There is no doubt that “entering the world of chronic pain” is a confusing and difficult process. Many times, patients do not understand some of the basics of pain management approaches to care. However, helping patients to become aware of various problems and mistakes, ahead of time, will allow them to respond differently and learn how to become part of the pain management team. This handout is to be given to patients as they start treatment for their chronic pain problems.
There is no question that for the person living in chronic pain, life is very difficult and exhausting. In fact, the Greek philosopher Aristotle is reported to have said “Pain upsets and destroys the person who feels it.” However, there are some very important factors that one has to think about relative to learning how to cope and manage one’s pain. Notice that some of these ideas are restated in different ways to help you think about them and how they help and hinder your progress in pain management treatment.
Mistakes Made in Dealing with Chronic Pain
Using medications to “totally block” all of one’s pain
Many times, patients want to “chase their pain” with more and more pain medications only to find that the medications are no longer as effective even at higher dosages. Medications are helpful but it all depends on how we use them and what we “expect” from them.
Not understanding that medications will only help with about 50% of the pain
You have to employ other active self-care techniques to help you manage the pain over time. You should not just rely on your pain medications–or keep hoping that you can continue to increase it and “finally” block it. That won’t happen. So, you have to learn to live with a certain amount of pain and accept this fact of life.
Using medication to help us “do more”
All this will do is to ensure that you will crash and have more problems later. It is critical that you learn to pace yourself and your activities by accepting that you are limited and have to now make adjustments. This is particularly true of patients who have just had surgery, or physical therapy, or even biofeedback techniques. They tend to “rush too fast” back to doing more activities, chores at home, returning to work too soon, and feel they can be their “old selves” only to end up feeling even worse. In other words, they cause a flare -up in pain and then ‘panic feeling they have to try even harder.” It is a “new start” in life, not expected but one that is “forced upon” chronic pain patients.
Taking medications any time that pain is felt
Medications are best taken on a time-contingent basis–regular by the clock–if you are to have the best results. Take them as prescribed not just when you feel you need them.
Taking more pain medication at times of flare-ups of pain and then running out of medications later
After a while you will have more pain because your body will “depend” on the medications being there to handle the difficult times. A “Rebound Effect” will happen whereby you will have more pain if you don’t have the pain medications. It is the medication that will cause more and more flare-ups in pain over time if you keep increasing the medications to get through many “bad” times.
Waiting till the last moment to refill your prescription
It’s not uncommon to try to get your physician to fill your prescription in a rush and then getting upset because “it is not done right away or on time.” This pattern will only increase the tensions between you and your health care providers. Have a regular plan for how you handle getting refills. Don’t wait until Friday, the weekends, or the evenings, etc.
Wanting everything to be the way “it use to be” before the pain
Everything has changed now and you have to work on grieving your past abilities and finding ways of now living with where you are at in the moment, pacing activities and being more realistic about what you can and cannot do.
Overdoing things because “you know you will feel bad later”
This insures that you will have even more bad times and many “ups and downs” with your pain problems.
Forgetting to pace yourself
Take breaks every twenty minutes to change positions, do something different, or to just rest. It is easy for time to “get away” from you and then a few hours have passed since you have moved or slowed down.
Thinking that your physicians will always understand your pain and be available to you when you need them
You are the only one who will really understand your pain problem and your needs. You can communicate them to your health care providers, but it is up to you to work out a realistic plan that will work for you AND them. They are not the “all-knowing priests” of life!
Thinking that one thing will work to solve it all
In pain management, as in other types of care, it is usually many things that you have to do to manage problems over time. You have to learn active self-care pain management skills. This is also like learning a new language. It helps work with a pain management professional such as a pain management psychologist, who can teach your new active self-care skills as part of cognitive behavioral therapy techniques that focus on practical things that can work in everyday life.
Thinking that it will all get better “if I push hard enough and work to get me back to where I was before”
This is a major mistake. You can improve and be more functional, but now some things have changed and you have to learn an entirely new way of handling things.
Avoiding seeking help from pain management counselors
These professionals can help you in learning active pain management skills and techniques. There are many things one can learn that can help you to manage and reduce your pains by consulting such professionals. The more you think that relief only comes in the form of a pill, the more problems you are going to have over time.
Thinking that you can’t have a life if you continue in pain
Many people have pain and go on with their lives. You can too even though it may not be easy. It requires positive, and realistic, thinking. Those who do better have been found that they have “accepted” their pain and limitations but still have decided to refocus and live live even though one has limitations.
Allowing fear to rule your life
Fear results in more anxiety and avoiding doing anything for FEAR that you will have more pain. This has been found to lead to even more disability and even more limitations over time. The center of the brain that controls pain is also the same center where your moods (anxiety and depression) are also controlled. One can set off the other so you will need help dealing with this issue.
Not understanding that increasing medications may lead to more pain in the long run
It is important to know that pain medications can have a rebound effect. The body becomes dependent on them and when you “run low” you have more pain. Research with headache patients shows that stopping pain medications will result in a 75% reduction in pain after three months. At first, things might get worse but over time things will get better.
Not understanding your patterns
Once you start to become an active part of the process, learn “the patterns,” and explore different ways of helping yourself, then you will know you are on “the right journey.” Ask yourself what emotions or fears come up at times that may make things worse? Also ask what tasks caused the problems–maybe noting the pain is not evident until the day after doing an activity? Is there a time in the week or month when things are worse? Do setbacks happen when you push to do things–emotionally or physically? You will find, if you are honest with yourself that there are many more questions that you can ask yourself about “the patterns.”
Things to Remember
Remember that “Stress goes to the weakest identified part of the body.” If it is your blood pressure, it will go to that system. If it is your ‘gut” then it will go to that area. If you are injured, or had surgery, then it will go that area. Remember, your body is “an equal employment opportunity host.”
Also remember that in a crisis, we humans tend to regress to previous levels of emotional functioning and can feel “sicker” and more emotionally drained at the time than we had ever thought possible. It is important to not panic at these times. Research on crisis intervention theory points to the act that we will return to our previous level of stability, and reduced fear, with time. The goal is to help in achieving that functioning by becoming aware of how we think, our fears, and our panic.
It also helps to know that progress can take time—more time than you may expect. We can’t rush recovery. Let go of the “magical belief” that everything is solve and the patient can go home the next day without any problems.
These are just a few ideas to consider. There is no magical cure. That is dreaming the impossible dream. You have to be part of the team of specialists that help you. You will have to learn many new things and ways of helping yourself over time. Pain Medications can be helpful but they are not the full answer. You have to be part of the helping team.
Photo credit: Pixabay/stevepb