Understand Pain Self Management – 14 Ways to Take Control of Pain

“One good thing about music – when it hits, you feel no pain.” Bob Marley, Trenchtown Rock.¹

OK, for people in chronic pain, that’s maybe a slight exaggeration, but it’s also based on something true – you can manipulate your pain experience and you can reduce its negative impact on your daily life.

Taking active steps to reduce pain’s impact is called pain self management, and people who work on their own to control pain have better outcomes than people who rely mostly on external sources of pain relief.

Pain self management leads to:

1. Less pain and disability.
2. Reduced healthcare costs and medication side effects.
3. Less mental illness.
4. Greater quality of life.

So, 4 pretty solid reasons to give this a try!

Read on to learn more about:

• Pain self management and its benefits.
  
• 14 essential pain management strategies to incorporate into your routine and lifestyle.
• Warning signs of long term disability.

What Is Pain Self Management?

We all manage pain – it’s a skill that we learn in early childhood. However, the idea of pain self management for severe or chronic pain is that with focused learning and effort, you can increase your pain management abilities.

For a number of reasons, relying solely on your medical team and/or medications for pain relief isn’t as effective as getting involved on your own:

• Pain treatment isn’t a one-size-fits-all type of therapy. You are a unique person with a unique history, health profile and psychological make-up. What works for another person, or even for most other people, may not work for you. By taking an active role and by trying a wide range of interventions, you are more likely to find a few therapies that work well for you.
  

You know what works for you better than anyone else. By getting informed about your options and by experimenting with different pain-control strategies, you can develop a better pain management system for yourself than any outside expert ever could.

But no one else can do it for you! You have to live with your pain and your behaviors and habits will influence your experience of pain. Since what you do matters, pain management is your responsibility.²

Limiting Pain's Impact without Limiting Pain

You can reduce pain or you can reduce pain's impact.

Pain negatively impacts many areas of your life, for example: work ability, finances, recreation, sex life, mental outlook, sleep, self esteem and many more.

Obviously you can reduce this impact by reducing pain, but sometimes that’s not possible – or not possible beyond a certain point. Fortunately, with conscious effort, you can find ways to limit pain’s impact on your life even when you can’t eliminate pain completely.

First Find Acceptance

Accepting that pain is a part of your life now frees you from trying to be what you once were and lets you be what you are now.

Once you accept that you have persistent pain and that it’s not going anywhere anytime soon, you can move past fighting for a pain-cure and move toward working for pain management.

• Once you can accept that with pain you can’t do everything you once could you’ll be more able to move on to filling your life with rewarding activities that you can do now.³

Examples of Pain Self Management Tools

Pain isn’t just a physiological occurrence, it affects all domains of human experience – physical, social, mental, psychological and spiritual – so it’s not surprising that you have a wide range of effective pain management tools to choose from.

Some (not all examples) of effective pain self management tools include:

1. Exercising

Chronic pain can lead to decreased activity, and this can lead to decreased strength and flexibility and to greater disability and pain. Therefore, exercise is an essential component of any self management strategy.

• Learn and engage in regular exercises to build or maintain strength, endurance, balance and flexibility.

2. Making Use of Pacing Strategies

Avoiding the ‘good days/bad days’ cycle of overdoing it on 'good' days and then recovering on subsequent ‘bad’ days.

• Pace yourself - Learn to take breaks before you need them to prevent pain exacerbation.
• Work slower – learn to work at a sustainable pace.
• Break up tasks – to prevent the overuse of any one part of the body.
• Prioritize and plan out your days – do the must-do's first and leave the could-do's for last.

3. Appropriate Medication Use

Learn to use medications effectively (and avoid their overuse).

• Learn as much as you can about your medications: about safe use, their side effects and possible interaction effects to watch-for.
• Develop a system to keep track of all medication instructions (a file).
• Use of an app or alarm to stay on a medication schedule.
• Use a daily-schedule pill box.

4. Stress and Tension Relievers

Stress increases your perception of pain and since stress causes muscle tension, it can also directly worsen pain. By learning effective stress-control and relaxation exercises you can decrease pain and increase overall quality of life.

• Learn to recognize the early signs of stress and then use techniques like deep breathing or progressive muscle relaxation exercises to self-soothe.
• Take time each day for relaxing activities that help you unwind – such as reading, walking, gardening, etc.

5. Constructive Thinking

Learn better ways to handle negative emotions. Cognitive behavioral therapy (CBT) training can help with this.

• Keep a pain diary to chart your successes and failures. This written record provides tangible evidence of your ability to self manage pain.
• Increase positive thinking.
• Learn assertive communication techniques.

6. Ergonomics

Ergonomics = Setting up your home and work environments to reduce pain and improve efficiency and learning new techniques that allow you to perform essential tasks with less pain.

• Improving posture when sitting or standing.
• Learning healthy lifting techniques.
• Setting up your work or home environment to reduce pain.
• Making use of assistive devices, when available.

