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Chronic pain management - Do not fight the pain, befriend it.

Updated: Jun 9, 2023

When dealing with chronic pain time is our ally. We live in a fast-running world oriented on functioning and performing on all fronts, and so when body aches we are looking for a fast remedy. On the healing journey we need patience and sometimes significant adjustments to our life style.

Pain is sensorially and emotionally unpleasant experience to the tissue damage. If it lasts

for more than 3 months it is considered to be chronic. Chronic pain is not only a personal problem but a global one. It is an illness on its own with huge impact on individual life and consequently on the society. The lost working days have a great impact on economy but also on patients´ lives. A chronic pain patient might feel isolated, useless, a burden to the family. While being on sick leave and preoccupied with the ailments they may lose the vital source of energy that comes from participating in leisure activities and socialising. The elderly who are not obliged to work may suffer even more from isolation due to the pain issues and reduced mobility.

There is underlying psychological distress that often comes hand in hand with the significance of the diagnosis (I have serious condition, I am too young for this, the operation will not help, I have terminal condition). Chronic pain attacks our integrity and, in a way, separates us from the others - healthy colleagues, healthy friends or a spouse who cannot fully grasp our suffering. It not only reflects the present suffering but often goes back to the past - what pain we have already endured, how have we been helped, what were the circumstances? In addition, it projects us to the future – will it ever disappear, what influence will it have on my private, professional life, what limits do I need to accept?

It is a reflex to get rid of the pain as quickly as possible. To cool down a burn, an insect bite, to rub in a cream into sore neck, to take a painkiller, get involved in physiotherapy. All of these can be applied when suffering from chronic pain, however it is only one part of the toolbox. Sadly often the only one we have at hand, proposed by the general practitioner or the specialist. We tend to run to see the doctors and they tend to prescribe us more and different painkillers, more physiotherapy sessions and if applicable with persistent pain linked to tissue damage a surgery. We are running in circles mostly because we focus on returning to the point of departure, we want to be as before. The pitfall is that our focus is on the past, the comparison of something we perceive as an ideal status as opposed to the unacceptable status. We are in constant alert mode, fighting the sensation of pain, the image of pain (a physically impaired person, not-so-well functioning person, sick person) the negative emotions such as sadness or anger and often struggle with our behaviour - irritability, loss of trust, wining attitude, victim-hood etc. All of this comes from non-acceptance of the pain. So how to accept and befriend the chronic pain and stop fighting it?

  1. Observe the pain as it is, describe it for yourself - heavy, hot, tingling, pinching, pulsating, stabbing, sharp. Do not add a story to the current pain - don´t imagine it will never go away, don´t fantasise about being out of your job, not able to take care of your children, losing a partner or similar catastrophic scenarios. It is our mind that adds unnecessary layers to the actual pain. What works is to redirect the focus. You need to test several strategies that work for you - a brisk walk, a bath with aromatherapy, infra red light, relaxation music, gentle massage of the sore body part, breath work. You can try to attribute the pain one of the natural elements: water, fire, wind and visualise yourself extinguishing the fire (targeting the bodily part in pain), cooling or heating the water around the painful spot or imagining the pain being a strong wind slowly transforming into gentle and comforting breeze soothing your pain.

  2. Be aware of what makes your chronic pain worse. It can be stress at work, too many things on a plate, if you are a woman your hormonal cycle, perimenopause or menopause. It all comes to the ability to listen to our body and adjust our life rhythm. Take it easy, delegate, skip activities, learn to say no. It will happen that despite this awareness you will eventually run into clash of theory with reality. If that happens do not punish yourself with inner criticism - I should have known better, I knew I needed the rest. Instead focus on what can be done. Do I need to take a painkiller, muscle relaxant, other medicament, or just lie down and listen to calming music or all of that? Once the pain settles write down the lesson learned - you will be better prepared for the next time.

  3. It is possible that chronic pain is present all the time, although sometimes it is more prominent. Talk to your pain. "I know you are here, what can I do for you?" Be in physical contact with the part of your body that suffers, caress it, cry in compassion if you feel like it. Promise it you will take care of it. Then say to it you have other things to do and involve yourself with some pleasurable activity - reading, watching TV, playing a game.

Why is befriending the pain important? The saying goes: What we resist persists. Therefore, learning to be with the pain, not ignoring it but on the other hand not to dedicate our entire focus on the pain is essential.

If we do not count sequels of injuries or consequences of serious illness, with sedentary lifestyle or one-sided manual work and ageing we will all experience periods of pain and it is in our best interest to introduce preventative measures such as regular exercise and correct pain management into our lives in order to stay active as long as possible.

When dealing with chronic pain time is our ally. We live in a fast-running world oriented on functioning and performing on all fronts, and so when body aches we are looking for a fast remedy. When painkillers are of no help, we might see a surgery as the only option how to become operational. Yet, it was proven by a comprehensive SPORT study that in the case of disc surgery the alleviation of pain is only short-term, i.e. significant immediately after the surgery but with no difference in a 2 year period when handled with conservative therapies. On the healing journey we need patience and sometimes significant adjustments to our life style.

Chronic pain management is complex and calls for involvement of several specialists. Ideally you can find them under one roof in a pain clinic or you need to search on internet. Look for people who can prescribe you painkillers and anti-inflammatory drugs, if the pain is debilitating you need an algesiology specialist, people who understand ergonomy at workplace, psychologists, body-mind therapists, acupuncturists, mindfulness coaches or hypnotherapists. The more tools you can use when managing your chronic pain the better.

If interested in more data - the most comprehensive study to date on the prevalence of chronic pain in Europe dates back to 2006 (Breivik, Collett, Ventafridda, Cohen, and Gallacher) but uses data from early 2000s and does not include socioeconomic inequalities in pain prevalence. The more recent study from 2019 published in European Journal of Pain mentions back/neck pain as the most prevalent with 40% of survey participants experiencing pain; then hand/arm pain at 22%, and then foot/leg pain at 21%.


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