Chronic Pain-Learn 5 Effective Ways to Manage It
- Dr. Watts
- Apr 13
- 7 min read
Pain is...a real pain! We have all experienced it , we do not like it and we go to great lengths to make it stop! If you have gone through a particularly bad episode of pain, you might even express the wish never to have pain again, but that is not something you would actually want. There is an extremely rare condition called congenital insensitivity to pain where people cannot feel pain. The nerves cannot send messages about painful sensations to the brain. Really dangerous, if you think about it, because if you cannot recognize the internal signals of an injury or infection you are not going to seek treatment in a timely manner, increasing the likelihood of extreme complications and death.
So how does the pain process work?
Let's say you touch the hot handle of a pot. What happens next? Here is a step by step flow chart to answer this question:
.
A truly extraordinary process, if you think about it! It is an instantaneous response that happens without pondering or thinking about a course of action. You just do it! You don't think about the mess the pot will make when you let go of the handle. Letting go is a reflexive reaction. If it took as long as it has taken for me to describe it or for you to read the flow chart, your hand would be burned severely, requiring serious emergency intervention.
This is one simple example of an injury that causes acute pain: in this case, a sharp, burning sensation. But there are other types of pain, in different locations, of differing durations and complexity..
Visceral pain is located in an internal organ, such as the stomach, intestines, liver, pancreas. It tends to feel like a deep ache that is sometimes hard to localize. Neuropathic pain, which involves the nerves themselves, tends to be hard to treat, and is experienced as burning, shooting, tingling, sharpness, numbness. Somatic pain involves all other tissues, bones, skin, muscles and is usually highly localized. Understanding the location allows doctors to perform further assessments to understand the cause of the pain.
Pain is also categorized in terms of duration - acute and chronic. Acute pain, such as post-surgical pain, a broken arm, a tooth abscess, a sinus infection is of short duration and generally goes away after treatment. Chronic pain, on the other hand, continues past the point of healing from an actual physical injury. Some chronic pain can also be the result of a medical condition such as arthritis, cancer, Lupus, fibromyalgia, and many other conditions.
It might seem like overkill to have all these groupings for classifying and describing pain, but if you think about it, the more you know, the more you can describe it, the easier it is to figure out an intervention and treatment. Most are familiar with a doctor's questions about pain:
where is it
what kind is it: sharp, dull, throbbing, stabbing, aching, burning -- many adjectives for pain!
how long have you had it
does it hurt when I press
what number is it on a scale of 1-10.
As a psychologist, I have worked with people who grew up in families where expressing distress about pain was judged and shamed and discouraged: “Suck it up,” “It’s all in your head,” “Don’t be such a drama queen,” “Just don’t think about it, and it will go away,” and other kinds of unhelpful and dismissive comments that affected their ability to understand and verbalize the feelings of pain. Boys, especially have been historically discouraged from talking about pain and taught that they have to be strong and tough: “don’t be a wimp,” “boys don’t cry,” "you're acting like a girl," so men often have much trouble recognizing an acknowledging pain.
The real cost of that is incalculable in terms of quality of life, relationship distress, and lost productivity. When people grow up being criticized for expressing distress about pain, they are less likely to seek help or medical attention until their symptoms are often unmanageable and untreatable. One hears stories all the time about somebody's friend or neighbor who was totally fine one day, and the next was diagnosed with stage 4 cancer and died 2 weeks later. If it is uacceptable to express distress about being in pain, then the underling cause for the pain goes undiagnosed until it is too late.
Pain...is a pain, no matter what kind it is, but chronic pain is most damaging to functioning, life satisfaction, and mental health because chronic pain is not just physical. It is a complex interaction between tissue injury and non-injury related problems, such as level of emotional distress, social support available, coping skills, feelings of efficacy (the belief that our efforts will pay off) rather than hopelessness and helplessness (the belief that our efforts are irrelevant and will not make a difference).
