Conquering Pain
Chronic pain has powerful impacts upon the lives of millions of people. Pain provides an unwelcome intrusion into our lives in a multitude of ways. It interferes with our work and family life. It affects our state of mind and makes us angry, irritable and frustrated. People who experience severe pain frequently become anxious, afraid or even depressed. Sometimes pain can prevent us from getting sufficient sleep. In extreme cases it can even lead to additional problems such as drug or alcohol addiction. People who suffer from pain often lose hope. Pain sufferers often become defeatist, disinterested or withdrawn.
Relief from chronic pain is however achievable for those who remain hopeful, positive and optimistic. We hope that this short article restores some genuine hope and lifts your spirits. Many millions of people have been able to regain control and reclaim their lives from the unwelcome intrusion of chronic pain. This article focuses on some of the ways that individuals who suffer from chronic pain can rediscover happiness and rebuild their lives. It provides only a general discussion of the management of pain but directs you towards more specific sources of information about specific situations. One of the most vital aspects of your personal healing journey is to use all of the help, encouragement, support and information that is available. Pain management is improving and evolving all the time. We strongly encourage you to learn more and to take advantage of the useful resources and help which are available.
What causes pain?
Understanding the cause of pain can provide some useful clues which help our healing and rebuilding. In reality, the cause of chronic pain is more complex than a simple cause and effect relationship. The underlying causes of many types of pain remain incompletely understood. Our understanding of pain is however improving all the time and answers are beginning to emerge which lead to more effective treatments. There are several clearly established causes of pain which include things such as trauma and injury, damage to the nervous system, inflammation, severe emotional stress, cancer and ageing. Many gaps still remain in our understanding. Why do some individuals with similar injuries suffer dramatically different levels of pain? Why do certain medicines such as those used for epilepsy and depression provide relief for some specific types of pain? How do various types of non-traditional therapy help in relieving distress? Why do some people who have suffered amputation of a limb still sometimes experience burning or itching ‘phantom limb pain’ coming from the missing limb? Why do we sometimes feel residual pain long after the initial injury has apparently healed? Intriguing mysteries still remain and there are still missing pieces in the pain jigsaw.
What does this mystery and uncertainty mean? These complexities have a number of implications for our personal healing journey. Sometimes we need to look at employing a combination of several pain relief techniques to optimise the result. We frequently need to experiment with different types of relief to pinpoint what works best. Some methods of pain relief work gradually over a period of weeks and months. Patience and persistence do make a real difference to the end result. Perhaps most importantly we need to look at a broad range of issues including our emotional well-being, activities, work, relationships, general health and maybe even our spirituality to find solutions. Many people refer to this as a ‘holistic’ approach to pain management. The aim is not just simple pain relief. It is much more ambitious than that! The aim is to maximize our quality of life. Individuals who have reclaimed their lives from chronic pain often discover happiness and meaning that they have never had before.
The Road to Recovery and Healing
A common reaction of many people who suffer from chronic pain is a loss of control over their daily lives. A key to conquering chronic pain is making a strong commitment to re-establish positive life choices. There are several ways that chronic pain sufferers have been able to begin this journey of hope. It is not easy but many have walked the path of hope and rebuilt their lives. We believe that you can also rediscover healing and independence from chronic pain. Some of the most important steps on that journey are discussed below. Good luck!
A Positive Attitude
Maintaining an upbeat attitude to life appears genuinely difficult for many sufferers of chronic pain. Even the hardiest of folks have miserable moments and setbacks, that is undeniable. Can our state of mind make any difference whatsoever? Does maintaining a positive, optimistic, hopeful approach to chronic pain make a difference to our quality of life? The answer is certainly yes! A positive attitude to our life helps us confront pain in several critically important ways and makes a real difference. There have been several thorough and well-constructed scientific studies that demonstrate individuals who remain optimistic have decreased levels of discomfort and distress. The quality of life improves. A positive attitude almost certainly helps people to cope with chronic pain on a day to day basis. Optimistic, positive individuals are more likely to be active, able to work and have better interpersonal relationships. Often their perception of pain is also reduced. It is difficult to remain chirpy, forward-looking and positive when we are in pain but it really helps in a number of meaningful and practical ways. Hang in there!
