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
[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
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
What do you do and say when you hurt? How do you react to chronic pain?
You may moan or groan. You may make a face and grimace or wince. You may touch or rub the area that hurts. You may stop what you are doing and limit activity. You may even say a few choice words.
The body’s natural vocal, verbal, physical, emotional, and social reactions to pain are called pain behaviors. They are our ways of expressing we are hurting.
While fine for acute pain like touching a hot stove, these pain behavior reactions place undue focus on chronic pain and reinforce the pain – causing emotional distress and anxiety. Which can lead to reduced coping skills, intensified perceived pain, disability, and increased use of the healthcare system.
But, wait, Tom. Are you reinforcing the pain by the sheer fact of talking about it in this article?
No. Not really.
It's okay to talk about chronic pain in a general or educational sense just like we do any other topic in a conversation. Our emotions stay in check. What is not okay is “stinking thinking” – verbally expressing pain, complaining about it, wallowing in it, or placing blame for it.
Pain is a learned response not just a physical problem
Research has shown as pain conditions become chronic, the relationship between pain severity and pain behavior weakens. In other words, pain behaviors can become over-exaggerated responses to the pain.
Rubbing the spot where it hurts may help you feel better. But what does rubbing and other pain behaviors tell your brain? They tell your brain how to react the next time you have pain. You not only learn the pain; you learn the reaction.
And what do pain behaviors tell others around you? How do they react to your demonstrations of pain? They may become confused, over helpful, over cautious, or over critical. They may even stop interacting with you.
Change how we react to chronic pain
We know what to expect from our pain by the very nature of it being chronic. It is not like twisting an ankle or getting stung by a bee.
Below are a few tips to reduce pain behavior:
While easier said than done, these tips can work with practice.
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