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COPING WITH CHRONIC PAIN

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There is not a single definition of pain that is appropriate for everybody because it is a highly subjective experience. What, to another person, is excruciating may be nothing more that a slight discomfort for you. Not only do views of pain vary among individuals, your own perception of it can change over time. Even when you do have a clear perception of what pain means to you, there is not an objective way to measure it you can use to convey your impressions to somebody else. It is not unusual for patients in a doctor’s office, who have come in because pain is severely impairing their day-to-day lives, to have great difficulty describing it clearly.

One thing we do know, however, is the difference between when we are hurting and when we are not. In the case of acute pain, you may cry out from it and experience terrible suffering for a time, but it ends eventually, and usually the sufferer returns to their normal activities and way of life. Chronic pain is different. A sufferer of chronic pain not only hurts, but they keep on hurting. Indeed, the psychological impact of chronic pain can be worse than the physical sensation itself, especially when the daily grind of it wears you down and turns the world grim. Acute pain usually does not change one’s personality. Chronic pain, if not addressed properly, can alter it drastically.

Chronic pain may have a physical basis, a psychological basis, or some mix of the two. Maybe it comes from an injury. Maybe it comes from stress. Maybe the two factors are interconnected. People who cannot pinpoint a clear physical connection often say, or are told, that it is “all in their heads.” But that is not how it feels. Chronic back pain caused by stress can hurt just as badly as chronic pain that resulted from falling off of a roof.

It has been estimated that over 34 million Americans suffer from chronic pain, be it from arthritis, migraine headaches or their backs (with lower back pain being the most common). 15 million people experience chronic pain at work on a daily basis. So if you are a sufferer of chronic pain you are not alone – though it can certainly feel that way.

What Can You Do About It?

To begin with, you must make sure clear lines of communication have been established with you physician(s) and any other health care providers being seen for chronic back pain. Do not just assume it is your cross to bear and suffer in silence. Though it is true that the majority of back pain in general is not symptomatic of serious illness, do not assume you are therefore free from all risk. There have been cases of people whose backs’ hurt persistently and they just mistook it for a fact of life and went on the best they could, only to discover that “bad back” was really a sign of something much worse, like cancer or otherwise damaged internal organs.

In order to facilitate communication to a health care professional it is a good idea to spell out some specific things to yourself first as a means of organizing your thoughts and presentation. For example, asking yourself and answering the following questions can go a long way toward clarifying what you are experiencing:

 

1. How bad, on a scale of 1 – 10 is my pain?

2. How long have I had this pain?

3. What words can be used to describe it (tearing, burning, throbbing, etc.)?

4. What could have caused my pain? Is there an injury, psychologically stressful event, or activity I can link to its onset?

5. Are there any other health problems I am having?

6. In addition to pain medication, what other medicines am I taking?

7. What kinds of things have I done to try alleviating the pain? Have any helped, even some?

8. Both emotionally and physically, how has pain affected my daily life, be it at work or at home?

The questions do not have to end with the examples above, of course, and asking a few may help you zero in on more specific inquiries – just as the information provided will help your physician to get a clearer picture of what is happening with you. Once the chronic pain is described, a variety of approaches, alone or in combination, are available to treat it.

Medications

A wide range of drugs are available for the treatment of chronic pain. Most commonly used are aspirin, acetaminophen, and the anti-inflammatory drugs like ibuprofen. Then there are the more powerful narcotic analgesics, such as morphine and codeine. People respond to these differently and there is no one medication that is right for everybody. Only a physician who knows your medical history and what other medications you might be taking is truly qualified to make the best recommendation for you. And, after beginning to take one, it is important to keep your physician updated on their effectiveness, not only if they are working or not, but also about any side effects you might experience.

Do not fall into the trap of thinking that a lack of effectiveness or the experience of side effects are things that must be tolerated without question. Many different drugs are available and improvements in pharmacology bring us more and better alternatives as time goes one. Regular contact with a physician is necessary to make sure the course of medication one is on is indeed the best available.

Psychological Approaches

Psychological approaches are best for chronic pain where a specific physical cause has not been identified or, when it has, is used in conjunction with a sensible course of medical treatment. The strategies used generally fall into four categories, with plenty of room for overlap and the use of more than one technique at a time. These categories are: relaxation, imagery, hypnosis, and biofeedback. Though it is best to seek the advice of experts to ascertain what, or what combination, is best for you, below are examples of some things you can do on your own in the effort to cope with chronic back pain.

Splitting: Separate your experience of pain from the pain itself. If the pain is throbbing, for example, focus on the throb and not the hurt. Another variation is to separate the painful body part (your back) from the rest of your body.

Numbing: Imagine an injection of a powerful medicine that numbs the area of your back that hurts.

Projection: Imagine yourself at a time in the past or future where you are free of pain. A pain-free location, like a favorite vacation spot, may also work.

Movement: Visualize the pain moving from your back to another area of the body where it is easier to handle. An alternative is to imagine it leaving your body and taking up residence somewhere else, like the ground.

Be are that psychological approaches are particularly helpful when stress is suspected as the culprit in your experience of chronic back pain. Our daily lives are constantly subject to stress, be it from work, relationships, or simply new and different experiences. People react to stress in different ways. Some individuals feel tired, others get upset stomachs, and many of us show our tension in the form of back pain. Instead of a psychological technique that focuses on pain management, then, a more sensible approach could be the identification and treatment of the factors that cause you to experience stress.

A Physical Approach

Most chronic back pain is the result of activities that have an adverse effect, such as lifting heavy objects improperly or simply sitting in a chair for long periods with bad posture. Changing our habits, therefore, can have a significant impact. Below are some of the most commonly advised physical measures to take. As always, see a physician or other qualified professional for assistance in deciding what is best for you.

• Weight loss: approximately 67 percent of Americans are overweight. These extra pounds put pressure on the back and strain both back and abdominal muscles, which can weaken these muscles and compound the problem.

• Improve Posture: Bad posture means your body is out of balance. When it comes to your back this means that only a small number of muscles and joints are doing most of the work. Proper posture will spread out the task and relieve the intense pressure on small areas of the back.

• Exercise: A good exercise program, designed by a professional, will strengthen muscles in your back, keep them limber, and increase endurance. Though our instincts may tell us to rest until the pain passes, the proper exercise can be an effective means of pain relief or reduction.

• Movement: Simple measures, like using your leg strength, instead of back muscles, to lift heavy objects can make a big difference. Whether at work, home, or engaged in leisure activities, be aware of how you can alter you movements to avoid unnecessary stress on your back.

If you are at risk of back pain, Who isn't, Prevention is the best treatment Come back next week for our article on   or subscribe to our free , yes completely free newsletter.

 

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