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My Approaches To Managing Chronic Pain

Chronic pain can be debilitating. It can be isolating. And it is almost always inexplicable. As I write this, I am in excruciating pain. And I recall all the pain stories I have heard from people suffering from chronic pain. Pain that fogs the mind and makes me second guess everything. Sometimes, the question is “am I really feeling the pain or is it just my mind”, and at other times it’s even more intimate; after years of pain, if there are days when a certain part is not paining, one wonders what happened! “Is my pain really gone?? Or am I imagining it??”.

That’s the most cruel truth about chronic pain. It is there, even when it is not. It becomes interwined with your life. You always think about it before answering the most common question, “how are you today?”. The innocuous “today” in the question immediately takes you to your pain: how is it doing? Your well-being becomes a question of your pain levels.

And now here I am sharing my experience and learnings about living with and managing my chronic pain.

1.   Listening to your own body and deciding how you want the pain to define your identity.

Trust Yourself !

If you are feeling the pain, it is real. It is always real. Your body is trying to talk to you through pain. Even if the entire medical community tells you that it’s in your mind, it is still real. You are feeling it! Lack of clinical findings does not invalidate your feelings. So feel it, acknowledge it and accept it. And try everything from here on to get the relief you need and absolutely deserve.

Just by doing this, you are relieved of the mental struggle. And sometimes, that itself can bring relief.

Love yourself. Be kind

There will be times when you won’t be too happy with what you can do, your own productivity and what you have achieved. On those days remember to be kind of a yourself and remind yourself that you are doing your best. With the pain and despite the pain.

There will be days, maybe many days when you will be tired. Rest it out. Take a few extra minutes in bed through the day. Be kind to yourself.

Write

Sometimes the best way to handle the stress and the emotions is to write them out on paper. Keep some paper and a pen handy all the time. And write your heart on it. Talk to your pain, if needed. If there is anything troubling you, write about it, if there is anything very important to you, write about it. If there is something that excites you a lot, write about it. Writing brings about a sort of clarity and acknowledgement that is missing otherwise.

And clarity sometimes can also bring pain relief. Try it!

Find your voice for your pain:

Chronic pain is personal. It is almost like an intimate partner, albeit someone you didn’t choose and much rather not have. It is important you find your words to describe it. For some, being a “pain warrior” gives them the push to carry on. They gain motivation from it to live their everyday life, do the chores, break into a laughter, despite the pain. For others, the “warrior” story might be too difficult to relate to.

I find it difficult to be at a war zone all the time. To imagine my body as a warzone was not how I could deal with my pain. I had to find peace and accept my pain. That was my method of handling it.

Everyone has a different story, a different voice. It is important to find the narrative we are most comfortable with.

2.   Deep Breathing and Meditation

Deep breathing

Painkillers (an important arsenal in the management of chronic pain) are often inadequate. Sometimes it has been difficult for me to even lift a finger because of excruciating pain in different parts of the body. What came to my rescue was deep breathing.

Just deep abdominal breathing, where the exhalation is longer than the inhalation, can bring pain relief within minutes. You can just lie down or sit in a relaxed posture and inhale slowly (feel your abdomen bulging out) and exhale slowly and completely (feel your abdomen sinking inside). It is more effective if one is mindful of the breaths. Observe every inhalation and exhalation. Count every breath. If you miss the count, it shows that the mind is meandering and not focussed on the breath. Start again.

This form of deep breathing has been most effective for me in managing my pain when all pain medicines failed. The bonus of course is that it has no side effects. There is no limit to how long this could be practiced neither any physical preparation is needed. It can be done right after a meal or on an empty stomach. It was liberating for me as the effect was quick, and I didn’t have to wait for at least 8 hours for the next dose. It can be done anywhere, anytime and as often as needed.

Meditation

Meditation has also been very effective for me in managing my pain and keeping the overall pain levels down. Regular meditation can help in getting a grip over one’s stress levels. Stress is often the root cause of physical pain, even if the stress is not apparent and just simmering below the surface. Sometimes even being over ambitious about some work can be stressful.

It can be difficult to meditate when the mind is not calm. You can prepare for the meditation with very light movements and alternate nose breathing (nadi Shuddhi or anulom vilom). If meditating is difficult in the initial days, just practicing anulom vilom can be useful. Just doing this has often given me pain relief and improved my movements.

