How do you think about and react to your chronic pain? Are you the victim? Are you overly-worried about the pain?
We all experience pain. That we can't choose.
The choice we have as humans is how we respond to the pain. We can either choose to let the pain control our lives or we can choose to live life, despite the pain.
For many people with chronic pain, a vicious circle can form between pain and suffering. Research has shown the psychological and social distress associated with pain is often more important to the pain experience as the perceived pain severity.*
Resilience is important
I just watched a great TEDx Talk from Dr. Trung Ngo about resilience that everyone who lives with chronic pain or treats chronic pain should watch.
He talks about how there are three types of people: those who are victims, those who are catastrophizers, and those who are resilient.
I can identify with all three types during my personal journey with pain. Early in my journey, i was the victim. It was the surgeon's fault for my pain. I was set on on making that doctor pay for his mistake and make my pain go away.
As the pain continued, I became the catastrophizer. It quickly became gloom and doom. I become fearful of the pain. I worried about all the bad things that might happen because of the pain. And I worried about my future and the future of my family.
Fortunately, my mindset changed to resiliency. Many thanks to the Mayo Clinic Pain Rehabilitation Center for helping me transition to that stage.
How to be resilient
According to Dr. Ngo, the keys to being resilient:
* Ojala, T., Häkkinen, A., Karppinen, J., Sipilä, K., Suutama, T., & Piirainen, A. (2014). Chronic pain affects the whole person – a phenomenological study. Disability and Rehabilitation, 37(4), 363–371. doi: 10.3109/09638288.2014.923522
If you have chronic pain, the answer is probably yes.
Central sensitization has been tied to a variety of chronic pain conditions including fibromyalgia, whiplash, shoulder pain, neuropathic pain, chronic fatigue syndrome, non-cardiac chest pain, irritable bowel syndrome, temporomandibular disorders, complex regional pain syndrome, low back pain, osteoarthritis, pelvic pain, and headache.
What is it
Central sensitization, also called centralized pain, is due to maladaptive neuroplastic changes in the spinal cord and brain. And is associated with the development, maintenance, and amplification of chronic pain.
The official definition by the International Association for the Study of Pain is, “Increased responsiveness of nociceptive neurons in the central nervous system to their normal or subthreshold afferent input.”
Understanding it - putting it in plain language
Chronic pain is an abnormal response and doesn’t improve over time. It can happen long after an injury or illness heals. It can be due to a degenerative disease, like arthritis. It can be neurological. It can also have no known biological cause, as in the case of fibromyalgia and many common low back pain conditions.
Once it becomes chronic, pain loses its warning function and becomes its own disease/condition. It changes how the brain processes pain – misfiring nerve signals and continuing to tell the body it hurts. Just like an alarm that goes on and won’t turn off. An overreaction or amplification, of sorts. It gets stuck on high alert and the body learns the pain.
And it can happen in all chronic pain conditions, no matter the underlying cause. We may feel it when only lightly touched or bumped. The pain can move around to different areas of the body other than the spot of the original injury. It can even change the type of feeling we may have like achiness, stabbing, tingling, or burning, for example.
The good news is we can change our nervous system. Central sensitization can be reversed by doing things that promote positive neuroplasticity like changing how we think about pain, react to pain, and manage pain.
Best treatment is a biopsychosocial approach, including pain education, physical therapy, cognitive behavioral therapy, pain acceptance, sleep management, and pharmaceutical management. I got a heavy dose of all these at the Mayo Clinic Pain Rehabilitation Center.
Self-management calming tools
One of the most recommended ways to manage pain is to change how much attention you give to it.
Paying attention to pain, amplifies the pain and increases the tendency for negative thinking.
Just like a kid screaming for candy at the store. If you always buy the child candy (in this case, pain) when they scream, they’ll continue to scream each time you take them to the store until they get candy.
Five ways to reduce your focus on chronic pain
Learn more - resources
Look at the photo below. What do you see?
Now change your focus. Do you see something different than before?
Just like this exercise, we can change our thoughts about pain and our reactions to it by changing how we look at it - by changing our focus.
Find more articles about changing how we think about pain.
Catastrophizing in an exaggerated negative response toward actual or anticipated pain.
Catastrophizing jumps to the worst‐case scenario. It quickly becomes gloom and doom, breeding more negativity. You become fearful of the pain. You worry about all the bad things that might happen because of the pain. You’re more likely to choose negative thinking over positive thinking. And you can feel helpless to manage the pain.
Catastrophizing has been linked to higher levels of perceived pain, interference with daily activities, increased healthcare utilization, disability, depression, and changes in social support networks.
This video helps explain catastrophizing and provides helpful tips to stop doing it.
Chronic Pain Champions is an information resource/blog/support group to help chronic pain patients, their families, and friends, as well as healthcare professionals. Learn more about this site and the author.
Chronic Pain Champions