Since June of 2000 I’ve been, as I say, a professional cripple. So chronic pain is something I’ve become really well acquainted with. There are things I should know not to do but I do them anyway. A perfect example is this weekend. I was having a really bad flare up of pain but decided I needed to go blueberry picking with friends. Then I came home and harvested things in the garden. I should have been taking it easy but sometimes I just push myself too much.
Although not going overboard on activities is a good strategy I know there are many strategies for dealing with flares of chronic pain. Perhaps they can help you, too.
Causes – Chronic pain is pain that doesn’t go away. It’s always there. But there are things that can exacerbate the pain.
Inactivity can help with pain it can also cause pain to worsen. Your body loses conditioning and this, by itself, can make you feel worse.
On the other end of the activity spectrum is over activity. Having a good day can make you want to get everything done all at once. But too much activity will definitely increase your pain level.
Lack of sleep and/or non-restorative sleep will also contribute to increased pain. Your body needs good rest in order to help keep pain levels manageable.
Stress often triggers chronic pain. Your body tenses and this puts strain on muscles, ligaments, and tendons causing pain.
Treatments – Since the causes of pain can be so varied the treatments also vary.
Medications are almost always prescribed for chronic pain conditions. They may be over-the-counter medications like NSAID’s (acetaminophen, naproxen, and aspirin, to name a few) but your doctor may decide that stronger pain medications are needed. Prescription pain medications may be opioid or non-opioid.
Depending on the disease anti-depressants are often also prescribed as some have been found to help reduce pain. Your doctor may also prescribe a sleep aid.
If you have neuropathic pain (nerve pain) you may be given an anti-seizure medication. These have been shown to be effective in the management of neuropathic pain.
Your doctor may order injections of local anesthetics directly into the affected areas such as spinal injections. For Myofascial Pain Syndrome injections are often given injections in the shoulders or neck. Severe chronic migraines are sometimes treated with injections of Botox in the neck.
Patches containing pain medications or local anesthetics may also be prescribed. Lidocaine patches are often quite effective but some stronger pain medications are also available in trans-dermal patches.
As your doctor attempts to find a medication regime that works your doctor may try several different medications and combinations of medication. You will normally be started on very low doses of medications to determine how well you tolerate them. Dosages will be adjusted until an effective level is reached.
Exercise can sometimes be helpful in reducing pain. Gentle stretching and even some other forms of exercise can help alleviate pain; especially arthritis pain and fibromyalgia flares. Your doctor can recommend the types of exercise you should try and may even prescribe physical therapy.
Posture and positioning are important, too. Holding your body in certain positions may help relieve the pain. Changing position frequently may also help reduce pain. Staying in one position may increase stiffness so finding varied positions may keep pain from intensifying.
Relaxation is very important for pain reduction. Muscle tension contributes to your overall pain and may actually cause muscle spasms that add to your suffering. Some people find exercise to be relaxing but there are many strategies to relax. Breathing exercises, enjoyable (non-strenuous) activities, warm baths, meditation, and other relaxation methods may help reduce pain. If you read to relax be sure to adjust your position frequently.
Heat, cold, and massage can be very therapeutic. Heat stimulates blood flow to painful areas which may reduce pain. Moist heat is generally the best so a moist heating pad or warm bath or shower will do the most good. Cold therapy can numb the pain and reduce inflammation. If you use ice packs be sure to wrap them in a protective cover, even a towel works. Don’t leave ice packs on for more than twenty minutes at a time. Massage, whether you do it yourself, have a loved one massage painful areas, or go to a professional can be very therapeutic. Just be sure to tell the person doing the massage to check with you often to ensure that the pressure and techniques aren’t too painful.
Use pacing to avoid causing unnecessary pain. You don’t want to do too much when you’re feeling pretty good as this will almost always lead to increased pain. This has always been a particular problem for me. I do too much even at times when the pain is telling me to rest. The best way to deal with a flare of pain is to reduce your activity level. Take rest breaks as often as you need them and don’t skip resting. Switch from high to low intensity tasks and back. If you know that certain times of the day are better for you do the most intense tasks during that time but remember, even if it’s a good time, not to overdo things and to take frequent breaks. Ask for help from loved ones and friends. If there are things that absolutely must be done these people will likely be more than happy to help you! Don’t feel that you must meet every social “obligation.” Sometimes your pain level dictates missing social engagements. And don’t feel guilty if you have to miss social events. Your chronic pain means you have to protect yourself from things that will ultimately cause you more pain.
Distractions can help take your mind off the pain. Find the things that don’t require too much exertion and do them. Listening to music, reading, watching movies, or going for a nature walk can all help. Even sitting outdoors can sometimes be a distraction from the pain.
Positive thoughts really do help. Don’t tell yourself that your life is ruined by pain or that this flare up will never end. Reminding yourself that the pain will get better and that there is plenty of time to do the things you can’t do right now will help relieve the depression and stress that accompanies chronic pain.
Keep the things you need nearby during a pain flare. Be sure you have everything you need so you don’t have to keep interrupting your rest. Reading glasses and books, something to drink, snacks, and even TV remotes should all be within reach. Think about what you might want or need while you’re confined to bed and gather them or have someone gather them for you. Then just relax and rest.
Accept the limitations your chronic pain causes. Instead of being angry at yourself remind yourself that you still can do a lot of what you love even if not as often or not as vigorously. I garden by sitting on my fanny and scooting around the ground. I end up with a really dirty rump but with the satisfaction of still being able to garden. I also accept that I’ll never be able to ride a horse again but I can still enjoy grooming them or just petting them. I can’t run and chase my grandchildren but I can discover fun activities we can do together.
Learn to assert yourself. When you really just want to be alone and loved ones want to hover, speak up. If something absolutely must be done tell someone you need help. Being assertive isn’t the same as being selfish. Remember, the sooner the flare ends, the sooner you can go back to being the person your family needs.