Treat Underlying Causes of Pain
Where possible, efforts should be concentrated on identifying and treating the underlying cause of the pain. A satisfactory result is much more likely if we use this approach. There are a number of implications which arise from targeting the underlying cause of the pain. Sometimes understanding underlying causes of the pain allows us to undertake useful and productive actions to minimize the impact of the discomfort. Sufferers of chronic back pain, for instance, have often found that exercises and physical therapy can be helpful to alleviate pain and reduce the frequency of flare-ups. Pain caused by inflammation is often responsive to anti-inflammatory medication. Infections or circulation problems can often respond to treatment. Improving general health is also useful. Attention to general health and well-being may help slow progression of illness, reduce discomfort and eventual loss of function.
In reality, things are often a little more complex. Underlying causes are often difficult to identify or may be difficult to treat. Success is often incomplete. Some people respond better to available treatments. Treatments often have consequences or troublesome side effects. Many treatments are costly or require time to travel or prolonged absence from work. In other cases the benefits quickly wear off. Many people who suffer chronic pain are forced to make difficult choices concerning treatment. What are some of the general considerations which might help us make effective choices with regard to treatment for chronic pain? Some of the important practical issues are listed below.
- How effective is the treatment? How much improvement should I expect?
- How long will the benefit last?
- What are the side effects? Could the treatment make things even worse?
- Are there safe, inexpensive and effective alternatives which could be tried?
- How much time is involved?
Finally, we should remain vigilant to alterations in the usual pattern of chronic pain. Pain which unexpectedly increases in severity or changes in character should alert us to either the possibility of another illness or complications of the current one. Commonsense really helps here. Medical advice should always be sought in this situation.
Pacing
One of the most significant advances in pain management in recent decades has come from an improved understanding of how to improve activity levels. Many pain sufferers have learned to use a technique called pacing to improve their activity levels and reduce the number of flare-ups of pain. Pain sufferers make mistakes with the organization of their daily activities. There are often periods of overactivity which exacerbate pain and result in inactivity. Learning to plan daily activities better can make a real difference. The overall level of daily activity is improved. Body function is maintained by a more active lifestyle. People are happier and less frustrated because they are more active and tasks are completed. The aim of the pacing approach is to maintain a fairly even level of activity through the day rather than short, intense periods of activity. The essential components of activity pacing are as follows.
1. Having frequent, short breaks
2. Progressive increase in activity as improvement occurs
3. Dividing bigger tasks into smaller, manageable fragments
Many chronic pain sufferers who have understood and embraced the philosophy of pacing their activities have reported significant improvements in levels of activity. Pain becomes less intrusive, less frequent and generally less of a problem. Medication use can sometimes be reduced. Learning about pacing is really worthwhile. At the conclusion of this article there is a list of suggested resources for sufferers which will guide you toward more detailed information about this important issue. Learn more about pacing, it might just change your life!
Understanding Pain Relievers
Managing chronic pain involves much more than just pain relievers! It involves looking after our emotions and activities as well. That said, learning to use pain relievers most effectively can often make a difference to managing daily activities. The issue of different pain relievers and the specifics of their usage goes well beyond the scope of this short article. Recommendations need to be individualized and discussed with your doctor. A few important general points however need to be understood regarding drugs used to treat chronic pain. No medication will work to best effect if used incorrectly. Medications often work much better when taken at regular preset times rather than just when pain is severe. Medications can sometimes be matched to activity levels. Some medicines work in unusual ways that we still do not fully understand. For instance, some types of pain are reduced by medicines such as those used to treat epilepsy or depression. Just how these medications sometimes work to reduce pain is a mystery. Communicate with your doctor and work as a team. In consultation with your treating doctor, there may be some scope for trying different types of medications to see what works most effectively. Some recent studies have also shown that simple, inexpensive analgesics can work surprisingly well if used correctly! Side effects of pain relief medications need to be understood, discussed and anticipated. Most anti-inflammatory medications, for example, need to be taken with meals to avoid gastrointestinal effects.
Feelings and Fears
Being brave is never easy but it makes a real difference! Every pain sufferer has bad days and setbacks. Fears and frustrations are understandable. What really makes a difference is how we are able to respond to these situations. People who have succeeded in conquering chronic pain often learn to think about life in a novel and challenging way. Some people are able to do this instinctively. Others need the help of a therapist to provide guidance and support. These skills can be learned and applied. Never be afraid to ask for assistance if you need a little help. It is amazing the difference that a positive attitude can make. A few suggested constructive and helpful thoughts and actions are listed below. Why not make your own list or seek expert advice from a qualified cognitive therapist?
