We can be our own worst critics. It's important to remember there's still a core you despite the pain and to be kind to yourself..

What you can do

• Write down your positive qualities and accomplishments – what’s good about you. Sometimes we can be own worst critics.
• Balance expectations.
• It’s okay to not be perfect – everything doesn’t have to be in place.
• Say “no” if you need to.
• Accept help.
• Forgive yourself (sometimes we are our own worse critics).
• Eat healthy.
• Sleep better with these tips.
• Talk with your loved ones about your needs and challenges without complaining. We don’t want sympathy, we want understanding.
• Reward yourself and celebrate your successes, no matter how small.
• Check out these helpful self-compassion exercises and practices from Dr. Kristin Neff.
• Read this article "The Role of Self-Compassion in Chronic Illness Care".

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

• Are You Missing Two-Thirds of Your Potential Pain Treatment Plan? (My article) - Highly recommend!
• Central Sensitization Syndrome (CSS) - Dr. Christopher Sletten (22:19) - Highly recommend!
• Central sensitization: implications for the diagnosis and treatment of pain
• The Truth About Managing Chronic Pain (w/Dr. Rachel Zoffness) - ZDoggMD (1:39) - Highly recommend!
• Neuroplasticity
• Chronic Pain Won't Stop Me: Tools to Make the Most of Life, Despite Chronic Pain (My free e-book) - Highly recommend!

Pain rehabilitation goes beyond medicine and medical interventions – and crosses different disciplines. It doesn’t just focus on removing the pain.  It focuses on the patient and how they can play a role in their own pain management.
 
It’s a proven approach based on the biopsychosocial model of medicine – benefiting patients while reducing costs and reliance on the medical system.  
 
In addition to their general efficacy, these types of programs using interdisciplinary chronic pain rehabilitation can be effective at weaning patients off opioid therapy with long-term improvements in pain, mood, and function.
 
I was fortunate to be able to attend the 3-week interdisciplinary Mayo Clinic Pain Rehabilitation Center – not just once, but twice.  It was both a game-changer and lifesaver for me.  I highly recommend the program to anyone interested in taking an active role in managing their own care.  Read about my Mayo experience in this article.
 
More programs like this are needed to shift the current reliance on biomedical therapy towards a greater reliance on provider-supported patient self-management and true biopsychosocial treatment.
 
Availability is important but so is accessibility. These programs aren't cheap, and insurance can be hesitant the pay the price tag. What payors need to remember is that these programs are cost-effective with a 68% reduction in medical cost spending.
 
Find links to programs in the U.S. and around the globe.
 
What to look for in a program
A pain rehabilitation program should focus on you as a person, not just your pain.  

Interdisciplinary pain rehabilitation programs that take place in the same facility with health care providers working together with open communication and shared objectives are the gold standard of comprehensive care outperforming medical pain services and less coordinated multidisciplinary programs.
 
A comprehensive pain rehabilitation program typically includes:

• Medication management – To find the right combination of medicines and taper/stop any unnecessary medications along with better monitoring of patients who are prescribed opioids.
• Pain education – To help patients better understand the purpose of pain and how best to respond to it – reducing any fears that pain is a symptom of a serious health issue, and that activity will cause more damage.
• Lifestyle changes – To improve diet and sleep.
• Psychosocial intervention – To change self-limiting thoughts and provide coping skills using acceptance commitment therapy and cognitive behavioral therapy.
• Physical therapy/exercise – To build strength and endurance.
• Occupational therapy – To modify and moderate daily activities.
• Relaxation training – To reduce stress on the mind and body – easing the pain experience.
• Family therapy – To teach loved ones how to help/not help those in pain – encouraging self-efficacy and reducing pain behavior.

 
Learn more about pain rehabilitation

• Interdisciplinary Rehabilitation Programs in Chronic Pain Management
• Interdisciplinary Chronic Pain Management: Past, Present, and Future
• Focused Review of Interdisciplinary Pain Rehabilitation Programs for Chronic Pain Management
• Interdisciplinary Chronic Pain Management: International Perspectives
• Interdisciplinary Chronic Pain Management: Overview and Lessons from the Public Sector
• Chronic pain affects the whole person – a phenomenological study
• IASP Pain Management Center – a series of chapters
• The Resurrection of Interdisciplinary Pain Rehabilitation: Outcomes Across a Veterans Affairs Collaborative
• A Call for Saving Interdisciplinary Pain Management

 
Learn more about the Mayo Clinic Pain Rehabilitation Center (PRC)

• Program information
• My experience at the PRC
• Dr. Christopher Sletten explains pain, central sensitization syndrome, and what they do at the PRC (22:19)
• Dr. Jeannie Sperry explains how the PRC can help those suffering with chronic pain (9:44)