My Perspective on Pain

America is in pain. Chronic pain, migraine pain, arthritis pain, mental pain, emotional pain, financial pain, stress pain, joint pain, abdominal pain. You name it, we’re in deep. Proof:

1 in 5 Americans use opiates regularly for pain. (Congratulations to the marketing departments at Big Pharma!)

1 in 5 Americans have serious anxiety or other mental health issues.

We are not dealing well with our pain.

Pain is a hot topic right now. Between the opiate epidemic, the aging of a generation of baby boomers, and the mis-management of athletic injuries, not a day goes by without a significant research study or news story about our pain. You’d think we could manage better with all of this information? But our perspective about pain, and our reaction to our pain, is actually very ancient. Our ancient instinctive need to rid ourselves of pain and to avoid pain at all costs, supersedes and interrupts any educational discussion of pain.

Even though we know pain can be managed well and safely for the most part, we have a lot of fear of being in pain. We may try and ignore it, too afraid to face it. Or we may fearfully obsess about the potential for pain. We may even identify ourselves as “someone in pain”. “I have a bad knee. I can’t do that.” Of course, there are those who see pain as some kind of badge of courage. “My legs are so sore from training, I can barely walk”……. “I almost puked after my boot camp class. What a workout!” Then, there are those people who refuse to take over-the-counter pain meds for fear of overuse or, due to some twisted mindset that tolerating daily pain is normal. There are many different reactions to pain!

On a more serious note, all addiction is about the need to get rid of pain. It rarely starts with the intent of becoming addicted. Initially, one might be just trying to get rid of physical pain like severe back or ankle pain. But we know there are hundreds of thousands of stories of average people- young athletes, accident victims, surgical patients- becoming heroin addicts after an addiction to pain pills. One reason for this is that, overtime, the effectiveness of hard core pain meds diminishes. Of course, this leads to self- dosing; increasing amounts to get the achieved physical (or mental) relief. It’s actually easy to see how people with severe pain become addicts. And it all started with trying to manage physical pain.

(Side note- Emotional and mental pain are other kinds of pain which can lead to addiction. This is why understanding and treating anxiety disorders and other mental illnesses is so essential to combat the opiate epidemic. Other influential factors for increasing the risk of addiction include a family history of addiction, trauma, abuse, depression, low self- esteem, and bullying).

It’s obvious from the list above, that there are many different kinds and levels of pain. And although drug and alcohol addiction in response to pain is a horrific national epidemic, the most common kind of chronic pain is low level and annoying. I’m particularly interested in what we do with this kind of pain. How do you react to daily knee pain? Or sudden shoulder pain? Or chronic foot pain from standing all day for work? Does your pain limit you? And most importantly, what do you do to help yourself with your pain? Do you take time for self-care for pain management?

We do have control over many aspects of low level pain. But we have to work at it. We have to stay aware and be proactive. We need to omit any activities or habits that increase our pain, and consistently add in activities and habits that decrease our likelihood of pain.

Here’s a few specific ideas and bullet points that are relevant to managing your pain:

– Remember that you are NOT your pain. You are the person experiencing it, and thus you have choices about how to deal with your pain. You have the ability to separate yourself from your pain. It is important to not identify with your pain. That makes it so much harder to deal with.

– Pain is a sign of something wrong, but it is normal. Pain is a highly important physiological reaction that is necessary for us to experience at some times in our day-to-day life. You should never ignore new pain or pain that increases with a specific activity. However, there can be some kinds of pain that are known to us, that we have specifically identified, and that we can learn to acknowledge and accept. For example, if you have arthritis pain, as much as it hurts, you know what it is. You know how to manage it. And there are many things you can do to help yourself. Fear does not need to be a daily reaction. Fear only makes pain worse.

– Your level of pain is integrally related to your psychological state, your general health, your nutrition, your sleep and your habits. If you are in pain and want to help yourself, you must address all factors which can affect your pain. Not sleeping? That will increase pain. Eating processed foods and inflammatory foods will increase pain. Sadness and depression can increase pain. It’s all related.

– Chronic pain is poorly understood. It often takes tremendous determination to find the proper health care professional and treatment plan. But never give up. Never let anyone tell you your pain isn’t significant or real. Keep pushing forward until you find your best plan of action. You might need to try many different techniques and practitioners to help you with managing your pain. Make sure you give each different modality plenty of time to work. Many people in pain skip around from one thing to another, not having the patience to allow the treatments to work. This can be self-defeating.

– Exercise is a healthy coping mechanism for pain. When we learn what activates and increases our pain, we omit those things, but we also must insert healthy coping mechanisms for our pain. For example, back pain can be debilitating. Our tendency might be to limit ourselves and give in to back pain. But excessive rest means muscle atrophy and core de-activation. The weaker we are, the worse our pain will be. Of course, it’s hard to find the motivation to exercise when you are in pain. But, more often than not, people with chronic musculoskeletal pain and even people with pain syndromes like fibromyalgia, find relief with the right kind of exercise. People with chronic pain should reach out to experienced trainers or physical therapists who can help them safely transition to an exercise program.

– Pay special attention to the day to day habits you unconsciously engage in that could be contributing to your physical pain. Static postures such as sitting at a computer, texting on your phone, leaning more on 1 leg than another, sitting with 1 leg tucked under, or sleeping in unusual sleep postures, can all set you up for muscle imbalances and significant pain. In my experience, many people have very bad chronic pain merely from knotted and angry muscles and fascia. Addressing soft tissue is job #1 for musculoskeletal pain.

– Mindfulness is another healthy coping mechanism for both physical and emotional pain. Acceptance of what is and practicing staying in the moment, rather than fearing the future or regretting the past, is the key to coping with pain (and life, for that matter!). What other choice do we have? We must learn to know our pain, not ignore it to our own detriment, or wallow in its depths of despair. This does not mean things will be easy. Mindfulness is never a miracle. But we often overcomplicate our reaction to pain. Our reaction to pain is what we can control.