Living with chronic pain

Back pain is a leading cause of chronic pain in adults across Australasia. Dr Nicola Swain, senior lecturer at the Dunedin School of Medicine, teaches and conducts research on the topic of pain. She suggests six ways to minimise its impact 

Kate Edwards was having a tough week. Her back was playing up again. Something as simple as vacuuming the house seemed like climbing a mountain. Her husband was sick of hearing her complain. His job was demanding and he was fed up with coming home to hear about how playing with the kids and keeping the house tidy was overwhelming.

Kate’s mum doesn’t offer much sympathy either. She’s raised four kids without help and tells Kate she should “toughen up”. The doctors have told Kate there is nothing else they can do. Kate feels exhausted and has lost contact with most of her friends. Ignoring the mess around her, she spends all her spare time surfing the Internet in search of a cure. She’s tried acupuncture, chiropractic and prescription drugs, but none of them work for long.

Back pain is the number one disability of adults in Australasia, according to The Institute for Health Metrics and Evaluation, an international health research organisation. Other common types of chronic pain include headache, arthritis, injuries and pelvic pain. Ongoing pain can cause disability, loss of employment, depression, anxiety and loss of quality of life. It is hard for those in the grip of it to know what to do. “A survey by the American Academy of Pain Medicine found that comprehensive treatment with painkilling prescription medicines only helps just over half of sufferers,” says Shaun Holt, adjunct professor at Victoria University, and author of the bestseller Natural Remedies That Really Work. Holt is also part of the team at HoneyLab, a New Zealand pharmaceutical company specialising in honey or bee venom-based products.   

The failure of painkillers to deal effectively with pain leads to a search for alternative treatments. Meanwhile new research suggests people with chronic pain need to give up focusing on a search for the cure and put their energies instead into wellbeing. Professor Lance McCracken of Kings College, London has published many research papers confirming that “disengagement from struggling with pain” will increase a person’s life satisfaction. Here are six steps based on the latest research to help you on your way.

1. Quit the fight with pain. If you have been searching for a cure, ask yourself if the effort you have put in has been paying off. It can take a lot of time and energy looking for that one treatment which will finally deal with the pain. Consider confining your search for a cure or new treatment to one day a week, or only between certain hours, such as weekday mornings, and put it out of your mind the rest of the time.

2. Accept pain in your life. This might seem counterintuitive – you might think that accepting pain means allowing more of it. But research in the latest New Zealand Medical Journal suggests that those people who are able to accept that pain is part of their lives experience less pain, less disability, and are more able to work. 

3. Start a gratitude diary. Just thinking about something positive in your day can make a tangible difference. Studies show that actively cultivating a sense of gratitude increases wellbeing. It might be as simple as writing three things each night at bedtime that you are grateful for – a practice that has been found to increase quality of sleep. Even if you have had a shattering migraine all day, there will be something to be grateful for: the lovely flowers in your garden, the smile of a stranger, your peaceful office. And it only requires the simple tools of pen and paper.

4. Focus on values. Try to recall what was important in your life before the pain and reconnect with this. Dr Russ Harris, author of The Happiness Trap, says, “Values are what you want your life to be about, deep in your heart. What you want to stand for. What you want to do with your time on this planet. What ultimately matters to you in the big picture. What you would like to be remembered for by the people you love.” Pain might have prevented you doing things with the family you did before, so consider an alternative approach. Maybe instead of the star player at beach cricket you may have been, be the referee and cheerleader. Giving can also improve wellbeing.

Is there a cause you believe in? Think about how you can help. Join the PTA or your local conservation group and feel the benefits of helping others. 

People who are able to accept that pain is part of their lives experience less pain, less disability, and are more able to work – ‘Chronic pain in New Zealand: A community sample’ – New Zealand Medical Journal

5. Do what matters. Save your energy and time for those things you really enjoy and are meaningful. Ask others to help out with things like housework. It can be hard to accept or ask for help so begin by saying yes whenever someone makes an offer.

If possible, consider paying for things that need to be done but give you little satisfaction, such as mowing the lawns. Cook double meals and freeze them for difficult days. Buy a few convenience ingredients for your cooking, such as pasta sauce, and know that no one will suffer from cutting some corners. Accept that your pain levels will fluctuate, so save a few jobs for ‘good’ days.

6. Live in the moment. Practising mindfulness means that instead of thinking about what has happened in the past and what might happen in the future, just let thoughts come and go, without making any judgment. Focus on the feelings and sensations in the moment. You can do this each day while loading the dishwasher or waiting at the lights. Simply focus on the experience and let all the other thoughts pass.

Chronic pain is a difficult and persistent condition. It can be frustrating and it can sap the joy from life. No matter what you do, the pain might remain. “Despite decades of medical research, chronic pain remains poorly understood and notoriously hard to treat effectively,” says Professor Holt. However, by quitting the fight with pain, practising acceptance, identifying your values, choosing to do more of what matters to you and living in the moment, you can live a good life, even while experiencing pain. 

Kate might explain to her mum that her back is really sore right now and if she could pay a visit and help with the vacuuming Kate would really appreciate it. Kate could decide to value her relationship and commit to sharing some positive moments with her husband, as well as her challenges. She could join a book club and indulge in the pleasure of reading and conversation. Research shows these actions will make a difference not only to wellbeing but also to pain. If what you’re doing now isn’t working – make the choice to change. As the saying goes, the definition of insanity is doing the same thing over and over again and expecting a different result. 

This may not be the life you planned, but it’s yours, and it’s your job to live your best life and to make the most of it, with or without pain.

Dr Nicola Swain conducts pain research and lectures at the Dunedin School of Medicine.

For more from Nicola or to sign up for seminars about living better with chronic pain, email [email protected]

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