SUPPORT FROM OTHERS
Seeking support from others with chronic pain
There’s nothing quite like the support you can get from someone who truly understands what you are going through because they have been through it themselves. You could join a local support group, or you can find communities of people on social media who share your diagnosis and can empathize with your experience.
Search for hashtags and keywords that relate to your diagnosis to find people who are talking about topics of interest. I have found a group of people on Twitter who mean the absolute world to me. We support one another through tough times, provide guidance to each other and encourage one another to keep going. This sort of support is invaluable!
Pros
- Gives a sense of community with others who understand
- Learn coping strategies from each other
- Build friendships and social connections
- Support from people who understand
- Being there for others
Cons
- Sometimes hearing others feeling negative about their pain can impact your coping strategies
Being social
Fear-avoidance often means that people withdraw from their social life, avoiding getting out to see family and friends because they fear the activity may make their pain flare, or because they feel that their loved ones won’t understand what they are going through. This can lead to isolation, which has a significant impact on both mental health and worsens symptoms.
Ensuring that you are maintaining social connections can make a big positive difference in your life. Having that support from those who care about you the most reduces loneliness, depression, and anxiety, and provides you with a solid emotional basis to tackle your pain.
Pros
- Provides practical and emotional support from loved ones
- Encourages activity
- Enhances mental health
- Promotes good cognitive functioning
- Good for general health
- Builds self-esteem
Cons
- Pressure to ‘keep up with loved ones
- Overdoing it could cause a flare in symptoms
Asking loved ones for help
Whether it’s talking through your feelings or more practical support like asking for help with household tasks or accompaniment to medical appointments, benefitting from those in your life can make a big difference. Often, we can feel like we don’t want to be a ‘burden’, but if you can realize that guilt and realize that those in your life want to be there for you, just as you would be there for them, you can learn to reach out for help.
Pros
- Emotional support through hard times
- Practical support with household tasks, attending appointments, etc.
- Allows loved ones to feel useful
Cons
- It can be hard emotionally to ask for help
PSYCHOLOGICAL TREATMENTS
These therapies can help to equip you with the skills you need to self-manage your pain. This study concluded that learning pain management skills from psychological therapies and then applying them in your day-to-day life, “increased self-management of pain, improved pain-coping resources, reduced pain-related disability, and reduced emotional distress”.
Some of these treatments you can actively seek from your doctor or specialist while others you may need to find privately. With psychological therapies, you could also find them online. This study concluded that “existing evidence suggests that technology-assisted psychological interventions are efficacious for improving self-management of chronic pain in adults.”
Mindfulness
Mindfulness allows you to calm your emotions and parasympathetic nervous system, so you can reduce pain and feel more in control of your life. Mindfulness involves being present at the moment without judging the situation as good or bad.
Guided mindfulness meditations typically involve using imagery, breathing techniques, or Progressive Muscle Relaxation (PMR). PMR focuses on each area of your body, instructing you to tense and then relax each muscle to achieve complete relaxation.
Movement can be incorporated into mindfulness, which can often be useful for those who struggle to calm their mind when sitting still. Often mindfulness techniques are incorporated into other therapies, such as the ACT, CBT, and graded therapies to achieve the best results. This study explains that “Mind and body practices such as yoga, meditation, progressive relaxation, or guided imagery use mental and physical abilities to improve health and well-being.”
Mindfulness can be integrated into your daily life, with proven results to help you relax and lower stress levels, in turn reducing pain. You could begin mindfulness meditations at home in your own time; the more you practice the more you can start to incorporate mindfulness into everyday tasks like washing the dishes or taking a shower. You can use mindfulness at night to improve sleep, and in the morning to set your intentions for the day.
