HF 5298

Coping with Chronic Pain

Unlike acute pain, where pain only lasts a short time, chronic pain may last for years. Chronic pain often has many causes that can change over time. These causes can include:

  • Changes in the nervous system

  • Lifestyle factors such as smoking

  • Lack of exercise, poor diet, or stress

  • Changes in your environment

No matter what the cause is, chronic pain is real. It does not go away. It can lead to a loss of physical activity and sleep. You may feel a sense of doubt about the future and feel helpless. Learning to manage pain is important to your health and wellbeing. No matter what the reason for your pain, you can change some of the problems pain can cause by learning to manage it.

Keys to Manage Chronic Pain
Admit your feelings
about pain and how it affects you. You may feel sad, angry, or anxious about how unfair your pain is and how it has upset your life. You should know that even though anger, blame, guilt, and sadness are normal feelings, they can be paralyzing. Share your feelings with family, friends, and your health care team. Accept their support and seek out new ways to cope. Adopt a sense of ownership of your pain problem to regain control of your life.

Adopt a healthy lifestyle. Like many chronic illnesses, chronic pain is best managed with healthy habits. Eat healthy foods, stay active, get enough sleep, and drink plenty of water. Because day-to-day stress can make pain feel worse, learn ways to manage your stress. There are many skills and resources to choose from. Ask your health care team for a list of options.
You can also refer to HFFY# 6585, How to Relieve Stress.

Set realistic goals to improve the quality of your life. Even though we may not be able to “cure” your pain or take it away, setting and meeting goals can help you have less pain and improve the quality of your life.

Take an active part in your care. You are the most important member of your health care team. Professionals can help you control your pain by looking at it from other points of view and coming up with other options, but only you can make changes that meet your needs.

Use a “multimodal” approach. There are no simple and easy ways to manage chronic pain. But this doesn’t mean we give up. There are many options and ways to combine treatments to reduce your pain and take back control of your life. Each person needs a plan that includes both drug and non-drug methods. Just as pain is rarely controlled with non-drug methods alone, pain cannot be managed with drugs alone. It may take many trials to find the best approach for you.

Sleep
Sleep is needed for good health. Plan to get at least 6 hours of sleep each night. During sleep, the body restores many of the hormones it needs to function. For most people, sleep, mood, and pain are closely linked.

A goal of your pain care plan will be to improve your sleep through exercise and staying away from drugs and foods that can disrupt sleep.
Foods that can impact sleep are

  • caffeine

  • chocolate

  • alcohol

  • spicy

  • high acid foods.

Medicines that may impact sleep are

  • over the counter headache medicines that contain caffeine

  • cold and flu medicines that contain alcohol

  • nicotine replacement products

Nutrition
How and what we eat affects how we feel and how our body handles sickness.

  • Eat a balanced and varied diet.

  • Lose weight if you need to but avoid fad diets.

  • Use small amounts of sugar, salt, and fat.

  • Avoid or limit caffeine and alcohol.

  • Drink at least 8 glasses of water each day.

For more ideas for healthy eating, or advice on how to improve your eating habits, ask to speak with one of our nutritionists.

Medicines
Several medicines may be ordered to help with pain, sleep, or other symptoms. Even though medicine can be an important part of your treatment plan, know that drugs alone are rarely the answer to chronic pain. Take them as ordered. Store them in a secure, locked place. Do not take more than you are supposed to. Talk to your doctor before you add any over-the-counter drugs or herbs.

Counseling
Psychological counseling and support is part of any care plan for people with chronic pain. Counselors can help you learn how to cope with the stress, feeling alone, and the troubles that pain can cause. Learning about your coping skills and new ways to cope can help as much as any pain medicine.

Exercise
When you are in pain, you might want to limit your activities, but this can make the problem worse. You may be referred to a physical therapist. They will work with you to plan a program you can do at home.

Exercise 30 minutes a day 3-4 times a week. The goal is to increase strength, flexibility, and endurance to prevent further injury and be active in your daily life. When you begin a program, you may have more pain at first. Your body is out of shape, not because your chronic pain is worse. Continue an exercise program to maintain pain control.

Overexertion
When your pain level is lower, you may want to push yourself to do more. But, like an athlete in training, you need to slowly build up to more activities. Pace yourself doing the same amount each day. Keep a journal to see how active you are each day and to become aware of how your pain varies. Be sure to alternate rest and movement through the day.

Plan for Pain Flare-Ups
Learn the difference between a flare and other pain that may need more testing. Keep a written plan ready for when your chronic pain flares up. Remind yourself that pain flares happen and rarely call for more tests or doctors’ visits. Knowing that this is a flare is the first step. Make a list of things that might trigger a flare up. Your plan may include

  • Ways to pace or change your activity

  • Skills to help you relax

  • The use of heat and cold

  • Short term changes in medicines

  • For more ideas on dealing with pain
    flares, refer to Health Facts for You #5761, Managing a Pain Flare.

Resources
American Pain Foundation
http://www.painfoundation.org
201 N Charles Street, Suite 710
Baltimore MD 21201-4111

The American Chronic Pain Association (ACPA)
http://www.theacpa.org/
E-Mail: ACPA@pacbell.net
The ACPA
PO Box 850
Rocklin, CA 95677
Phone: (916) 632-0922
Fax: (916) 632-3208

National Chronic Pain Outreach Association (NCPOA),
http://neurosurgery.mgh.harvard.edu/ncpainoa.htm
7979 Old Georgetown Road, Suite 100,
Bethesda, MD 20814-2429,
Phone 301-652-4948,
Fax 301-907-0745.

References for foods and medicines that affect sleep
http://www.webmd.com/sleep-disorders/features/food-sabotage-sleep#1
https://www.health.harvard.edu/newsletter_article/medications-that-can-affect-sleep