In palliative and hospice circles, doctors refer to this as “total pain,” the sum of a person’s pain as the total of physical, emotional, social, and spiritual factors. Any one of these factors can either add or detract from the overall experience of pain in a continuous process of ebb and flow. If you have chronic pain, you know what that means: pain is worse if you are anxious or depressed, for example, or feel lonely and isolated. On the other hand, if you are busy doing something fun and you are surrounded by friends, your pain is lessened.
Unlike acute pain, which resolves relatively quickly and responds well to medication, managing chronic pain is far more difficult because of the various factors that can play a role. To make things worse, chronic pain becomes an internal source of chronic stress that compounds the pain, which creates more stress in a spiral of increasing pain. You can read here how chronic stress impacts us in many ways, all the way down to the cellular level.
Fortunately, strategies that help reduce stress are also beneficial for reducing chronic pain.
Chronic Pain - Learn 5 Effective Ways to Manage It
Eat to fight inflammation – What you put in your body affects your pain. Mountains
of reseach show that anti-inflammatory foods—like the Mediterranean Diet, rich in omega-3 fatty acids, anti-oxidants, fiber, vitamins, and minerals -- reduce levels of pain severity and duration. Ultra processed foods, sugar, and excessive alcohol? They do the opposite. Junk food, fast food, convenience foods are just that: fast and convenient, but junk. They provide short-term pleasure for long term inflammation and chronic pain. Switching to a whole foods diet, prepared from ingredients that you can recognize, will provide the balanced nutrients that nourish your body and decrease pain.
Move (even when you don't feel like it) – It sounds counterintuitive when you are in pain and all you want to do is lie on the couch, but movement is medicine. Studies have found that physical exercise and strength training help reduce chronic pain by increasing endorphins and improving muscle function. Dancing, yoga, swimming, or even a simple daily walk are all good forms of exercise that deactivate the stress response. In the end, the type of activity is less important than actually putting your body in motion. The current recommendations for exercise are 150 minutes a week of moderate activity, which comes out to 30 minutes 5 days a week. If you can only manage 10 minutes a day for now, it is 10 minutes more than you were doing before.
Avoid alcohol -- Although drinking a couple, or a few, beers might seem to take the edge off the pain, in reality alcohol only compounds the problem -- small short-term benefit (decreased awareness of pain), with a large long-term cost: increased inflammation, increased pain, and alcohol dependence on top.
Try alternative therapies; they actually work -- Acupuncture has been shown to be successful for reducing pain for conditions like migraines, arthritis, and back pain. Massage therapy also improves circulation and reduces inflammation, easing musculoskeletal pain. Mindfulness can literally change how your brain processes pain. Studies have shown that mindfulness-based stress reduction exercises helped people with chronic low back pain function better and feel less pain. Hypnosis, yoga, gentle stretches, breathing exercises, meditation are all non-medical ways for lowering stress, which lowers inflammation, which lowers chronic pain, which improves functioning, and increases quality of life. A domino effect of beneficial results!
Do something that is fun and light and brings you pleasure -- I always ask my clients what they like to do that absorbs them and bring them enjoyment. Many times they tell me that they used to have a hobby or do crafts that they loved, but that they lost interest or don't feel well enough to do such things. It is understandable - chronic pain puts a damper on enjoyment. But a pleasurable activity, such as a craft or a hobby is the quiet place in the storm where you can do something that is positive and enriching and calming. Just like physical activity releases brain chemicals that reduce pain, so does engaging in an enjoyable activity.
Ultimately, though, coping with chronic pain is a journey frought with challenges and many ups and downs that cause negative thoughts and feelings of discouragement and frustration. A trained mental health professional, particularly one specializing in cognitive behavior therapy, can be a great ally in developing an effecive approach for coping with chronic pain.
"If you can't fly then run, if you can't run then walk, if you can't walk then crawl, but whatever you do, you have to keep moving forward."
Martin Luther King, Jr.
Dr. Dana Watts
Clinical Psychologist
Helping Clients in the Greater Cleveland Area
440-895-1100
Great, informative post. I love the way you explain what happens to your body when you experience pain.