I love this metaphor about who's driving the car - you or your pain.

Things you can control - Focus on these

• Understanding how pain works
• Changing how you think and feel about pain, and how you respond to it
• Accepting the pain
• Not being afraid of the pain
• Being aware of what you listen to, read, and watch to avoid negativity and drama
• Being kind to yourself and others
• Taking active responsibility for your care
• Not verbally expressing or complaining about the pain
• Not wallowing in the pain
• Not placing blame for the pain
• Staying away from people who only want to complain about pain
• Not sharing your pain with others
• Reducing stress
• Eating right
• Moving more and increasing your activity level
• Moderating what you do
• Modifying what you do
• Being grateful – focus on what you have, not what you’ve lost
• Developing better sleep habits
• Preparing for a flare in advance so it doesn’t overwhelm you

 
Things you can’t control - Don’t focus on these

• Pain
• Imaging test results
• Past medical interventions
• Past painful experiences
• What other people say or do
• Weather
• Cultural and family norms
• Socio-economic background
• Demographics (sex, age, ethnicity, etc.)
• Genetic make-up

If biomedical treatments like medicines, rest, supplements, ice, heat, injections, and physical therapy didn’t resolve pain when it was acute, is it reasonable to expect using only the same treatments to change our symptoms when the pain becomes chronic?

It's not.

We must change the paradigm. Pain is more than a biomedical condition. We need to treat both mind and body. As Dr. Rachel Zoffness reminds us, " Because pain is biopsychosocial, treatment must be, too."

Comprehensive pain treatment that addresses the biopsychosocial aspects of a person's pain experience is not only more clinically effective than conventional medical treatment by itself, it’s also more cost-efficient.

Acute pain vs. chronic pain
There are two types of pain: acute and chronic.

Acute pain is the body’s normal response to tissue damage or injury. The pain matches the damage and treatment works - lasting less than three months.  

Chronic pain is an abnormal response, becomes its own disease/condition, and doesn’t improve over time.  It can happen long after an injury or illness heals. Treatments don’t always work or stop working and symptoms can change and grow over time.

The longer we have pain, the less likely it is related to tissue damage or injury and the better our bodies can become at creating it and turning up the pain volume. It’s a process known as central sensitization. 

Sensitization can happen in all chronic pain conditions, no matter the underlying cause, including fibromyalgia, whiplash, shoulder pain, neuropathic pain, chronic fatigue syndrome, non-cardiac chest pain, irritable bowel syndrome, temporomandibular disorders, post-surgical pain, complex regional pain syndrome, low back pain, osteoarthritis, pelvic pain, and headache.

This 22-minute video from Dr. Sletten with the Mayo Clinic Pain Rehabilitation Center (PRC) does an awesome job explaining pain and sensitization, why traditional medical treatments don’t always work for chronic pain, and their approach at the PRC. I encourage you to watch it.

Learn more

• We Have a Chronic Pain Problem, Not a Prescription Opioid Problem (my article)
• Are You Missing Two-Thirds of Your Potential Pain Treatment Plan? (My article) 
• Central Sensitization Syndrome (CSS) - Dr. Christopher Sletten (22:19) 
• Central sensitization: implications for the diagnosis and treatment of pain
• The Truth About Managing Chronic Pain (w/Dr. Rachel Zoffness) - ZDoggMD (1:39)
• Neuroplasticity​