobs, pain can restrict what they can do at work. It may even mean that they cannot work at all.

Unfortunately people are often told, even by medical doctors, that nothing can be done about pain. Medications like pain killers are often prescribed, but some of these carry a risk of addiction, and they can become less and less effective over time. The medications may even increase pain levels. Also, some typical ways of coping with pain (for example, resting much of the time) often make things worse. People can become trapped in a cycle of helplessness, and hopelessness, and high, disabling levels of pain.

So what does help? One thing is knowing more about chronic pain. It is very much an interaction between the mind and body. That doesn’t mean that chronic pain is “in your head,” and somehow not real. It is very real. But unlike acute pain, it’s more influenced by stress, for example, or fatigue. Pain itself is of course a form of chronic stress, leading to a nasty interaction between stress and pain levels. Chronic pain also has typical patterns to it. One aspect of treatment is to identify your particular pattern. Many people feel more pain earlier in the day, after a night of being more or less immobile in bed. Others feel more pain later in the day, when they’re tired. Increased pain when hungry is also frequently seen. Because of these individual patterns, tracking pain levels and figuring out what triggers each person’s pain is an important aspect of treatment.

Another major part of treatment is learning how to calm down your body and nervous system. Again, tracking is very helpful here. Pain means that the nerves are constantly irritated and over-active. So gentle exercise, stretching, breaking tasks into smaller components, relaxation and/or meditation, emotional support, and fun experiences are all ways to reduce the arousal level of the nervous system and in turn, reduce pain levels. Medication and rest, by the way, are typically important aspects of pain management, but they become two of the tools in the kit rather than the only options available.

Do these strategies result in no pain? I wish I could say yes. But a success story with pain management usually means a much-reduced daily pain level, and less need for pain medication. When pain is manageable, daily living gets easier. Doing relaxation and stretching after work might mean that a parent can coach soccer rather than having to go to bed right after dinner. Washing the dishes for ten minutes, then paying bills for 15 minutes, then carrying a small load of laundry to the machine is much more likely to be successful than toughing it through an hour of cleaning the kitchen. Again, everyone is different, but there’s a very good chance that psychological approaches to pain management can improve the quality of life for someone who has chronic pain.

If you want more information, a great book is Managing Pain Before it Manages You, by Margaret Caudill.