There are a lot of effective methods to reduce chronic pain.
- Mind-body techniques such as meditation and yoga, visual imagery, hypnosis, dance and music therapy.
- Psychological strategies such as cognitive behavioural therapy, acceptance and commitment therapy, education and biofeedback are all useful.
- There are medications and a myriad of other ways to interrupt the pain signals.
Unfortunately, research has not yet advanced to the stage that it is possible to tell which treatment will be the most effective for any one individual.
Most studies of a particular treatment show that it reduces pain intensity by about 25%. However adding treatments together can have a greater effect.
Most chronic pain programs are of benefit because in addition to medication there is added benefit to working on the physical body with stretches, yoga or tai chi and at the same time using mind-body techniques such as cognitive behavioural therapy, pacing strategies, relaxation and meditation. To these strategies is added education about chronic pain and the power of mixing and working with others who have a shared pain experience.
An individual journey.
Each person needs to test, explore and discover what works best for them.
An important thing to notice is that pain is not always at the same intensity every day. When pain is less an individual may try to do more or push through the pain. This approach is doomed to failure as it often results in a flare of pain.
The concept of pacing is a valuable concept to learn. It means working in stages, using relaxation regularly and pausing to become aware of the body’s signals and adjusting work rates accordingly. It means going with the flow of the pain level.. It is the technique of listening to our body, taking time to relax when the pain increases and gently increasing the activity level ” in a dance” with the pain. Having chronic pain is an emotional experience and allowing our emotions to run away with us often leads to overdoing things and further pain exacerbation.
To cope effectively with chronic pain requires having realistic expectations as to what can be achieved with treatment. It is rare for an individual to find a treatment that completely eliminates pain. Nevertheless, a reduction of pain intensity by about 30% has tangible benefits on improving quality of life. It is not necessary for pain to go away completely for individuals to function at a higher level.
The only way to tell if a treatment is working is to stop and start the treatment a few times while being aware of the body signals at those times.
An often underrated aspect of treatment is the benefit of emotional support. The focus of this support is to assist individuals to move from the mindset of a disabled patient to seeing themselves as a functioning person who is taking an active role in the recovery process.
The key to success and to improve quality of life is for an individual to develop their own coping skills and to be intimately involved in developing and implementing their treatment plan.
How to achieve the best outcome.
When someone has chronic pain the initial mindset is to find the right doctor in order to get the right treatment so that the pain will go away. When pain has persisted for some months this mindset is doomed to failure.
A better way is to use a multimodal approach which means trying different things in different combinations.
The better result can be achieved by
- Self-education to understand what aggravates and what relieves the pain symptoms
- Use mind-body techniques daily such as meditation, yoga and tai chi.
- Add physical therapies,
- Use medication with knowledge.
Combining treatments has a synergistic effect. Unfortunately there is no recipe that works for each person. For each individual it must be a journey of discovery. Part of that discovery is to learn to be gentle with oneself, to become intuitive in learning what works best.
It is usual for pain intensity to ebb and flow. It is very beneficial to monitor this change in pain intensity and adapt the level of function accordingly. We need to learn that it is okay to nurture oneself when the pain levels are high and to avoid the frustration that on a bad day you may not be able to do what you want to achieve.
There is no treatment that has been demonstrated to completely remove the pain in all people. However, a 30% reduction in pain makes a huge difference to the quality of life that one can experience. This level of pain reduction is generally achievable with a commonsense multimodal approach to management.
The unwanted effects of treatment
On the downside, there are frequent unwanted effects of treatment which may be more problematic than the pain. Medications can cause nausea, vomiting and constipation. Each individual must evaluate these adverse effects as a quality of life issue. Pain relief versus side effects.
The benefit of support
The experience of chronic pain can be very lonely. However, it is neither brave nor clever to insist on managing pain without support. The benefit of support from a person or group is the ability to cope with pain more successfully and to have an enhanced quality of life. Asking for support sometimes requires courage but that coverage will be repaid many times over.