Managing persistent or chronic pain is complex but with better understanding and effective ways to cope, you can greatly improve the quality of your life.
If you’ve had pain which persists for more than the time it normally takes for an injury or illness to recover, or more than three months, you most likely have chronic pain. It probably will not have responded to medicines, physiotherapy, surgery and in some cases, feels worse over time.
It is important to explore physical, emotional and psychological coping strategies so you can manage your pain condition better. Controlling pain isn’t just about taking strong pain relief medication. Information, learning and understanding are all crucial elements in the pain journey.
Here we explore alternatives to help with persistent pain.
Exercise and Stretching
We know that activity levels can affect your experience of pain.
People will sometimes rest more or even take to their bed to recover. These recovery times get longer, leading to longer periods of inactivity before pain settles and then repeats.
These behaviours over time can lead to less and less activity and usually more pain. This repetition or cycling is called “Boom and Bust” and it can lead to a lessening of movement, strength, energy, sleep and the things you like doing over time.
Pacing your activity is the cornerstone of self-managing your pain condition.
Recognising how much activity you can do and how you can achieve it is crucial and should be achievable without adding further pain.
People may restrict movement as they feel the pain requires them to rest to recover but this can lead to further loss of strength, stability, balance and mobility.
For some people, this can lead to a fear of moving. For example, if standing or walking makes your pain feel worse, you feel you need to rest more and walk less. It is important to understand moving does not lead to more harm to your body tissues.
Any movement can be helpful and good for you.
Walking, stretching, yoga and even housework can be good for you. These and other movements or exercises can improve your blood flow, the oxygenation of your body’s tissues, as well as your mood and sleep.
Crucially the benefits of movement and exercise can directly and indirectly benefit your pain experience.
Better balance, strength, stamina, coordination and blood flow are important in the processes that can help your body and nervous system respond positively to your pain.
Better blood flow and oxygenation allow tissues to be more tolerant of movement and aid recovery, enabling you to continue moving and exercising on a regular basis without adding more sensitivity to areas of grumpy tissue.
Movement and exercise can also help reduce cholesterol and weight loss and produce natural anti-inflammatory and pain-relieving substances in your body.
Rest, Relaxation and Better Sleep
Pain can leave people feeling unrested, tired and exhausted with no energy in the daytime when you do want to be more alert and active. Pain affects your levels of stress in your life. Feeling unable to relax and rest can make things worse. Introducing relaxation to the stressed and sensitive nervous system can help it retrain to notice the positive thoughts, feelings and behaviours.
Rest is not just watching TV on the sofa with family in the evening. Developing better sleep patterns and better rest and relaxation techniques during the day and night is just as important.
Try to establish a night time routine for an hour before bedtime.
This may include a hot shower or bath, reading for pleasure or a relaxation exercise.
Turn the lights down or even out. Quieten your environment, turn off any TV or digital devices and stop drinking about two hours before bed (sip tepid water if you must). Try not to eat.
Leave your phone or gadgets in another room to avoid being disturbed.
Do try to establish a pattern where you go to bed at the same time and wake up at the same time every day. Your body and brain remember these and will develop a pattern or rhythm.
Do not push the snooze button, get up at the time you have decided to get up. Open your eyes to daylight, pull your curtains showing your eyes the day.
Try to walk before midday and if unable to, try to be outside or do some of your activities or movements.
Relaxation in the context of self managing your pain condition is:
thinking about what you want
finding a resource
planning and practicing approaches that work for you.
Examples of different approaches may include listening to narrated audio files of muscle relaxation or seeking to make changes to your thoughts and feelings around stress and insomnia by using guided meditations.
Going to classes like yoga, pilates or maybe even Tai Chi and Qigong are all beneficial for decreasing pain levels.
Diet and nutrition is really important in long term conditions like pain.
A healthy balanced diet, good nutrition and a healthy weight can really improve outcomes for your health such as the risk of Type 2 diabetes and hypertension and can have a noticeable effect on your pain experience.
Learning to self manage your pain condition may include learning more about how your body tolerates or makes use of certain foods and substances in your diet such as caffeine levels, processed foods, excessive alcohol and refined carbohydrates.
A meal plan that includes oily fish like salmon and mackerel, extra virgin olive oil, dairy or equivalent, dark leafy greens, green tea, garlic, nuts and seeds every week is going to be a great investment.
Processed foods were not very common fifty years ago and snack foods were not readily available or affordable like they are today. Like everything today, balance is important and in the case of processed food, it is important to keep the amount of these as low as you can.
Try to eat fresh food where possible, either as cooked or uncooked.
Try to focus on eating three meals a day, and if possible, at regular times, to promote good digestion and energy absorption.
Consider a variety of food types like carbohydrate, protein and fibre.
Remember to drink plenty of water daily, ideally 6-8 glasses of fluid a day but water is best.
Remember coffee increases cortisol levels which can lead to difficulty sleeping. Drinking too much coffee in the day can lead to restlessness and anxiety. The time it takes for half the amount of caffeine to leave your body is variable but generally is around five hours so avoiding caffeine before bed is important.
Finally, by trying to introduce yourself to alternatives for treating your chronic pain you will need to find activities and approaches that work for you. It may possibly involve making changes to your thoughts, behaviours and emotions.