When painful symptoms first arise, patients and their health care providers work together to see if they can identify and address the underlying cause. For many conditions and injuries, however, there is no precise medical or surgical cure. As time passes, in addition to other diagnoses or even without an identifiable cause, patients may be diagnosed with chronic pain. Treatment goals will then shift from resolving the pain to reducing and managing it.
Typically, pain is considered chronic when it persists for six months or more. But for some patients, chronic pain can last for years or even a lifetime. There are many possible causes for long-term pain, including injury, such as involvement in a car accident, or underlying disorders or diseases, like fibromyalgia or arthritis.
The type of pain experienced can be as varied as the reasons behind it. Pain can be felt as burning, stabbing, aching, pulsing, and many other sensations. These sensations can occur anywhere in the body, and can range from mild to severe, from intermittent to continuous, and from distracting to disabling. Over time, chronic pain can become a disease in and of itself, creating notable changes in the body, particularly the nervous system.
Because each individual person with pain is so unique, it can be challenging to manage pain effectively. There is no one-size-fits-all approach to treatment, and pain management is usually aimed at reducing pain, not eliminating it. Working alongside health care providers, most people with pain will need to engage in a process of trial and error to find a treatment plan that works for them. Typically, successful pain management requires finding a combination of multidisciplinary, multimodal therapies that reduce pain enough to improve quality of life and increase function.
Chronic pain, especially severe pain, can have an enormous impact on your emotional health. Research has shown that people with pain are significantly more likely to experience anxiety, depression, and suicidal thoughts. Remember that you are not atypical, oversensitive, or weak for experiencing emotional distress because of pain. These are normal, reasonable responses to physical suffering and its associated limitations.
Unfortunately, despite the widely recognized psychosocial effects of pain, caring for mental health often takes a backseat to treating physical symptoms. But stress levels exacerbate chronic pain, and chronic pain exacerbates stress levels. This does not mean the pain is “all in your head.” It simply means that the mind and body are linked. Taking care of your emotional well-being can help improve your pain, or, at the very least, help you cope with your pain.
An estimated 50 percent to percent of people with chronic pain have ongoing sleep difficulties. Studies show that inadequate sleep, however, can exacerbate pain. Here are some tips for ensuring you get a good night’s rest despite pain.
- Establish a routine.Going to bed and waking up at the same time every day—even on the weekends—reinforces the natural sleep-wake cycle in your body. You can also help reinforce bedtime by establishing a wind-down routine, e.g. by taking a bath, meditating, reading or listening to soothing music.
- Create a restful environment. Turn on white noise, use ear plugs, invest in comfortable bedding, and keep the room temperature cool. Exposure to light is especially important: dim or turn off the lights in your house 30 to 60 minutes before going to bed. The light from cell phone and TV screens can also interfere with circadian rhythms, so shut down all devices as you prepare for bed.
- Watch what you eat and drink. Caffeinated products—like tea or coffee, chocolate—anything containing nicotine, or any other stimulants should be avoided for at least four to six hours before you plan to go to sleep. Even alcohol, which initially makes you feel tired, makes it harder to get high-quality sleepy. Furthermore, heavy meals and too many fluids before bed might keep you up because you are uncomfortable or need to use the bathroom.
- Get tired! Napping during the day can interfere with sleep at night. If you must, limit your snooze to 30 minutes, and give yourself at least four hours between the nap and bedtime. In addition, exercising during the day helps tire out your body and can foster better sleep at night. Try to work out at least a few hours before bed, if possible.
Still struggling? Ask your doctor about meeting with a sleep specialist.
Pain increases stress, and stress increases pain. But you can break this cycle by proactively trying to reduce stress wherever possible. Multiple studies have shown that reducing stress and relaxation techniques can improve overall health and wellbeing, and may even reduce pain or improve the perception of pain.,
Some examples of stress reduction techniques and strategies include:
- Relaxation techniques such as breathing exercises, progressive muscle relaxation, visual imagery, and mindfulness
- Music, art or dance therapy
- Support groups
- Counseling and cognitive behavioral therapy
Generally speaking, reducing stress with chronic pain also requires:
- Pacing yourself to allow for sufficient rest and recovery;
- Learning to say no and putting your health first;
- Focusing on the things you can do and not what you can’t;
- Communicating clearly with your loved ones about your needs and challenges;
- Letting go of guilt and shame surrounding pain.
For more advice on managing stress when you have pain, find a psychologist, counselor or life coach in your area.
My chronic pain started when I was diagnosed with Lyme Disease. Since then the pain has increased in many areas of the body, some days it’s hard to walk. Bursitis, Arthritis, and Fibromyalgia have entered my life and it can be exhausting. Sleeping at night is hard, laying down puts pressure on my trigger points, and the pain flares up. I constantly wake up in pain, Laying there until going back to sleep or get up.
I’m not on pain medication at the moment but have a referral to see someone. I’ve been off pain medication for a year but it’s not worth living in pain. Managing pain often includes medication and that has to be monitored closely. Pain medication is addictive, it is made worse when your doctor fires you or you fire them without notice and have no withdrawal plan. What I do is not take the full amount prescribed, saving them in case I have to do self-withdrawal. It may not the best method but I’ve fired a doctor, it was hell coming off everything with only two weeks of medication.
One of my self-care techniques is to take a nap most afternoons. This gives my body a rest, and it helps ease the mind. That doesn’t mean I sleep, most of the time it’s just resting.
What do you do to manage your pain?