From the Docs

Coping with Chronic Pain

The psychological and emotional impact of chronic pain can have serious consequences. To the extreme, dealing with chronic pain can become so overwhelming that a person might suffer from severe depression or anxiety, abuse substances as a means to cope or even consider suicide as a means to end their pain and suffering. Research has consistently demonstrated the brain–body connection associated with chronic pain. The silver lining (yes, there is one) — you can train your body and brain to respond more effectively to chronic pain and regain some control over your pain experience. The following non-medication-based techniques have been shown to be effective in helping people better manage their chronic pain when used in conjunction with medical interventions.

Change how you think about your pain. Your thoughts impact your mood and can alter your perception of physical pain. Think about the thoughts connected with your pain. How does the pain make you feel? How does pain impact your sense of purpose? Some common thoughts are: “I can’t take this anymore,” “It will never go away,” “I’m miserable,” “I can’t even be a good spouse/friend/partner” and “I can’t do anything I used to.” Although these thoughts can feel accurate, they may not necessarily reflect what is factually true. For example, let’s take a look at the thought, “It will never go away.” This definitive statement suggests that nothing can be done to help the pain. Although the nature of an injury or illness can medically cause prolonged physical pain, people with chronic pain will often report fluctuations in their pain level throughout the day in response to movement, external stressors, etc. As much as the brain may want to focus on the negative, it is equally important to focus on when the pain may not feel quite as bad as it does at other times in the day. Modifying the thought to, “It will never go away entirely, but I know I feel a little better at the start of my day,” helps the brain also pay attention to how the body feels during moments when the pain is less intense.

Improve your body’s relaxation response. Chronic pain physically stresses the body — in addition to the injury itself — which can tense muscles and increase inflammation. Training your body to shift to a more relaxed state can provide some relief. Breathing techniques (e.g., box breathing or diaphragmatic breathing) are an effective way to physically relax the body. Focus on slowing down breathing to a steady pace and imagine the sensation of relaxation with each exhale. There are several guided breathing exercises available online to help you train this skill — I like the free phone apps Calm, Headspace and Blue Life Coach. Another relaxation technique is the pain–comfort pendulation exercise, which involves intentionally shifting focus between parts of the body where pain exists and where there is an absence of pain. Begin by getting into a comfortable position and taking a few deep breaths. With eyes closed, focus on a part of the body where the pain is (e.g., back) and pay attention to what it feels like — hot or cold, sharp or dull, pressure or tightness, hard or soft, etc. Mentally put this pain aside and shift focus to a part of the body where there is an absence of pain or discomfort (e.g., earlobe or tip of your nose). Pay attention to what the absence of pain feels like — hot or cold, soft or smooth, heavy or light. Mentally put this comfort aside and shift back to the pain. Again, spend time focusing on what the pain feels like. After a few moments, shift back to the comfort and so on. Repeat this a few times and end this exercise with the comfort sensation and a few deep breaths. I’ve found this exercise to be particularly effective with people who experience chronic pain as it shows how powerful the brain can be when it comes to how one perceives physical pain.

Educate yourself. Take the time to learn about pain and seek professional help when needed. Information is a powerful tool and often a readily available resource. Learning about the human pain response provides knowledge to help you understand the chronic pain experience and regain a sense of control over how you choose to cope with chronic pain. I recommend the book Change Your Brain, Change Your Pain by Mark Grant. Counseling with a licensed mental health professional who has experience in treating chronic pain can also be helpful. You can speak confidentially with a licensed psychologist, trained peer supporter or chaplain by calling Psychological Services Bureau at (213) 738-3500. You can also contact a peer supporter or chaplain via our free and anonymous Lighthouse PSB Wellness mobile app. Call us if you’d like more information.