Coping with Chronic Pain

Chronic pain is unrelieved pain that lasts for longer than three months. This often occurs when the pain mechanism in the body no longer works correctly or when certain diseases that are associated with pain become chronic for unknown reasons. Usually, the source or cause of the chronic pain is not known. Examples of chronic pain include continuous back and/or neck pain, diabetic neuropathy, ongoing headaches, interstitial cystitis, and fibromyalgia. A variation of chronic pain is intermittent pain, which is when pain-free times alternate with weeks or months of daily pain. Types of intermittent pain include migraine headaches, rheumatoid arthritis, and irritable bowel syndrome (Caudill, 1995).

Even if there is no clear understanding of the cause of the pain, when we experience pain, we often feel pressure to act on its presence and to resolve the problem. Pain is adaptive when it is a warning of danger or harm and there is something that can be done about it. However, when the pain is constant and with no clear reason, it can be a source of physical and emotional stress. Such stress can further increase the pain by causing fatigue, muscle tension, and difficulty sleeping (Caudill, 1995).

When experiencing ongoing severe pain, life's daily stressors become magnified and appear to be insurmountable obstacles. It can lead to depression, anxiety, social withdrawal, feelings of inadequacy, and feelings of being "beaten down" and abandoned.

So, what can be done to cope with such chronic pain?

1. Utilizing relaxation techniques can help to reduce the stress caused by the chronic pain, making it easier to cope with stressors of daily life, in spite of the pain. In addition, relaxing the body can help to reduce the experience of pain (i.e., through the release of "endorphins", natural pain-killers released by the brain during deep relaxation and through the decrease of the secondary symptoms caused by stress, such as the fatigue, muscle tension, and insomnia mentioned above). There are many types of relaxation techniques, such as focusing on one's breath, focusing one's mind on a repetitive phrase, progressive muscle relaxation, or visualization.

Example: Close your eyes. Breathe in and out slowly three times. Imagine that you can see your breath entering your body as a pink mist. See and feel that pink mist circulating healing energy throughout your body. See and feel it surround your pain, soothing it. See it leave your body as a blue mist, as you exhale, taking your pain with it.

2. Increasing your level of pleasurable activities is very important. People with chronic pain tend to think that they cannot or do not deserve to engage in pleasurable activities. Yet, this is very important, both for distraction from the pain and for decrease of the depression that may result from the pain.

3. Changing your thoughts about the pain and changing your thoughts about yourself for having the pain may be necessary. Many people tend to put themselves down for having chronic pain, as they may think of themselves as inadequate to meet this challenge or that they are defective. One of the most powerful tools for changing the way that you think is to notice your "self-talk" and to rephrase it or challenge it. For example, if you say to yourself, in response to having chronic pain, "I'm defective," then you are likely to experience feelings of depression or low self-esteem. Notice the difference when you change this to: "Being in pain curtails my activities, but it does not reflect on my character" (Caudill, 1995).

4. Pace yourself. Engaging in an activity routine that alternates between more or less physically demanding activities can help you to increase your activity level and decrease your pain. Consider asking others for assistance, when possible. Be sure to include in your schedule some high-quality recuperative time. The body has a chance to recuperate most effectively when it is not in a constant state of exhaustion (Caudill, 1995).

5. Poor sleep quality or insomnia can make the experience of pain much worse. Good quality sleep is necessary for rejuvenating and repairing the body. In addition, poor sleep can increase the risk for depression. Here are some recommendations to improve your sleep (Caudill, 1995):

• Have a regular bedtime and wake-up time
• If naps are necessary, sleep only for 30-45 minutes
• Take a hot shower or bath about 2 hours before sleep
• A small carbohydrate snack before bed can induce sleep
• If sleep is delayed or you have trouble falling back to sleep for more than 30 minutes, get up and do something until you feel sleepy again
• Utilize a relaxation technique before you go to bed or if you wake up during the night.

These are just a few basic techniques for coping with chronic pain. Here are some suggestions for further reading about coping with pain.

References

Benson, H. (1975). The Relaxation Response. William Morrow: New York, NY.

Caudill, M. A. (1995). Managing Pain Before It Manages You. The Guilford Press: New York, NY.

Ellis, A. & Grieger, R. (1977). Handbook of Rational-Emotive Therapy. Springer: New York, NY.

Kabat-Zinn, J. (1990). Full Catastrophe Living: Using the Wisdom of Your Body and Mind to Face Stress, Pain, and Illness. Delacorte Press: New York, NY.

Seligman, M. (1991). Learned Optimism. Knopf: New York, NY.