Chronic pain is tough enough to cope with. But when you add in the stress it creates, its impact on life choices, emotions, and overall quality of life, it can be overwhelming. That’s why it’s important to have a variety of pain management techniques available to you so that when you need to find a foothold for managing the pain, you’ve got options. I often coach my patients to think about managing their chronic pain in regard to “energy dollars.” When you’ve got chronic pain, you have limited energy and ability in any given day to get done the things that matter most to you. If you spend your energy dollars on things that don’t really matter, you won’t have enough left over for the things that do. On the other hand, there are some pain management techniques that allow you to “earn energy dollars”—energy in the bank for when you need it. Following are some of the tried and true ways to help you manage chronic pain and your “energy dollars.”
1. Add relaxation to your daily routine.
When we talk about relaxation as part of pain management we’re not talking about the kind of relaxation that is achieved by watching your favorite TV show or hanging out with good friends. That kind of relaxation is very important as well, but here I’m talking about relaxing your muscles and your mind. Chronic pain is stressful and when we’re stressed we tend to tighten up our muscles, and guess what chronically tight muscles lead to? That’s right, more pain. Progressive Muscle Relaxation (PMR) is a technique that teaches you to tighten and relax major muscle groups in your body from head to toe. As you progress through your muscle groups you will likely notice your breathing and your mind calming as well. Doing this on a daily basis means that your body is more relaxed and better able to cope with a chronic pain flare. It’s putting energy dollars in the bank.
2. Breathe Deeply.
When we’re stressed out we tend to breathe in a shallow way, pulling oxygen into our chest but not fully filling our lungs. Engaging in purposeful, slow, deep breathing for several minutes several times a day is an excellent way to manage stress. And managing stress is good for managing chronic pain. More energy dollars in the bank.
3. Reduce the number of stressors in your life.
(Well, that’s easy, right?) Do take a close, hard look at what you have going on and decide what is bringing enjoyment to your life and what is making life more difficult and, quite possibly, your chronic pain worse. If you’re doing volunteer work, choose the organization that is most important to you and that you enjoy the most and consider letting the others go. If work is overwhelming, think about how you can decrease the stress there—do you need a different position within your company? A different job altogether? To avoid certain “toxic” people at work? To ask for accommodations at work given your chronic pain condition? What about at home—can others pitch in more to keep the household running? Whatever you can do to reduce your overall stress level will be like putting energy dollars back in your pocket that you can spend elsewhere on things that matter more to you.
4. Seek support.
Sometimes others don’t seem to really understand chronic pain and the limitations it imposes. Feeling misunderstood and alone creates stress and sadness. Finding others who get it and who can offer words of encouragement can mean a lot. And most likely you’ll find that most of the emotions, thoughts, and struggles that you’ve encountered are shared by others too. Informally, you may have some close friends who also have chronic pain and who would be good choices to talk with and learn from. Chronic pain support groups are also a great resource for support.
5. Use distraction.
Distraction can be a very effective means of getting through a painful flare. No doubt you’ve noticed that when you’re fully engaged in something you enjoy, the rest of the world tends to fade away. We can use that to our advantage in coping with chronic pain. You may be able to distract yourself from your pain with an activity you love. If that doesn’t work, however, other techniques are available that more actively pull your mind away from the pain. One of these is imagery. Imagery asks you to recall a favorite memory in detail or to invent a pleasant scene in your mind. This memory or scene should be rich and complex with plenty to see, and sounds to hear, smells to notice, sensations on your skin from sun or wind or whatever you choose (it is, after all, your scene!). You’ll want to use all your senses. See how long you can stay in this scene, distracted from your pain.
6. Find the balance between engaging in physical exercise and overdoing it.
Because we are afraid of making our pain worse, often those with chronic pain will avoid exercise or other physical activity, losing out on both the physical and emotional well-being that comes with a fit body. Talk to your doctor about exercises that are safe for you in regard to your chronic pain and then gently and patiently increase your fitness level. That’s like putting energy dollars in the bank. At the other end of the continuum, because we so often don’t feel well, on the days we do have some energy we tend to go, go, go and….totally overdo it….which we pay for the next day and perhaps several days after. Again, balance that burst of energy with recognition that overdoing it today is like an overdraft on your energy dollars plus some hefty fines. Spend your energy in a balanced and wise way.
7. Engage in pleasant activities.
Yes, chronic pain has a nasty habit of taking away things we enjoy. But that doesn’t mean that you can’t find a way to still enjoy some of these things and discover new things that you like to do. So, for example, if you want to be able to enjoy your child or grandchild’s sporting event, figure out what is getting in the way of you attending. Is it climbing up the bleachers? See if you can reserve a spot on the bottom bleacher. A need to stretch and move your muscles every so often? Sit in a spot where you can stand up and do this as needed. Don’t think you can tolerate the entire game? Let your child or grandchild know that you are excited to attend but will only be able to attend part of the game—they will understand and be thrilled that you’re choosing to come. Don’t forget to add some new activities to your list of fun things to do. Consider starting a new hobby, joining a new club, volunteering…there are many activities you can do despite chronic pain. So often clients will share that embarrassment over their chronic pain keeps them from getting out in the world. But would you look down upon someone who, despite their pain, found a way to engage in activities that are important to them?
8. Accept your pain for what it is.
Mindfulness is a form of meditation that can help you to accept your chronic pain for what it is. We can spend a lot of energy fighting against and denying the impact of chronic pain. By accepting the reality of the pain, we can give up some of the struggle created by attempts to deny the pain and, importantly, move forward with our lives despite the chronic pain. That’s energy dollars in the bank.
9. Do your best to get enough sleep.
That means establishing a sleep schedule for yourself, putting away all the electronics well before bed time (no phones, computers, televisions right before bed), avoiding alcohol as it can disrupt sleep, making sure you have a comfortable bed, and that the temperature is not too warm in your bedroom. If your sleep remains poor, talk to your doctor or therapist about the problem and see if they can help you identify other factors that may be disrupting your sleep. Good sleep equals lots of energy dollars in the bank.
10. Be aware of your thoughts and feelings and challenge thoughts that are unhelpful and or inaccurate.
Chronic pain is notorious for helping your mind create all sorts of negative thoughts about yourself, your abilities, and your worth. Those thoughts are, at a minimum, unhelpful, and often just flat out wrong. Don’t waste your energy dollars on them. Learn to notice your thoughts and how they may be impacting your emotions and then challenge them. What’s the evidence for these thoughts? Are you looking at the whole picture? What would people you trust say about the accuracy of these thoughts?
The more you use these skills, the easier and more automatic they will become. Which means that you'll get back to enjoying your life despite chronic pain.
If you would like to discuss your chronic pain concerns or schedule an appointment with Dr. Jana Drew, please call 512-960-5265 or contact her here. Dr. Drew offers free 30-minute consultations and welcomes the opportunity to work with you.