Chronic Pain
Pain is a signal from the brain that serves to inform us that we are in danger and should change something – like take our hand off the stove. Pain motivates us to look for the source of the danger, to solve the problem at hand, and prepares our body for a response (e.g. muscles brace, blood pressure increases). These basic systems provide a helpful mechanism to protect us in the short term.
However, when they are active over a long period they make us prone to anxiety and depression; they exhaust us and make it difficult to sleep. A useful analogy is to think of a dangerous situation– ie if you saw a shark coming towards you while swimming, you would find it hard to relax; and sleeping and eating would be the furthest things from your mind! Consider being in this state all day, every day. That is what chronic pain does to us.
The critical thing is that pain is MEANT to motivate you to fix whatever your brain thinks is causing “damage”. But once pain becomes chronic (lasting longer than 3 months or beyond the normal healing process), it can become very demotivating because what has worked for us with acute pain (for example, resting) does not work for chronic pain. So what should you do?
What we currently know is that breaking this cycle is best done using a team of health professionals to help you move better, pace yourself, use appropriate medication and reduce the danger signals and anxiety that your pain is producing. See your GP to discuss the possibility of accessing health professionals for a team based approach to managing persistent pain.
Practical advice
The Impact of Thoughts
The thoughts you have about your pain are critical in managing the pain. If you think “this is unbearable,” then your feelings will follow. Hence, saying to yourself “that dog will bite me” will make you more anxious when approached by a dog; or saying “I’ll never be able to play golf again because of this pain” will make you feel sad/depressed.
To change these thoughts, you may need time, the support of a Clinical Psychologist and good quality information about pain. There are online resources that can help and some are listed at the end of this article.
Tackling existing issues is also an important task as these can keep your anxiety and stress levels elevated which can lead to increased pain.
Relaxation Strategies
Find ways to reduce your tension. Bracing when you are in pain is natural. Many of us know what it is like to have dental work carried out. When the Dentist assures us that, “this won’t hurt a bit,” do we relax? No. Just in case, we tense our jaw and anything else we can clinch. Imagine doing that for months on end – it’s exhausting, painful and stressful.
Learning to stop bracing while you are experiencing pain takes time. A starting point for relaxation can be to try lying down in a quiet space and slowing your breathing down. Breathe so that you feel your abdomen rising and falling. This is called diaphragmatic breathing and signals to the body that we are safe, relaxed and not in danger. You will find a link to some recordings and information about relaxation breathing at the end of this article.
Mindfulness meditation is another technique you can use to address both anxiety and tension. It is not for everyone but it can be very helpful.
Movement
Movement is essential. Physiotherapists and Occupational Therapists can help you develop a tailored exercise program to improve your conditioning and strength in ways that can help you move better and increase your activity in everyday life. This too can help with anxiety and tension as your body learns that movement is safe – if done right.
Chronic pain is not something that humans are designed to deal with and it is no surprise that many of us find that it dramatically reduces our quality of life. I would encourage you to engage with a team to help you develop the skills to cope better. Living with chronic pain is a tough journey – there is no need to do it alone.
By Dr. Vance Locke BA (Hons) M.Psych (Clinical), PhD
References:
Thoughts and mood: Centre for Clinical Interventions – WA Dept. of Health
http://www.cci.health.wa.gov.au/resources/consumers.cfm
An online CBT course for pain through Macquarie University
http://ecentreclinic.org/?q=PainCourse
Relaxation: University of Western Sydney
http://www.uws.edu.au/currentstudents/current_students/services_and_facilities/counselling_services/stress_and_your_wellbeing/relaxation_recordings
Provides a range of recordings – try them all.
Centre for Clinical Interventions – WA Dept. of Health
http://www.cci.health.wa.gov.au/resources/infopax_doc.cfm?Mini_ID=46
