Medical Issues, Relationships, Therapy

Chronic Pain – An Inside Look

Chronic pain is a big part of my life, both professionally and personally. I treat clients with chronic pain, and – to come out of the closet, or the medicine cabinet 🙂 – I am a chronic pain patient myself. In fact, it’s doubtful I would be sitting here, two Masters degrees completed, licensed as a therapist, and most of the other productive things accomplished in my life if it were not for competent, responsible pain management. That includes coping well with Secondary Progressive Multiple Sclerosis and advanced osteoporosis. Both of those come with a hefty amount of chronic pain. Proper pain management has allowed me to live well and productively. I am living proof it can get better.

Chronic pain is different than acute pain. You fall, break your arm, boom – that’s acute pain. There is a clear reason, a treatment for an expected period of time, and your pain should be gone. Chronic pain doesn’t go away. Once it’s present for 6 months or longer, it is generally typed as chronic.

Chronic pain can be mild, and inconvenient, it can be severe and crippling, it can be somewhere in between, or it can switch back and forth between barely noticeable and excruciating. It can feel like aching, burning, shooting, stabbing, throbbing, or any combination thereof. It can make you fatigued, lethargic, and mess up your ability to think and concentrate as well as your sleep. Your moods may fluctuate with your pain levels as well. You may have a good idea where your chronic pain comes from. I did. Or you may not have any idea why you are hurting. It’s very discouraging to have every medical test available and not be able to pinpoint an exact diagnosis that will explain your chronic pain.

That leads me to treatment for chronic pain. When we think of pain, in our culture we generally think first of pain medications, and these can have their place in managing chronic pain. We’re all aware of the abuse of prescription drugs, and medications used for chronic pain are some of the most widely abused. This can make it very difficult to obtain adequate relief for those genuinely experiencing moderate to severe chronic pain. For the sake of this discussion, I am going to assume we are talking about genuine chronic pain, not drug-seeking behaviors. In my experience doctors are hypervigilant about the possibility of a patient seeking drugs out of addiction, not for legitimate reasons. And that’s okay! Pain medication is serious business – these are powerful drugs and should never be used recreationally or to get high. Most pain patients tell me the last thing they feel is “high” when they finally obtain pain relief. They feel closer to normal. They do their laundry, they play with their kids, they exercise a little, they study, they sleep better. Again, this is when pain management is used as it is intended. If you receive pain medication from your physician, take its use seriously. Use a pill dispenser marked with the days, or morning/afternoon/evening, keep them in a safe place, and follow directions to the letter. If you have any questions or problems, tell your doctor immediately. Ideally, you have a doctor who has training in pain management. Yes, they exist. I have one, and she is fantastic. I had to attend a mandatory workshop, see a psychologist, and jump through about a hundred hoops to get assigned to her, but I did, and it was worth every hoop. Ideally also, you are monitored overall as often as your doctor suggests. Even a medication like acetominophen (Tylenol) can be deadly if overused.

Medications are not the only treatment for chronic pain, and even if you do use pain medication, I strongly recommend you round out your treatment plan with more helpful activities. These take into account the connection between the body and mind, and offer a more holistic approach.  Practitioners such as acupuncturists, massage and physical therapists, and licensed mental health professionals can be a great help in treating the big picture of chronic pain. This is more effective than just focusing on individual symptoms.

One common recommendation is to exercise in whatever way you can. You may have limitations or ways it is not safe to move your body, but your doctor or physical therapist can help you design a safe exercise plan. It’s good for your state of mind as well.

Speaking of your state of mind, it’s important to address the mental and emotional effects of chronic pain. There are a number of ways to do this…to find ways to calm your mind and relax your body. Meditation, spending quiet time listening to music or reading, gardening, getting a massage …. whatever appeals to you will be the right choice. As a therapist, I have found that cognitive behavioral therapy is one method of assisting clients in managing their pain effectively. Using the mind to cope with pain more effectively, many patients report significant improvement.

Finally, support is vital. You can join a support group, take a class through a local hospital or continuing education site on living with chronic pain, and most of all share your experiences in an environment where you will be understood. The mandatory workshop I attended started with a Power Point slide, bright red, with three words that changed my life. “WE BELIEVE YOU.” That gave me even more determination to get adequate care for my own chronic pain, and maybe it can for you too.

Thank you for reading! I welcome your comments below about chronic pain and what has worked for you.

This blog post is now in video format, too! Please pay a visit to YouTube and check out TalkTherapy Channel 🙂   Here is a link to the Chronic Pain video:  http://youtu.be/h4xX4Qe1xsM

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