Living Well with Chronic Pain
How do you live well with chronic pain?
This post comes from Alexandra Courts, a DPT in Ohio whom I have had the pleasure of meeting over social media. We bonded over pain–specifically helping people in pain!–and I am so grateful she could contribute here!
If you have been suffering in pain for months or years, you may think that living well is only possible after you have gotten rid of your pain. Unfortunately, for some of us, there is no current cure for our condition. If you have stumbled upon this post, you have likely tried many plausible solutions and I will assure you that this is not another empty promise to get rid of your pain. I am about real life solutions to complex problems. While I can’t promise that this approach will leave you pain free, I can guarantee that these steps have helped many people to reduce their suffering with chronic pain and to continue to pursue the things in life that they value most.
First, go through an exercise with me. Take your hands and place them in front of your eyes. Now, observe the room before you. Your view is changed because your hands are very likely obscuring part or all of your vision. Now, gently lower your hands to your lap. You can likely still see your hands, but you should be able to see the room more fully. In this exercise, our hands are our thoughts. Likewise, if we hold our thoughts about our pain so closely to us, our experience of life is largely dominated by our thoughts of pain. However, if we hold those thoughts gently, pain is a part of our experience, but it does not dominate our entire perspective. The first step to living well with chronic pain is addressing our thoughts not only about our pain, but about ourselves and the world around us.
A Mindful Approach
Let’s discuss how our thoughts about our pain can hold us back. Did you know that the concept of pain is actually learned? According to the International Association for the Study of Pain (IASP), it is, and that means that we are also able to change our personal concept of pain. As a first step towards changing our personal concept, let’s change the word chronic to persistent pain.
IASP acknowledges that pain is both a sensory and emotional experience that is not always associated with tissue damage. In fact, persistent pain that is present for at least 6 months is not typically correlated with tissue damage. This is great news because that means we can start making value based decisions rather than decisions based in fear that our persistent pain is causing damage. I cannot know your specific circumstances as I am writing this, so please continue to consult with your individual, supportive medical provider as you continue on your journey.
If you have followed me so far, hopefully you are starting to understand that it is actually our thoughts that often hold us back. Our thoughts about ourselves, particularly feelings of shame, can be another barrier to pursuing things we value. I have noticed in myself and others that when I experience pain, there is usually a factor of shame – ‘I must have done something to cause this’ or ‘What am I doing wrong?’ Often, the way that medical professionals are trained to assess our pain can even unintentionally set us up for shameful thoughts – “What did you do that caused your pain?” Today, I give you permission to let go of your shame!
If you are struggling with shame or judgmental thoughts about your pain, self, or life, mindfulness can be a helpful tool to start implementing.
Judgmental thoughts may sound something like:
‘My life is over because of my pain’ or ‘It’s not fair that I have to live with this pain’.
We all have these thoughts sometimes, including me! In the past, I would let these thoughts protect me, or so I thought. They gave me reason to stop pursuing the things that I enjoyed, but at the end of the day, I realized that these thoughts were not serving me. I was suffering not only because of my physical pain, but because I was allowing my thoughts and my fear to dictate my life.
Before I started practicing mindfulness, my internal dialogue sounded like this when I would notice my pain:
Me: “It’s not fair that I have to live with this pain, I just won’t go today”.
When I remember to be mindful about my pain, it sounds more like:
“I notice that thought. I notice that I am having pain. I can put on my shoes and continue to go to meet my friends. This is an activity that brings me joy.”
Mindfulness, when practiced correctly, includes being present and reserving judgement. Pick an uninterrupted time, every day to practice – you might even start with just 5 minutes a day. If you are new to mindfulness, I recommend you checkout Headspace or Insight Timer. If you are not new to mindfulness, here is your nudge to start practicing regularly.
I am going to bust a myth: you do not need to be pain free to get moving. As we discussed, persistent pain is not typically associated with tissue damage, so assuming you have been cleared by your provider, you can and should get moving. There are real health benefits to moving regularly, and for people with persistent, generalized low back pain, general exercise is an effective treatment. A temporary increase in pain may be normal as you start new activities. I encourage you to explore your abilities from a place of mindful curiosity rather than from a place of fear. What activities bring you joy? If you are having trouble answering that question, what activities previously brought you joy?
Start with an activity that you think you can accomplish right now that brings you joy or you may start with a movement as simple as your breathing. What happens if you take a deep, relaxed breath, breathing all the way into your pelvic pelvic floor, stomach and back and take a nice, long slow exhale? When you are ready, move onto joyful movements, incorporating that breathing if you would like to. Break down activities into bite-sized chunks if you need to. Focus only on the present moment.
Living well with persistent pain does not happen overnight. Don’t let fear be your guide. Stay curious, mindful and moving! If you need help making healthy habits with persistent pain, a health coach may be just what you need.
This article is not medical advice. It is intended for educational purposes only. Please consult with your medical provider to address individual concerns.
Alex Courts PT, DPT, PCES is a Physical Therapist living in Cincinnati, OH, where she runs Vibrant Physical Therapy and Wellness. Alex’s own experience with chronic pain after a back fracture led her to the field of physical therapy. During her career, Alex had the privilege to start a program for clients with chronic pain alongside an amazing rehab psychologist at The Ohio State University Wexner Medical Center. The program reinforced Acceptance and Commitment Therapy and helped clients to address their wellness in all aspects of their life. Alex now focuses on helping clients during and after pregnancy to stay active and to thrive in their new role. Alex firmly believes that a healthy baby starts with a healthy mom.