22 Things You Should Know About Treating Chronic Pain
Treating chronic pain can be a complicated and frustrating task as any individual with chronic pain (or their providers) can attest to. While all of us who treat chronic pain would love to be able to wave the proverbial 'magic wand' and make pain go away, the complete elimination of pain for all of humanity is impossible. You (or the patients you treat) have been to a myriad of professionals to complete the necessary tests, offer medications and injections, suggest surgeries and other procedures. No doubt these strategies have been very successful for some but...
What do you do when pain remains despite its appropriate treatment?
Functional restoration programs (AKA chronic pain programs, comprehensive pain programs) work on the concept of improving functioning of an individual. In most instances, those individuals who experience chronic pain have improved emotional well-being when they are able to attend to normative activities, such as pursuit of an education, being involved in gainful employment, caring for their family, participating in physical activities, being involved in social activities, pursuing hobbies.
Of course this may represent the 'chicken or the egg' phenomenon. Do individuals who engage in more normative, age-appropriate activities have less chronic pain? Or do the activities somehow modify the complex experience of chronic pain?
This video outlines some of the key points paramount to improving one's functioning with chronic pain. Honestly, regardless of whether you have chronic pain or not, these concepts will lead you to some health habits in your daily life.
1 No naps. While taking a rest during the day is important, naps sometimes go on for a longer time than expected. This can make you feel groggy later in the day and disturb your sleeping patterns at night.
2 Exercise daily. Releases your own body's pain fighting chemicals (endorphins and enkephalins).
3 Stay positive. Negative energy makes pain worse. You can turn a challenging day around.
4 Deep breathing (diaphragmatic breathing). Proven to reduce stress, allows clearer thinking.
5 Stay distracted. Find a friend, listen to music, draw, take a walk, daydream.
6 No thinking about pain. As long as your pain has been worked up appropriately, constantly worrying about pain can have negative effects on your mood.
7 No talking about pain. Similarly, we sometimes focus on what we talk about. And this can have a negative effect on mood and lead to worry.
8 Don't ask me about my pain. Ask me about everything else, what I enjoy doing. I am so much more than my pain so let's connect in other ways.
9 No pain behaviors. Includes rubbing your head, saying 'I'm tired' constantly, withdrawing from social activities.
10 Homework. Do brain work every day. While your brain is not a 'muscle', it must be used on a regular basis or it can become 'weaker'. Read a book, do homework, do brainteaser puzzles.
11 Moderation. This assures that you can show up every day for the activities that are required or you desire. So participate but not 1000%. Attend that social activity but leave a little early so you can take care of required tasks.
12 Modification. Modify activities so you can participate. For example, with yoga, you only participate as you are able, being mindful of your limitations. Make an attempt to do some of the poses even if you can't do it all. Consistent participation will have you improving your skills and stamina in no time.
13 Time management. Plan how long it takes for sleep, eating meals, personal hygiene, school work, chores, relaxation. If you fail to plan, you are planning to fail.
14 Positive self-talk. You might not feel like you can do something but you can say things such as
'I am working harder every day'
'I am making good progress'
'I will accomplish this with gentle persistence'.
15 Self-care. Exercise, personal hygiene, sleep hygiene. These activities are honoring your body and soul and can make you feel better.
16 Structured schedule. Plan your waking and bed time. Will you shower in morning or evening? Homework before fun time? When will you relax? When will you set your phone away for the night (so the blue light doesn't interfere with your sleep)?
17 Relaxation every day. 30 minutes daily. This isn't napping. It includes listening to music, reading a book, chatting with a friend, drawing. You should remain upright so you will not fall asleep (and nap!).
18 No pain meds. This means that you should avoid opioid medications and all costs for chronic non-malignant pain. Temporary use for acute pain from a surgical procedure may be indicated (but all of these suggestions can be used for acute pain as well!).
19 Difficult days happen. They're temporary. Don't let their presence drag you down and negate all the progress you have made. Your reaction to a difficult day is an important factor of how you will recover from chronic pain.
20 Three chores daily. This gives you some ownership for the process and can empower you to be effective. Chores include making your bed, taking out the trash, walking your dog, things that help you contribute to the running of your household.
21 Sleep 9 hours every night. Vary your sleep and wake time by no more than one hour on the weekends. Sleeping much more on the weekend will disrupt your sleep schedule and make it difficult to fall asleep or stay asleep.
22 Five reasons to miss a scheduled event.
Fever, broken bone, bleeding, suicidal thoughts, unconscious. While not necessarily meant to be taken literally, this solidifies the notion that you should have a good reason for missing school, work, a social activity, or physical exercise. Participants in the pediatric pain rehabilitation program speak of the expectation we have that they attend our program every day. If you look at school in this way, you may find some very good aspects of attending school and socializing, advancing your education, and acting in a normative fashion.
Have you used any of these skills before and how have they made you feel? Do you have other helpful suggestions for those with chronic pain? Share your comments with us!