| Has chronic pain ruined the
quality of your life? Like the person shown in the picture it
may be dominating your life affecting your capacity to work
and enjoy other activities. Life may be a struggle against the
pain and fatigue: it may have become joyless or even meaningless.
Relationships with family, friends and your partner may have
deteriorated, no longer providing support, instead contributing
more pain. You may be feeling useless as you do less at work
and home and wondering how you can have the confidence to return
to work or do your share of things around the home. |
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Many people with chronic pain end up feeling
frustrated and furious because no-one can tell them what is
wrong and no-one seems to be able to fix the problem. Fear about
what is wrong and the future can result in lots of worry and
sleepless nights. Depression can set in as the pain continues
without relief. The character in the picture has a head full
of distressing thoughts and is unable to find a solution to
the problem but continues to call out for help. |
People respond with all sorts of coping
strategies to deal with pain and the changes in the quality
of their lives. Can you recognize some of your coping strategies?
- Keep searching for the cause
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- Keep searching for the cure
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- Keep hoping it will go away
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- Wait for someone to fix it
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- Keep trying new treatments
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- Keep hoping someone will fix it
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- Wish it weren’t like this
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The remarkable part of this whole disaster
is that most people feel that they have no choice and continue to
use the same coping strategies for months and even years. Instead
of finding relief their misery generally grows or they just manage
to keep going. The simple message of self-management is that you do
have a choice and you don’t have to remain a victim of your pain.
The Medical Model and Self-Management or Self-Healing Most of us learn from early in our
lives that we go to the doctor when we are sick or in pain and that
the doctor cures us by diagnosing the problem and providing treatment.
This is called the Medical Model because we hand responsibility over
to the doctor to work out what is wrong and fix it. Unfortunately,
it does not seem to be very effective in managing chronic pain. Patients
end up on a medical merry-go-round trying to find out what is wrong
and what can be done to fix it. Everyone ends up frustrated and disappointed
when there are no answers and the pain continues.
There is a better way to work with Chronic Pain, or pain that continues
beyond the normal
healing time, which involves you working with your doctor and other
practitioners. Sometimes this may be just a physical therapist (physiotherapist,
chiropractor, osteopath, feldenkrais practitioner) but will often
include a psychologist or counselor, and rehabilitation provider.
Some people attend a pain clinic where all these practitioners work
together as a team. However, the key to the success of this approach
is your participation. Introducing Self-Management
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What seems
to be a catastrophe can become an opportunity as you learn the
skills of self-management. You won’t have to wait any longer:
for the pain to go away, for someone to tell you the cause,
or someone to fix it for you. You can learn how to take responsibility
for healing yourself. Your doctor and therapists become partners
in this healing process, guiding and supporting you. Self-management
is just what it says: you will learn how to manage your condition.
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This will involve learning new skills and
changing old habits. If you think back to a time when you were learning
something new, you will remember that you needed to practice what
you had learnt and the more practice you did the more skilled you
became. The same applies for self-management. You will need to open
your mind to learning new ways of perceiving and doing things, and
then you will need to practice them. Many people with chronic pain
have made self-care a low priority in life and understanding the
reasons for this can be an important part of your recovery. A good
diet, exercise, relaxation, rest, recreation, time alone, and time
with family and friends, are all part of good self-care. Top
of page |
- Do you do some form of aerobic exercise
5-6 times per week for 20-30 minutes ?
- Do you relax or meditate,
daily, for 15-20 minutes ?
- Do you do mobilizing and strengthening
exercises 5-6 times per week for 10-20 minutes?
- Do you believe
this condition is potentially reversible ?
- Have you accepted
primary responsibility for healing yourself ?
- Are you having
a lot of passive treatment ?
- Do you rely on medication to
reduce your pain and control your mood ?
A “Yes” answer to the first 5 questions and a “No” answer
to questions 6 and 7, will help you reverse
your chronic pain condition and become a self-manager.
Top
of page |
Just like
taking medication, the program works if you follow the prescription,
but you will need to try it first to discover the benefits. This prescription
gives you an idea of the amount you need to practise each part of
the program. With good planning you can find time for it, even with
a busy schedule. Make it a habit, like cleaning your teeth, and you
will really notice the days you don’t do your program. If you
miss your exercises you may notice that you become stiff and if you
don’t do your relaxation practice you may become irritated or
anxious.
