Management of Chronic Pain
Making pain not equal to loss
As if experiencing pain isn't enough, for some people with severe persisting pain many parts of their life seem to be turned upside down. In addition to the physical pain, there is the emotional pain, the anxiety, stress, depression, and anger (amongst other emotions) that they experience following occurrence of the pain on their life. There is also the loss of activities that were previously found to be enjoyable and perhaps gave life a sense of purpose and meaning. Relationships may have degraded as a result of all of the above difficulties. And, most frustrating of all, what leads to feelings of helplessness, is that current medical science may not have a cure. Just as a cure has not yet been found for diabetes, neither has a cure been found for many of the causes of persisting pain. But hope is not lost. For although it may not be possible to remove the pain, it may be possible to minimize the effects it has on your life.
How can this be done, you may ask? The first thing to do is to learn more about chronic pain. Growing up, when experiencing acute (or short-lasting) pain, we learnt that pain = damage. For example, when we cut the skin on our hand, we experienced pain. However, this may not be the case with chronic pain. Increases in pain may not indicate that more damage is being done. Instead the increase in pain may be due to muscle weakness or an over-sensitive central nervous system. Speak to your medical practitioner about what increases in pain indicate for you. If they do indicate new damage, seek further medical advice about appropriate strategies. If increases in pain do not indicate that additional damage is being done, then consider following the suggestions below.
Learn to change how you think about your pain. Rather than focusing on what you have lost since developing your pain condition, focus on what you can still do. For example, can you still hug your loved ones? Can you still walk to the bathroom and do some household chores? Be aware of any “catastrophising” you may be doing – do you find yourself worrying about ending up in a wheelchair? How likely is this really? Perhaps ask your GP about the likelihood.
Set clear goals for what you would like to achieve, focusing on activities rather than reductions in pain. For example, would you like to be able to garden for a couple of hours each week, be able to walk to the shops and back, remain in a seated position for a few hours, and so on. Focus on imagining how much better your life will be when you have achieved these goals. Use this focus to keep yourself motivated to continue on with the strategies below when you are experiencing difficult times.
Learn relaxation and distraction strategies. They will assist you to reduce muscle tension, to cope with anxiety and anger, and to remain calm when experiencing exacerbations of pain by decreasing the intensity of the pain,
Be aware of how you currently approach tasks. Do you tend to do as much as you possibly can, resulting in an increase in pain? Do you then need to rest for a long time to recover? This cycle, of overdoing then underdoing, is unhelpful, resulting in more frequent exacerbations of pain, lowered mood and higher anxiety, as well as diminished ability to complete tasks over time. So how else can you complete tasks? Helpful strategies to use include breaking large tasks into smaller components (eg vacuum half a room rather than the whole house) and taking regular short breaks. Setting yourself goals for increasing your ‘tolerance” for tasks is also advisable. However, first you need to determine your tolerance. Over the next week or two measure how long you can do specific activities without too much extra pain. Average that amount and then start 20% below that average.
Coping with chronic pain can be challenging. If you need additional assistance learning to cope with chronic pain, seek assistance from your local medical practitioner or contact me on 1800 768 411.