- Concentrating on things that you can achieve rather than problems and limitations
- Learning effective new skills and coping strategies
- Celebrating achievements and gains
- Accepting help and well-informed advice
- Improving self-esteem. Recognising your strengths and competencies.
- Deciding that you are in control, not your pain
- Being receptive to different ways of looking at life
- Choosing to be creative and bold
- Making achievable goals and dreams
- Communicating your feelings and needs
Relieving stress and minimizing anxiety also have important indirect effects on the well-being of chronic pain sufferers. Stress and anxiety strongly contribute to our perception of pain. If we feel calm and relaxed then our discomfort level is more manageable. Stress and anxiety also have other undesirable effects on our mood and daily activities. Actions to minimize anxiety and stress help us to regain our confidence and composure. Some people can reduce stress and anxiety with counseling. Other folks find techniques like meditation, breathing exercises or yoga make a significant addition to quality of daily life. It is the final result that matters. What works for you? Take the opportunity to learn more about this important issue. Feeling calm, relaxed and confident keeps our energies focused on helpful thoughts and actions.
Complimentary Therapies
Millions of pain sufferers have discovered the benefits of alternative therapies. Surveys have shown that at least 40 per cent of chronic pain patients use alternative therapies. Traditional techniques have well-documented limitations for the treatment of chronic pain. Many traditional treatments work incompletely or have unwanted side effects. Combined with the benefits of the best traditional medical treatments, complimentary therapies often make a real difference. Many people who have used complimentary therapies have discovered benefits that extend beyond pain relief. They feel generally calmer, happier and healthier. Just how these alternative treatments work is incompletely understood. What are some of the commonly used complimentary treatments used for chronic pain? Which ones produce results? Let us introduce just a few of the commonly-used complimentary treatments available for pain sufferers.
- Acupuncture and acupressure – developed in China but now reasonably widely accepted in the West. Used for a wide variety of conditions ranging from arthritis to musculoskeletal pain, fibromyalgia and cancer. Acupuncture has even been used for anesthesia in some patients.
- Yoga – developed in India by spiritual teachers over thousands of years, yoga refers to a wide range of disciplines based on spiritual, mental and physical exercises. Yoga can help with pain relief in some people but has other benefits as well. It improves flexibility and function. It also assists with relaxation and promotes psychological well-being.
- Mind-body Techniques – millions of people across the globe are discovering benefits from meditation and other mind-body techniques. Mind-body techniques may reduce the discomfort experienced by chronic pain sufferers. One of the most important benefits from these techniques is an emphasis on the patient being in control. As a result, positive and health-promoting messages are reinforced and highlighted.
- Chiropractic – many sufferers of acutely painful conditions swear by the benefits of chiropractors for the treatment of acute episodes of pain. Chiropractic and osteopathic techniques focus on either the bony or soft tissues to correct any imbalances and restore natural function. These types of treatment are certainly worth considering for flare ups of pain. The effectiveness of chiropractic treatment for everyday chronic pain is perhaps less convincing.
- Massage – not only pleasant and relaxing but often helpful to reduce the severity of episodes of pain. Some recent research studies have suggested that massage may be quite useful for exacerbations of back pain and produce results comparable with some more traditional treatments.
Clearly the above list is only an introduction and is not intended to be complete. We most certainly encourage you to keep an open mind and learn more about the possible benefits of complimentary therapies. You will find links to more detailed and specific information and resources at the end of this article and also in the medical section of the useful links area of this website. Good luck …you deserve it!
Physical Therapy - Physiotherapy
Physical therapists can often play an important role in the management of chronic pain. Physical therapists of often use a number of so-called ‘passive’ techniques including diathermy, ultrasound and manipulation to treat short-term exacerbations of pain. Even more importantly perhaps is the role of physical therapists to build strength and mobility in sufferers of chronic pain. Improving body function helps to improve activity in chronic pain sufferers. Reputable physical therapists are an invaluable addition to your chronic pain support and recovery team.