RELAXATION/MEDITATION
Relaxation
can take the tension out of life and learning to let go and “go
with the flow” leads to inner peace. Muscle relaxation, breathing
techniques, visualization and meditation can all provide release and
relief. It is the daily practice which produces results.
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TYPES |
HOW OFTEN |
HOW LONG |
| 1. AWARENESS |
Of your muscle tension
Of your self-talk
Of your reactions |
As much of the day as possible |
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| 2. PRACTICE SESSIONS |
Visualization
Breathing Techniques
Muscle Relaxation |
1-3 times daily |
10-20 minutes |
| 3.CALM BREAKS |
Calming Techniques
Doing Nothing |
3 or more times daily |
1-5 minutes |
EXERCISE
Exercise is a way
of moving out of pain. Exercise doesn’t cause
pain when you move with awareness.
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AEROBIC
Walking
or
Swimming or
Cycling |
5-6 times per week
(for getting fit)
4 times per week
(for maintenance) |
30-40 minutes
30 minutes |
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SSS
Stretching
Strengthening
Stabilizing |
Daily (for getting fit)
5 times per week
( for maintenance) |
10-20 minutes |
ATTITUDE
“Belief becomes Biology” (Norman
Cousins)
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Attitudes (thoughts and
feelings) of fear, anger, anxiety, depression, resentment,
helplessness, guilt, and so on are expressed in our bodies
as tension, pain or illness. Letting go or releasing these
attitudes is perhaps the most important part of healing
Be Patient, Persistent, Positive |
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A pessimist can become an optimist as
he/she takes charge of his/her life and learns the skills
of self-management.
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| Pessimist |
Optimist |
OCCUPATION
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Feeling good about yourself is the bottom
line. Healing can happen when we feel satisfied with our work
or role in life. Feelings of self-worth are restored as we
find direction, meaning and purpose in life and learn to accept
ourselves.
People who Live, Love & Laugh
rarely get sick
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Many things can get in the way
of you learning to manage your condition and heal yourself. Let’s
have a look at some of the obstacles.
1. “It
Hurts To Move”
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Once chronic pain has set in many activities of daily living
become painful. The person in pain does less and less because
most activities cause pain. The last thing a person in pain
wants to do is exercise because exercise causes pain. The secret
is in learning how to move without aggravating your condition.
Movement is the path out of pain. |
2. “I
Hate Exercise”
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Many people with chronic
pain hated exercise before they developed chronic pain. The
prospect of exercising their way out of pain does not have a
lot of appeal. They will do anything to avoid exercising. They
believe that exercise is boring and takes a lot of effort. |
3. “I
Can’t Relax”
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When
asked how they relax, many people with chronic pain say that
they have never relaxed. They tell me that they like to keep
busy and if they stop to relax, all that they can think about
is the things which still need to be done. There is never enough
time to do what they expect to do. |
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4. “I can’t get off
the merry-go-round”
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People with chronic
pain can end up on the medical merry-go-round when they are
searching for the cause of their pain and a cure for it.
For those receiving compensation for a workplace injury or
a car accident, there are endless visits to specialists for
the insurance company, their lawyers and seeking opinions
for themselves. Their lives can become consumed by medical
appointments and visits to their treating practitioners.
Each doctor or practitioner may refer them on to someone
else and they find that they can’t get off the merry-go
round. |
5. “ I Am Scared To Take
Responsibility”
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Whilst people treat pain as something
purely physical, it is seen to be in a mechanical body which
is not functioning properly like a car that’s will not
working. The car is taken to the garage to be fixed by the mechanic
just as a malfunctioning spine is taken to the doctor or chiropractor
to be fixed. It is as though it does not belong to the person
and just needs a repair job to fix it. To allow for the possibility
that pain is more than a physical problem, that what we are
thinking and feeling influences the pain, is to begin to own
the problem. This is not saying that the problem is “in
the mind” but that the mind and body are not separate,
they communicate constantly. You can play a part in your healing
by learning more about the relationship between the mind and
body. Taking responsibility gives you the power to heal yourself. |
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- More
involvement in all aspects of life
- More mobility,
strength, fitness and ease of movement
- More physical and
mental relaxation
- Better balance between activity
and rest - pacing yourself
- Better understanding of pain
- Less
reactivity to pain
- More self-awareness
- More self-acceptance
- Less worry,
fear, anger, frustration and depression
- More peace, joy
and happiness
- Less medication
- Fewer visits to
the doctors
- Fewer visits to other health care
practitioners
- More play and pleasure
- More purpose
in life
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| LESS PAIN |
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