Five things we must consider when navigating chronic pain…
An estimated 50 million adults in the United States experience chronic pain, making it easy to see how it is one of the most common, debilitating conditions that humans deal with. Debilitating because it affects too many facets of life - it is actually linked with depression, higher suicide risk, and more(1).
While there are many things to consider when dealing with chronic pain, these are the 5 most crucial to help you take action and deal with your chronic pain.
1.) Pain is not an accurate measure of tissue health
Pain is defined by the IASP as “An unpleasant sensory and emotional experience associated with, or resembling that associated with, actual or potential tissue damage” (2).
Why is the definition relevant? Because it is reassuring.
This is for you if…
You’ve been told that you shouldn’t be in pain because an MRI is clean
You’ve told yourself that an injury was years ago and that it should be healed
And more…
It’s so common for people to have pain with no significant MRI findings. It’s also just as common to have NO pain and have significant MRI findings(3). Use this to your advantage - addressing the “root cause” may not be your first step to move away from chronic pain, but with that… what is the best way to view this type of pain if may not be an accurate measure of tissue health?
2.) Pain is sensitivity
Since we can’t rely on tissue health to describe chronic pain, we tend to view it as more of a sensitivity.
View pain as a smoke alarm - alarms are meant to make you take action in some capacity. Sometimes alarms can go off for no reason, and most of the time the alarm doesn’t necessarily tell us what the problem is.
You want the smoke alarm to go off if you are in danger and need protection from a fire.
However, you don’t need the alarm to go off in error, or if your cooking is slightly overcooked or if the battery is simply low.
This is how we see chronic pain… that smoke alarm goes off when it may not need to…
Even though there may be no sign of tissue damage, we do realize that your pain is ALWAYS REAL.
While your brain technically is the alarm producing this pain, that does not mean it is all “in your head”.
Pain is a byproduct of your body’s systems trying to protect you in any way, and that sometimes comes with unpleasant sensations that are 100% real.
Your experiences are valid and you deserve to know that.
3.) Pain is a personal thing; how is it affecting your life?
So… if pain is less about tissue damage and more about sensitivity, where do you go from here?
First we need a goal - the obvious answer here is to “be pain free.”
While that is understandable, it isn’t enough.
Your life is a beautiful mix of unique experiences AND your pain is no different - so when it comes to goals, it should reflect the uniqueness of you, as a human.
Start here:
Could you envision living a life with pain?
What about a life without pain?
What does that life look like?
Answering those question will help you look deeper into the life you want to live while understanding pain’s role - from there, reverse engineer some goals that will help you live that life.
4.) There are many ways to address chronic pain
With goals being set, it's crucial to understand there are many ways to reach them.
Reaching your end goal usually involves methods to help you increase your resilience and move in variable ways.
While doing this, we also need to address the alarm system by promoting safety if and when we perceive painful, unpleasant sensations. A great way to get moving is through graded exposure.
This is slowly reintroducing meaningful activities in a way that is tolerable despite it being potentially painful. Along with this, you can do activities such as expressive writing and breathing exercises to help regulate the sensitive nervous system and promote safety.
A few options but a GREAT start to understand that when one path seems like a closed door to addressing your pain, there are so many more options to explore so you can live the life you so much deserve.
5.) Movement matters, mindset matters
Movement is one of our strongest tools to address chronic pain. However, mindset also plays a vital role. When you move around, do you automatically view that movements that cause pain as “bad” and the movements that do not cause pain as “good”?
As mentioned previously, you can see why this belief is limiting. Pain is multifactorial, so it’s hard to label one thing as just good or bad.
Things like physical stress, anxiety, work stress, social support, and many others are all factors that can influence pain. So instead of acknowledging the negatives of these unpleasant sensations, we should shift our mindset to instead acknowledge our resilience.
Whether your pain caused you to miss a social event, take time off from work, or miss anything meaningful to you, we know that your journey with pain has not been easy. And often, it is very misunderstood… movement and mindset are some of your strongest tools to move forward to a place where pain does not cause you to miss out on life.
Take time with yourself and reflect on how resilient you are, despite the pain.
You’ve come so far; take a second to yourself and keep moving forward.
If you’re struggling with chronic pain and want to see if our team can help guide you along this journey then schedule a free discovery call here to speak with our one of physical therapist.
Citations:
Rikard SM, Strahan AE, Schmit KM, Guy GP Jr.. Chronic Pain Among Adults — United States, 2019–2021. MMWR Morb Mortal Wkly Rep 2023;72:379–385. DOI: http://dx.doi.org/10.15585/mmwr.mm7215a1.
Raja, Srinivasa N.a,*; Carr, Daniel B.b; Cohen, Miltonc; Finnerup, Nanna B.d,e; Flor, Hertaf; Gibson, Stepheng; Keefe, Francis J.h; Mogil, Jeffrey S.i; Ringkamp, Matthiasj; Sluka, Kathleen A.k; Song, Xue-Junl; Stevens, Bonniem; Sullivan, Mark D.n; Tutelman, Perri R.o; Ushida, Takahirop; Vader, Kyleq. The revised International Association for the Study of Pain definition of pain: concepts, challenges, and compromises. PAIN 161(9):p 1976-1982, September 2020. | DOI: 10.1097/j.pain.0000000000001939
Brinjikji W, Luetmer PH, Comstock B, et al. Systematic literature review of imaging features of spinal degeneration in asymptomatic populations. AJNR Am J Neuroradiol. 2015;36(4):811-816. doi:10.3174/ajnr.A4173