Breathing exercises can help you to slow down and consider your options when you face a difficult situation, allowing you to figure out the best route forward. Mindfulness allows you to have greater control over your emotions, to fear your pain less, and to feel empowered to increase your functioning. This study explains that “Meditation practice has been found to promote well-being by fostering cognitive and emotional processes”
Pros
- Reduces pain
- Reduces stress
- Helps you to control your emotions
- Aids in problem-solving
- Increases focus on the task at hand
- Improves mental health
- Helps to promote positive thinking and acceptance
- Tackles pain catastrophizing
- Aids in sleeping
- Can be done anywhere
- Doesn’t need special equipment
- Different types to suit everyone
- No side effects
- Can be used alongside other treatments/medications
- Easily accessible: face-to-face through doctor referral or privately, or online.
Cons
- Can take time to get the hang of
- Can be tough to learn to focus your mind on the present
Cognitive Behavioral Therapy (CBT)
CBT is a talking therapy based on how our thought processes are linked to our actions. CBT helps you to see how your thoughts are influencing your behaviors. By addressing unhelpful or negative thoughts and behaviors head-on, CBT helps you to replace them with more positive, helpful thoughts and behaviors.
Once you have gotten the hang of these techniques you can then use them in your daily life to stop negative thoughts in their tracks and adopt much healthier coping strategies.
CBT can help to tackle fear avoidance, hyperviolence, and catastrophizing. This allows patients to be more in control of their emotions and cope both emotionally and practically with their chronic pain in the future. This study concluded that CBT lead to, “Decreased negative emotional responses to pain, decreased perceptions of disability, and increased orientation toward self-management”
Pros
- Scientifically proven
- Helps you establish healthy coping behaviors
- Gives you greater control over your emotions
- Tackles hypervigilance
- Tackles stress
- Treats catastrophizing
- Tackles fear avoidance
- Increases functioning
- Reduces pain
- Encourages self-management
- Builds confidence
- No side effects
- Can be used alongside other treatments/medications
- Easily accessible: face-to-face, privately
Cons
- Takes time and dedication to pick up CBT skills
- Patients can be skeptical of the results of pain relief
Acceptance and Commitment Therapy (ACT)
Rather than trying to change negative thoughts as in CBT, ACT focuses on understanding that a thought is just a thought and that it doesn’t have any power unless you allow behaviors to be formed around it. ACT gives you the skills to let negative thoughts pass without worrying about them or letting them influence your behavior.
ACT is about accepting your current situation, accepting that you are in chronic pain but at the same time, understanding that it does not have to control your life, and is not causing you damage. As well as this acceptance, ACT teaches you to commit to actions that will allow you to live the life you truly want. It’s about you taking the lead and being determined to put healthy coping behaviors in place, to live well despite your chronic pain.
In essence, ACT focuses on changing behaviors rather than thoughts. This study concluded that ACT strategies can be integrated at home stating “the benefits of therapy are durable or may further integrate into people's lives after treatment is complete”
Pros
- Scientifically proven
- Promotes acceptance
- Promotes proactivity in own treatment
- Helps you establish healthy coping behaviors
- Tackles hypervigilance
- Treats catastrophizing
- Treats fear avoidance
- Increases functioning
- Encourages self-management and control of own condition
- Builds confidence
- No side effects
- Can be used alongside other treatments/medications
- Easily accessible: through doctor referral face to face, privately
Cons
- May not be an approach suited to everyone
- Takes time and dedication to pick up ACT skills
- Patients can be skeptical of the results of pain relief
Graded Exposure Therapy
Often patients can become fearful of situations they feel may increase their pain. This leads them to avoid these activities (fear avoidance). This can lead to deconditioning, an increase in stress levels, emotional distress, and fundamentally, actually perpetuate chronic pain!
Pain Neuroscience Education (learning the science behind pain) is a vital starting point for graded exposure therapy. This knowledge allows patients to understand what is going on in their bodies and how the therapy will work.
Graded exposure therapy then tackles the fear of movement and unhealthy avoidance behaviors by facing each feared situation head-on but in a gradual way. This can sound scary but patients are guided by a therapist. Far from jumping in at the deep end, each situation is broken down into small, manageable parts and dealt with one at a time.