7. Improving Mood (Avoiding Depression)

Chronic pain often leads to activity disruption and reduced social participation. For these reasons and others, people with chronic pain are at elevated risk of depression. Taking active steps to ward off low mood makes sense.

• Laughter – try watching comedy shows or movies.
• Helping others – volunteering or other altruistic acts can improve mood.
• Learn CBT techniques to overcome negative maladaptive thinking patterns.

8. Better Healthcare Usage

Taking an active and involved role in the healthcare process helps you get more benefit from professional expertise and interventions.⁴

• Understand your condition. Be capable of monitoring your condition and managing and understanding your symptoms.
• Know the full names of all your medications, the dosages you must take and what each medication does for you.
• Communicate honestly with your health care providers and get answers for any questions that you have about your condition.
• Share in the decision making process with your doctor and others on your healthcare team.
• Take full advantage of support services.
• Learn how to evaluate the merits of new treatments⁵

9. Social Life

With pain it’s harder to stay social, but social isolation and loneliness increase your pain focus and lower your mood. Staying social helps you ward off depression and as long as you don’t overdo it, socializing can even reduce pain.

• Don’t let pain curtail your social life – plan manageable ways to get out and see friends and family; try shorter visits and schedule in plenty of times for breaks.

10. Distraction

Excessive pain-focus worsens pain sensations; sometimes getting your mind off your pain helps a lot – in fact, MRI studies show that brain activity in pain processing areas goes down when people get engaged in a secondary task.⁶

• Try getting more involved in activities you used to enjoy before pain interfered. If these activities aren’t realistic now, experiment with new manageable activities.
• Listen intently to music – try using headphones to immerse yourself in the sensory experience.⁷
• Visit with friends or family members.
• Read, play video games or watch TV or movies.

11. Mindful Consumption

• Avoid alcohol and illicit drugs – these can disrupt sleep, cause medication interaction effects and worsen side effects.
• Avoid tobacco –  it worsens general health and may interfere with endogenous pain management.
• Eat well – to increase energy levels, stabilize mood and increase medication effectiveness.
• Drink enough water – staying hydrated is especially important for anyone using opioids or other medications that can constipate.

12. Sleep

Pain makes it hard to fall and stay asleep and sleeplessness leads to fatigue, irritability and stress, which can all exacerbate pain.  Anything you can do to improve sleep will pay dividends in reduced pain.

• Maintain good sleep hygiene – Make your sleeping area inviting, avoid stimulating exercise immediately prior to sleep, avoid heavy meals prior to sleep - and many more.
• Consider medications that can help with sleeplessness.

13. Imagery Techniques

Use sensory imagery to alter your sensation of pain. Imagery techniques take a little practice to master and you may find working with a professional to learn these skills useful.

• There are many effective imagery techniques – here’s one example: imagine healing energy moving through your body toward your pain. As you breathe in the energy travels to your pain and soothes it. As you breathe out, the energy leaves your body, taking some of your pain away on each exhalation.

14. Problem Solving

Though you might have been an adequate problem solver prior to your pain condition, chronic pain brings novel complex problems and makes finding solutions more difficult. For this reason, and because research shows that people who learn problem solving skills have better health outcomes, learning effective problem solving skills makes a lot of sense.⁸

• One common problem solving model is based on a 6 step method: 1. identify the problem -> 2. set goals -> 3. brainstorm solutions -> 4. choose a solution -> 5. make a detailed plan and execute it -> 6. review and revise after the fact.

The Benefits of Pain Self Management

Pain self management techniques probably won’t cure you completely, but that’s OK – because self management techniques will likely reduce your pain and improve your overall quality of life. 

Some commonly experienced benefits include:⁹

• Reducing the frequency of severe pain flare-ups.
• An improved sense of self control over pain.
• Reduced pain-related stress.
• Reduced pain-related relationship discord.
• Decreased disability.
• Increased physical activity.
• Decreased anxiety and pain catastrophizing.
• Reduced healthcare costs.¹⁰
  
• Better sleep.

Taking a Pain Self Management Course

Disease self management works well and saves money – so it’s not surprising that a wide array of hospitals and other institutions offer brief outpatient or online courses to provide an introduction to pain self management and some initial instruction on some effective management techniques. Ask your doctor for a referral to a course near you, or simply search online for a course with the search term ‘pain self management + your city/county name'.

Your State of Mind and Long Term Disability Risk

Not yet convinced that by taking control of your pain management you improve your quality of life? Well consider the following risk factors of long term disability that medical professionals watch for during pain-assessments. If some or all of the following match your experience you’ll need to work a little bit harder to avoid long term disability - and you’ve got extra incentive to get started with pain self management right away.

Warning Signs of Long-Term Disability:¹¹

• Believing that pain does you harm.
• Feeling very distressed about your pain.
• Believing that passive pain control strategies work best.
• Significant pain catastrophizing.
• Excessive fear of pain (and fear avoidance).
• Psychosomatic tendencies.
• Low problem solving abilities.
• Believing that you probably can’t return to work.
• Believing that you probably won’t be able to do your job well again.