The Importance of Creativity
Creativity can be an important asset for pain sufferers at several levels. People who have chronic pain often cope better if they learn to think about life in a challenging, creative way. The focus should be on an overall improvement in the quality of life. Some effort should be made to maximize activity, achievement, enjoyment and fulfillment rather than just concentrating on pain levels, personal suffering and loss. We often need to reconsider and challenge many long held ideas. Sometimes we are compelled to learn to think in a more productive and life enhancing way. At another level, we frequently need to learn how to complete daily activities in a different and creative way. Sometimes important new skills need to be learned. Paradoxically, the experience of chronic pain often brings out a hidden creative or artistic side in some folks. Artistic expression often provides a useful and productive release of pent up emotions and frustrations. Physical or emotional pain has proved a potent creative influence for many artists and performers!
Having a Laugh
There isn’t too much that is funny about chronic pain. Fortunately, life in general is filled with moments to tickle the funny bone. Learning to laugh at life in general has a number of benefits which are increasingly being recognized and accepted. Many recent scientific research studies have highlighted the medicinal effects of having a laugh. The benefits go far beyond just lifting our spirits. Laughing has been associated with decreased distress from symptoms of illness. Included amongst these benefits is an apparent reduction in the perception of pain in some patients. Humor has even been found to play an important role in improving the quality of life in seriously ill patients with life-threatening conditions such as cancer. Everyday life throws up countless opportunities to have a quiet chuckle. Doctors, nurses, friends, therapists, neighbors and even media celebrities are capable of amusing us. Perhaps more importantly however we often need to discover how to laugh at ourselves …our successes, failures, limitations and amazing abilities!
Support Groups
Involvement in a support group can be really helpful for many sufferers of chronic pain. Support groups help overcome the sense of isolation that is experienced by many people who are forced to contend with chronic pain. A support group provides a highly practical demonstration that the participant is not the only person who suffers pain. Groups provide an opportunity to share ideas, fears and feelings. Common challenges and problems can be addressed and solved. We can learn useful lessons from the experiences of others both positive and negative. Other individuals can develop as positive role models or mentors during difficult times. There is also the possibility to share resources and knowledge. Many people also benefit from the opportunity to contribute to the group. Providing our guidance and support to other members of the group provides further chances to add to the experience. Support groups are not without drawbacks and do not suit absolutely everyone. All groups have the potential for creating interpersonal conflicts and may not be right for all participants. Some people cope better in a group environment than others. Certain people cope better by using their own individual resources and abilities. If you are trying to locate a support group try asking your doctor or therapist. Look in the local phone book or conduct an online search in your area. You might just be surprised.
Looking after Yourself
Chronic pain sufferers often need to make important strategic decisions to look after their own personal interests well-being. This is not being selfish, it is simply a reality. Choices need to be made to improve the quality of everyday life. There exists a delicate balance between our personal freedom and independence and the important role that other people must play to help us. In order for people to support us, we sometimes must trade off some independence. Clearly we must be comfortable that this balance is right. Appropriate time management is a key issue for chronic pain sufferers – we need to organize tasks cleverly and sometimes need to say no to people who demand too much from us. Our rights need to be understood and respected. Our overall health is also critical. Pain need not restrict us from eating right and maintaining sensible exercise. Time out is crucial. We need to make specific plans to enjoy activities that give us pleasure. Sometimes this requires a little planning and organization but it is absolutely essential.
Many chronic pain sufferers have been driven by their predicament into self-destructive dangerous or addictive behaviours. There is a temptation to become dependent on alcohol or painkillers. Gambling problems are also common. These addictions do not provide an escape or satisfactory solutions. Do not indulge in these destructive behaviours …they never help and only create additional distress. There are much more effective ways of controlling discomfort and rediscovering lasting hope and happiness. Effective control of chronic pain can often result in decreased use of painkillers in the longer term.
Activities
One of the legitimate frustrations of chronic pain sufferers is that flare-ups of their pain can sometimes occur at unpredictable or inconvenient times. Even the best and bravest get frustrated at times! How can we cope most effectively? Remaining cool, calm and committed certainly helps. One of the most critical aspects of conquering pain problems is the management of daily activities. We have previously referred to the concept of pacing of activities. Pacing has transformed the lives of many chronic pain sufferers. In practical terms, we need to allow sufficient time for the completion of tasks. Sometimes we need to be creative and think about other ways of doing things. Often we can make use of useful tools and aids to make tasks easier. Many people have discovered that simple modifications to their home such as hand rails can make a significant difference. Many people who suffer from arthritis have employed modified tools useful to complete daily tasks. Anything which improves mobility, confidence and independence is well worth considering. You would be surprised at the large number of helpful gadgets that have been invented! Consulting with a reputable occupational therapist is certainly worthwhile for some folks.