A graded approach allows the brain to learn that each action does not need to cause pain and allows the patient to understand fundamentally that the action does not need to be feared. This study explains that during graded exposure therapy, “Patients are instructed to safely break the cycle of inactivity and deconditioning by engaging in activity in a controlled and time-limited fashion”
Pros
- Scientifically proven
- Educates patients about pain science
- Tackles fear avoidance specifically
- Done in a gradual way to make the patient comfortable
- Trains the brain away from pain
- Increases functioning
- Reduces/eliminates pain in specific situations
- Builds confidence
- Can be used alongside other treatments/medications
- Can be accessed through your doctor or privately
Cons
- Not as widely known as other therapies (less likely to be referred by a doctor)
- Patients can be skeptical of the results of pain relief
- Could cause a flare during the initial performance of movements
Graded Motor Imagery (GMI)
Our brains are neuroplastic, meaning that they are changeable; they learn and develop based on our experiences. Graded Motor Imagery (GMI) uses this neuroplasticity to the patient’s advantage. A quarter of our brain is made up of mirror neurons. This means that these neurons start sending out messages even when you’re just watching other people doing certain actions, or when you’re imagining them!
GMI reduces pain and retrains the brain away from pain by using imagined movements to gradually build up to performing a full movement. Any movement that the patient finds painful can be focused on. Essentially, your brain is learning that it doesn’t need to send out pain messages in response to these movements. The results of GMI are long-lasting as explained in this study.
Pros
- Scientifically proven
- Provides pain science education
- Can reduce/eliminate pain
- Has long-lasting results
- Increases confidence
- Aids in overcoming fear avoidance
- Increases functioning
- Increases confidence
- Done in a gradual way to make the patient comfortable
- Trains the brain away from pain
- No side effects
- Can be used alongside other treatments/medications
- Can be accessed through a doctor, privately
Cons
- Not as widely known (less likely to be referred through your doctor)
- Takes time and dedication
- Patients can be skeptical of the results of pain relief
Biofeedback
During biofeedback, a therapist will teach you how to be aware of your bodily processes (such as heart rate and respiratory rate) through the use of monitors. They will introduce the association between these biological processes and your levels of stress and chronic pain. The therapist will then teach you how to calm these biological processes to reach a state of relaxation.
Biofeedback can also be used to become aware of tension within your muscles which may be contributing to pain and in turn, help you gain the tools to relax those muscles. These tools can then be used in your day-to-day life to reduce stress and lessen your pain levels as this National Institutes of Health report explains.
Pros
- Reduces pain
- Reduces stress
- Gives you greater control over your symptoms
- Provides tools to implement into your daily life
- Can be used alongside other treatments
- Can be accessed through a doctor/pain clinic
Cons
- Not as much research as other treatments
- Not as widely used as other therapies
Art and Music Therapy
Art and music therapies provide relaxation and stress relief. Having a form of creative expression allows patients to get their feelings out in a new and often very cathartic way.
Music therapy can involve listening to music, writing songs, playing instruments, or singing. Art therapy often involves painting, drawing, or other artistic crafts.
This study explains that “The idea behind this type of therapy is that the stimulation of creative activities promotes the healing process and rehabilitation.” Art or music therapy can be done in classes or one-to-one sessions with a therapist. It can also be done in your own home.
Pros
- Promotes relaxation and stress relief
- Allows expression of feelings
- Lots of variety to suit each individual
- Can encourage social bonds if done in classes
- Provides distraction from symptoms
- Can be done at home
- Doesn’t require a lot of supplies
Cons
- Doesn’t actively reduce/cure symptoms in the long term
- Not as much research done on it as on other therapies
Weighing up the pros and cons of each type of available management technique and medical treatment can help you to figure out what is best for you. Remember that even though it’s difficult, there are options out there; your situation is not hopeless.
Precision Pain Care and Rehabilitation has two convenient locations in Richmond Hill – Queens and New Hyde Park – Long Island. Call the Queens office at (718) 215-1888, or (516) 419-4480 for the Long Island office, to arrange an appointment with our Interventional Pain Management Specialist, Dr. Jeffrey Chacko.
