The Anatomy of Dealing with Chronic Pain

Tired of dealing with flare-ups of chronic pain constantly?

I struggle with chronic back pain and am currently receiving treatment through the pain clinic at Madigan Army Hospital. I recently went through a full time rehabilitation program with really positive results and a reduction in my pain. I want to share what I've learned to be allow that information to help others.

  DISCLAIMER: I am not a health care professional and this post is simply advice on what has helped me that I learned during my treatment. If you are dealing with chronic pain, I urge you to be under the care of a health care professional and not to rely on this content as a way to cure you of that pain.

  There are a few different categories that these techniques fall under and I will discuss each of these as we approach that topic. I understand that it's hard to make changes, especially when its a lot. So, try each of these techniques out and slowly add in the ones that are the most beneficial to your lifestyle.

  The first category is physical changes. These are things that you can do that have research backing it up as a way to reduce chronic pain and help you start to take back some control of your life and discover new ways to accomplish things that you believed you could no longer do.

Sleep Management

Sleep is the bodies way of resetting itself. It's important for the mind and the body to have that time to repair and regenerate. Unfortunately chronic pain disrupts many people from being able to get that vital restorative sleep. Pain and lack of sleep go hand in hand. Inability to sleep due to pain prevents the body from restoring itself and leads to more pain and the cycle just continues. So how do you break the cycle and get the rest that you deserve?

Use these tips to practice healthy sleep habits and get the best chance to achieve restful sleep.

• Create a set pattern for waking up and going to sleep every day even on the weekends.
• Avoid naps during the day especially after 2pm.
• Use the bed for sleep and sex only.
• Create a ritual of what you do before bed to help the mind and body synchronize
• Adjust the environment by eliminating noise and light.
• Avoid caffeine six hours prior to going to sleep.
• Apply relaxation techniques and avoid mentally stimulating activities prior to bed.
• Get OUT of bed if you aren't going to sleep in what you feel like has been to long and doing something like listen to relaxing music or read a book. Clockwatching and restlessness in bed are recipes for insomnia.
• Shut you phone off or leave it elsewhere if you use your phone as alarm. The blue light flashing or the sounds of a notification can keep you awake.
• GET UP in the morning when you're alarm goes off! Don't press snooze. (I have a really hard time with this one guys but it really does help.)
• Open the curtains or turn on all the lights in the morning. It helps turn off your body's natural melatonin production and increases alertness.

Healthy Eating

There is a lot of research that demonstrates that when you give your body the nutrients that it needs  then there is a lot of health benefits that occur including having a reduction in your overall pain. I'm not going to preach that you take on extreme changes and adopt a perfect diet. Just try to make better food choices in general and remember to use moderation when you do decide to splurge. Also, don't worry about the numbers on the scale. I only get on the scale at the doctor's office because its more important for me to focus on how I feel and not what the scale says.

Getting Active

Consult with your doctor about what activities you can do and what activities you should avoid. Together, you should be able to create a program or select some activities that you can participate in. It's important to take it easy and listen to your body for signs that its time to try something else. Here are a few examples that I started with and still enjoy.

• Yoga
• Tai Chi
• Hiking
• Swimming
• Spin Class

 

Time Based Pacing

This concept was probably the most difficult technique for me to put into practice but has also made the most difference in my life. When I had a "good day" and had little pain, I would try to get everything done that I had been putting off. I was also extremely reluctant  to stop working on a project once I had started even if it meant causing myself more pain. This usually meant that I would do too much and be almost unable to move without extreme pain for days afterward.

This is the reason for applying a time based pacing strategy. Pick the task that you need  to accomplish it and set how many minutes you are going to work and how many minutes you are going to rest. The goal is to avoid having a pain flare- up happen at all. It will take longer to get certain tasks done but when you skip having added discomfort the next day then,  you are able slowly accomplish everything on your to- do list  instead of  trying to tackle all of it on one day.

The next list of techniques are about changing your way of thinking. This is definitely not to say that your pain is fake or that it isn't severe as you make it but the power of your thoughts cannot be denied. The attitude you have and how you choose to see a situation play a big role in your mood. It's really important especially when being in pain all the time tends to make it easier to get angry or have a negative outlook.

Stress Management

Stress is caused by both external things (environment, major life events, daily hassles, etc.) and internal stressors (negative self talk, mind traps, and lifestyle choices). Pain will lead to stress but added stress will often cause more pain and create another negative cycle. Here are some ways  to decrease your stress levels and break the cycle.

Change your lifestyle habits

• Eat a balanced diet and try to eat less junk food.
• Try to exercise at least thirty minutes, three times a week.
• Get the right amount of sleep.
• Practice self care every single day.
• Practice things that make you feel relaxed. (yoga, meditation, coloring) 

           

 

Change how you approach situations

• Consider whether you have effective problem solving and coping skills.
• Practice having the appropriate amount of assertiveness with others.
• Use good time and money management.

Change your thinking

• Always have realistic expectations.
• Use your sense of humor to help keep things light in the situation.
• Be an optimist.
• Make sure to use the people in your life that are supportive to you.

Anger Management

When we feel threatened, anger is our bodies natural reaction to the situation.  It can be a good thing when used to push yourself in a work out or to defy the odds that are against you. However, when anger is fueled to the point that you can no longer think clearly, that is when problems begin. It can cause someone to act out of character and the negative impact on the body will increase pain. Did you know  that for some people, pain can actually lower the threshold, allowing more pain information to be sent to the brain?

Controlling Anger

1. Recognize the things that make you angry.
2. Learn and use effective relaxation skills and strategies to help replace negative thoughts with positive ones.
3. Don't avoid the conflict. Respond assertively even though you're angry and it can actually result in a decrease in the tension of the conflict.

Cognitive Restructuring

This is a technique used to help change negative emotions. It involves realizing that negative thoughts allow negative emotions to arise and finding a way to substitute it with positive coping thoughts.

• When a negative emotion is triggered, pause and describe to yourself the emotions that you are having at that  time.
• What are the thoughts that triggered these emotions for this event?
• Judge how true these thoughts are and the evidence that proves it to be true or false.
• If it turns out that the thoughts that triggered your negative emotions are not entirely accurate think of a positive thought that is in line with the evidence that you have gathered.
• Now, rethink of the situation using the positive thoughts and re-evaluate the emotions that you are now feeling.  

With a bit of practice, you should be able start changing how you think about a situation. Your ability to keep a positive outlook through adversity can really make a difference. 

Cognitive Errors

1. All or Nothing Thinking: An easy example is if you lost a game of chess and see yourself as a complete loser at everything even though that is not the actual reality.
2. Overgeneralization: When you see one event as a never ending pattern.
3. Mental Filter: Continually dwelling on a single negative detail until the entire
   event has become negative in your mind.
4. Disqualifying the Positive: Choosing to discount positive experiences for whatever reason.
5. Jumping to Conclusions: Having a negative idea of an event without any facts to support your conclusion.

Try to think of a time that you might of used each of these cognitive errors and how you can avoid getting caught  up in this sort of thinking in future situations.

Relapse Prevention and Flare up Planning

Prepare: Be ready before it occurs by  paying attention to triggers that warn of increasing pain.

Timing: Don't make it worse by increasing negative thinking. Instead use positive coping thoughts.

Reflect and Plan: Think about what strategies and techniques worked best for the flare up and write it down so that you are better prepared for next time.


I hope that this guide of techniques has been helpful to you. Personally, I found the physical changes to be the most helpful for me and I have much less frequent flare ups than in the past. Give all of these techniques and tips a try to discover that you can still live a full life despite battling with chronic pain.

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