Many pain sufferers have discovered new passions and activities which have completely changed their lives. They have studied, started traveling, discovered new careers, found their hidden artistic side or become musicians. It has all been done before. Don’t lose hope …the good times might be closer than you think!
Our Relationships
Maintaining and improving our personal relationships must be a high priority. It is easy to become self-absorbed and self-pitying and feel that the world owes us something. It is tempting to become frustrated and envious of those around us but this normally proves counterproductive. Our family, friends and carers are an absolutely essential part of the healing process. They need to understand our situation and treat us with empathy, dignity, integrity and respect. For our part, we must understand the legitimate needs of the people around us. Acts of kindness need to be acknowledged, recognized and appreciated. A simple few words of thanks can mean a lot. Where possible, we should take every chance to spend time with positive people who inspire, uplift and educate us. Individuals who can be positive role models are absolutely precious. Finally we need to remember our own self-worth. Just because we are uncomfortable or ill does not diminish our value in any way whatsoever. We can still make a contribution to the lives of others and give them strength support and inspiration when they need it most.
Realistic Expectations
Successfully coping with the challenge of chronic pain requires a realistic perspective. There are several things we need to bear in mind. Most people are able to eventually achieve a satisfactory level of pain control that allows them to recommence an active, happy and rewarding life. Complete pain relief is a rare event. More usually, pain flares up from time-to-time for most chronic pain sufferers. These setbacks should be learned from and provide opportunities to adjust treatment and activity levels. Responding to exacerbations of pain is a highly personal experience but many people can help you through the bad times. Conquering chronic pain is almost always a gradual process occurring over a period of time. It requires patience, strength and some experimentation to learn what works and what does not. What matters at the end of the day is quality of life.
A Final Word
Chronic pain intrudes unwelcomely into the lives of millions of people across the globe. Many people have however conquered chronic pain and discovered lasting happiness and healing. These individuals have learned how to reclaim control of their lives and remain independent. Chronic pain sufferers have found ingenious and creative ways to improve their quality of life and remain active and productive. These individuals have used the advice, support and experience from other individuals including health professionals, family, friends, fellow pain sufferers, physical therapists, alternative health practitioners and work colleagues. In recent years specialized pain management clinics have emerged offering valuable expertise and advice from experts in the field. These pain clinics have offered new hope to many chronic pain sufferers. In the ‘In the News’ section of this site you will learn about many ordinary people who have bravely triumphed over pain and disability. The secret behind these stories of triumph often seems to be a positive attitude and a willingness to accept all opportunities to build a better life. Help and resources are available but you must aggressively seek them out. We wholeheartedly wish you every success on your personal journey of healing. Good luck!
Learning more
There is a considerable amount of help, advice and support now available for people who suffer from chronic pain. Some general sources of information are listed below. You will also find information by referring to your specific medical condition. There are numerous other resources included in the useful links section of this website.
Books
1) Natural Pain Relief by Jan Sadler, C. W. Daniel Company Ltd, (2001)
2) Living with Chronic Pain by Jennifer Schneider, Healthy Living Books (2004)
3) The War on Pain by Scott Fishman and Lisa Berger, Harper Collins (2001)
4) Managing Pain Before it Manages You, Margaret Caudill, Guildford Publications (2001)
5) Pain Free by Pete Egoscue and Roger Gittnes, Bantam Books (2000)
6) Overcoming Chronic Pain, Frances Cole, Hazel Howden-Leach, Helen Macdonald,
Constable and Robinson
7) Manage Your Pain by Michael Nicholas, Allan Molloy, Lois Lonkin, Lee Beetson,
ABC Books
Web Resources
www.iasp-pain.org/chapters.html International association for the Study of Pain provides a gateway to resources in many different countries around the world
By Dr Andrew Rylatt (Medical Doctor)
9th August, 2005
