A friend of mine, Sara Villa, a molecular neuroscientist who lives with chronic pain, recently posted an insightful Twitter thread about working with pain.
While her post was specific to working with pain, I saw in her tweet some key messages for anyone living with chronic pain and collaborated with her to distill the messaging into nine helpful tips:
Thank you, Sara!
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
There's still a core you despite the pain.
What you can do
[Updated: 10/14/21 with new research link.]
People with chronic pain often do too much when they’re having good days and not
enough when they’re having bad days.
Pacing/moderation has become a common tool for people living with pain to help provide them with balance. It includes setting time limits, slowing down (start low, go slow), breaking up tasks, and taking frequent short breaks.
But be careful not to let pacing become an excuse for not being active or avoiding pain. Doing so can add more focus to the pain, worsen symptoms, and reduce physical stamina.
Pain doesn't mean harm. It's the result of an overly-protective system trying to protect itself. Our bodies become over-sensitized.
Pacing should instead be used to gradually increase what we can do, despite the pain.
The difference is in the goal and execution. Keep moving forward!
Learn more and do more
Compliments of James Stark, MS PT, Alphora Pain Education
The stressors of life are constant. They are both invaluable and troublesome depending on our capacity to cope with them. When we cope well they increase our capacity for others. This is what learning and growth are all about.
However, when our capacity is too limited for the stressors we are experiencing, the jar overflows and life gets very messy. Most of us can recognize that when we are in a lot of extra stress our pain increases.
I love the analogy of the overflowing jar to illustrate this concept. In the context of pain, it doesn’t matter what caused the jar to overflow, it just did. This concept helps explain how some seemingly trivial event or comment can set us off. This image can lead to several strategies to deal with stress.
First, decreasing the stressors may be possible. If so then that could help. If you are in a job that you hate, a relationship that is toxic, or have pain that is out of control will all challenge our capacity to cope. Having some control over our daily pain
Second, actively working to increase your capacity to handle stress is often the best strategy. This can take time but long term is the most effective. Physical exercise is a great example of how this strategy is often used but this strategy can easily apply to other types of stress. Also improving your sleep will improve your capacity to deal successfully with stress. Last, learning and using some stress relief tools such as taking what my friend Sharna Prasad calls mindfulness and movement snacks. Or developing a journaling practice, Or developing a consistent meditation practice.
The possibilities are endless and unique to each of us. This is all part of the exploration of stress and pain that we each must take. We are working to create maps of the new terrain that we are living in. Since the pain arrived in our lives, the terrain has shifted and the map that we had of the life that we were living no longer applies. It is as if we have a map for Kalamazoo, MI but find ourselves now in Boseman, MT. The longer we keep trying to make sense of the old map, the longer it will take to create our new map and find our way back to a life we enjoy. Remember When map and terrain differ, follow the terrain.
A successful exploration out of a life controlled by pain often starts with developing an active (not passive) go to pain relief strategy. Again this is the relief valve. Something that you can reliably use to calm your pain. Having this can give you the confidence to explore the terrain with curiosity rather than fear.
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