Anulom Vilom : exhale out forcefully with both nostrils, then inhale through your left nostril, holding the right nostril with the help of thumb and middle finger. Hold the breath for a second and exhale out of the right nostril by holding the left nostril with the help of the thumb and middle finger. Hold for a second and now inhale from the right nostril, hold and exhale from the left. This is one full round. Repeat this at least 21 times.

Letting go

Stress can also create blockages in us sometimes. Acknowledging that and letting go of the emotions that are binding us with our pain can be crucial in getting pain relief.

Once a terrible shoulder pain that was troubling me over months reduced in a day when I let go of the acrimonious fights and troubled feelings I was having at that time. The body needs the mind to heal.

3.   Light and therapeutic movements

Optimum movements

I suffer from Psoriatic Arthritis. Keeping the body active is crucial to pain relief. This is often counter intuitive. Pain tends to trigger an instinct in us to not move the painful parts. Going against this instinct and gently moving the body can be very helpful in reducing pain. Lack of movements can incrementally make the pain worse. Just moving the part as much as is tolerable for the body can bring in relief slowly. Over time, I have realised that having active movements regularly can keep the general overall pain levels down for those suffering from chronic pain. One has to be mindful however to not overdo any movement or exercise. It is only by listening to your own body can you determine your limits. Be mindful, but not afraid of testing one’s limits.

Sometimes when active movements have not been possible, getting assisted movements have also proven to be useful for me. This too has to be done upto tolerable levels and within the limits of the body’s ability.

Yoga

My general pain levels reduced a lot by practising therapeutic Yoga. In some parts there was no pain at all after a few weeks of regular practice. Taking advice from an expert yoga therapist (not a practitioner but someone training in therapeutic Yoga) can be helpful.

4.   Physical Interventions

The pills.

While regular painkillers can have poor side effects, they are sometimes needed. Get medical advice to know which painkiller suits you. Often, it is a combination of painkillers that might help since different painkillers have different ways of functioning and hence different effects.

Hot water fomentation dry/wet

For me, hot water fomentation on the painful joints was very relieving. Hot salt water was even more effective. Just soak a towel in hot salt water, wring out the water and place it on the affected area. Or soak the affected area in hot salt water. You can even take a long bath in hot salt water. Make sure that the water is comfortably hot for you.

I tend to get more relief with “wet fomentation” than “dry fomentation”. In fact, dry fomentation adds to my pain. For those who find dry fomentation helpful, you may use a dry warmed dry towel or a take some salt in a cotton cloth pouch and heat it on a hot plate and apply it on the affected area.

Anti-inflammatory Diet

Be careful of what you eat. Some foods are inflammatory, while some are antiinflammatory and can have pain relief effects. Ginger, garlic, turmeric has been very helpful in managing my pain.

One needs to have an open mind and test different foods to see which one may causing them inflammation and pain. While some foods cause pain within hours, others may cause pain over time. The quantity of what is being consumed and the time of consumption are also important factors. Taking advice from expert dieticians and nutritionists can be very helpful. There is no one master diet plan that can suit everyone. All bodies and their needs are different. A diet plan that considers all your physical needs is what is most suitable for you. And again, you can feel and understand your body the most. Keep an open mind to know which food is having what kind of effect on you even as you follow a professional diet plan.

5.   Activities that are uplifting

Dance!

Or sing. Or paint. Or just listen to some music that you like. Something soothing, something peppy, something that helps you sleep, something that wakes you. Just anything you like. This is probably the simplest and yet, the least used pain reliever. There will be days when you might not want to do anything. Your pain might have tired you out to even breathe deeply. Turn on the music. Smile your pain away.

Dancing and painting can also bring in pain relief and help with movement. I have often forgotten my otherwise debilitating pain when I have been dancing. Even if that meant just swaying in the wheelchair. You don’t have to be a dancer. Just move with the music to the joy of your soul.

At other times, try to add colour to a plain paper and see how your body feels colourful too. Let the colours push away the pain.

Hug someone!

And finally, there is no better pain killer than love. Get some tender affection. Be open to hugging your loved ones.

A combination of these things helps. We all need to find the combinations that work for us. And they may change over time.Most importantly, give your body an attentive hearingto know what will work for your body the best.

by Soumita Basu