The Strain of Pain
You’ve probably heard about people who walk off the mountains, or out of the wilderness having endured a life-threatening accident, or stories about people with severe injuries themselves who have managed to perform herculean tasks to rescue others in a state of emergency. Somehow they managed to conquer their immediate pain. But at the same time, for too many people, just getting out of bed in the morning, or lifting your child for a hug at the end of the school day also requires a herculean effort.
That’s because pain means different things to different people, in different contexts, and based on different experiences. Acute, short-lived pain following a traumatic injury, in many cases heals. The pain that becomes increasingly hard to live with and manage, is the pain that has persisted month after month and often year after year. Some adults say they have lived with pain their entire lives from teenage years, whereas others develop this persistent or chronic pain later in life, sometimes for reasons that can’t be diagnosed.
How we see it?
As medical professionals we generally like the science to be black and white, with definitions, classifications and clear boundaries that allow us to accurately diagnose our patients. Knowing this we can then follow a stepwise management or treatment protocol that we can have confidence will work. Unfortunately this is rarely the case with chronic pain. People suffering from chronic pain, may have no history of significant injury or disease. Living with chronic pain is almost a disease in itself. It slowly and progressively eats away at you, your confidence, self- worth, and independence. It can consume your life and thoughts, often alienating you from your friends and family even your workplace. Living with pain is exhausting, lack of sleep, anxiety and depression often go hand in hand with pain. This can lead to anger and frustration and problems with your relationships at home and with yourself.
The physical pain can stop you from doing things you love, like taking walks, playing sports and socialising. It can even stop you from doing the things you don’t love, like housework, cooking and chores. But the effect of not being able to physically do things can have two consequences. Firstly, it’s not good for your joints and muscles, your fitness, weight or cardiovascular health. Secondly, losing your ability to be active can lead to more emotional problems of dependence, defeat, and feeling ‘useless.’ Everyone has their own stories to tell about pain. It may be a mother unable to lift her child when its hurt or crying, or having been the breadwinner in the home who is now unemployed worrying about bills, and supporting your family. The sense of loss can be overwhelming, loss of the life you imagined, the things you planned to do, and a disconnect from others who are seemingly going about life ‘as normal’.
You know all of this, you may be living it daily and you may have tried a bunch of things already. The reality is there is no quick fix to chronic pain, nor is it as simple as an on/off switch. Chronic pain is more like a dimmer switch, there are things that turn it up, but there are also things you can do to reduce the pain to a gentle glow. Not one specific thing will work, and what works for your friend doesn’t mean it will work for you.
Firstly, lets dispel some myths about chronic pain:
- The pain then it must be in your head If you cannot find the exact source pain – wrong
- Chronic pain isn’t that bad, you get used to it after a while – wrong
- You should expect that one day your pain will be completely cured – wrong
- You went out yesterday so your pain can’t be that bad – wrong
- Chronic pain treatment should be effective within a short period of time – wrong
- You must be weak, a low pain threshold – wrong
- If you look healthy, you cannot be in pain – wrong
- If you have failed to control your pain in the past you will fail in the future –wrong
- Chronic pain is the only reason for all the problems you have – wrong
- Just push through it, no pain, no gain – wrong
- If pain can be reduced through stress management techniques then it must be imaginary pain – wrong
- Your pain will improve if you remain inactive, and avoid physical activity – wrong
- People with chronic pain are just lazy and looking for attention – wrong
- To consider yourself worthwhile you must be able to function in the same way you did before the pain – wrong
- You must have complete control over everything in your life – wrong
People often say they feel trapped by the pain, conned by their body and what it can’t physically do as well conned emotionally, sometimes unable to engage in the world, or make meaningful contact with others.
There is a way out though, and the key steps to getting there include:
Firstly educating yourself and those around you, family, friends and care-givers about chronicpain. Understanding how it really works andits entanglement with the brain’s emotions and experiences, past and present. Step 1 is all about empowering yourself through education and understanding, which can lead to acceptance and a sense of calm, because there are ways to improve yourdaily life. You can nd a balance betweenactivity and rest and a balance in your emotions that allows you to get more outof life. We have produced another leaflet in this series called ‘Understanding the Complexity of Chronic Pain’.
Arm yourself with coping tools. As you know everyday is different some are better than others, and some are terrible, but with the right tools you can find the perfect balance that works just for you. Coping tools may include exercise, activity, healthy diet, yoga, medication, practicing mindfulness or joining a pain support group. Techniques to use at home include meditation, distraction and deep breathing. Again we have another lea et in this series covering these coping tools.
Seeing the right pain specialists or physical therapists can also be of great help and support. Physical therapists are experts in handling pain, ending the source of the pain and treating your body holistically. Physical therapy can be very beneficial in managing chronic pain by promoting joint movement, using exercises to reduce stiffness and improve muscle strength – all of which can reduce your pain and improve your mobility which may help with daily activities. Specific nerve mobility and physiotherapy treatments can help reduce sensitivity to pain and massage has always been a trusty stalwart as it reduces stress and anxiety as well as pain.
Finding an activity you love to do is really important. This could be walking the dog, dancing, singing in the choir or painting, anything as long as you love it. Enjoying doing the activity is part of the treatment process, as it feeds into your emotional state, promoting the release of endorphins (happy hormones) which in turn will make you feel better. It may have to be a new activity that you can manage with your pain, or something you used to do in the past but with less vigour, however finding that something to do regularly without a grudge (or the sense of I am only doing this because I have to/was told to) is another vital coping tool.
Ownership. Possibly the most important step and which arguably should rank before Step 1, is to say “it’s all about you” because it really is. This is not to preach or dictate but to remember this is your life, your pain and your body that no one else can control. You have to take the wheel and be in control of the journey. It’s not a simple point A to point B along the highway route. Learning to manage your pain will require taking the scenic route, with dead ends that sometimes mean you have to go back to where you started. However, as long as you keep going, the twists and turns will eventually open out onto one of those beautiful coastal roads with that sense of open freedom – a stage where you are in control, and you know your body and pain so well that you can have a more fulfilled life.
You know the saying it takes a village to raise a child, well we believe it takes an army to survive and thrive with chronic pain. Although it’s important that you are in control and are the driver of your pain management, it would be unrealistic to assume you can do this alone. You need the support of friends and family, work colleges or associates. Not just emotional support and encouragement, but their actual help daily. Making sure you are all ‘on the same page’, sharing this information and these links with them, will go a long way in their understanding of what you are living with.
The information contained in this article is intended as general guidance and information only and should not be relied upon as a basis for planning individual medical care or as a substitute for specialist medical advice in each individual case.