ALMOST 10million Brits suffer from daily pain resulting in a major impact on their quality of life.
Back pain, headaches and joint pain are the three most common ailments, and millions of working days are lost each day because of them.
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Numerous studies reveal a genetic vulnerability for chronic pain is likely – family studies show that people with chronic pain often have first-degree biological relatives who suffer too.
It’s also common for people with chronic pain to report a triggering episode that happened before the pain started.
An event such as a car accident, broken bone, surgery or infectious disease might have been the culprit, or a psychological trauma such as a major bereavement.
Clinical psychologist Afton L Hassett is a principal investigator at the Chronic Pain and Fatigue Research Center (CPFRC) at the University of Michigan and has been researching pain for decades.
In her latest book, Chronic Pain Reset, Dr Hassett explores how pain comes about and offers techniques to help manage it.
She says: “Left to its own devices, chronic pain can cheat you out of the life you envisioned before it came along.
“Through more than two decades of research, I have learned that many people find ways to lead fulfilling lives, despite their chronic pain.
“Your experience of chronic pain may result partially or almost completely from changes in the structure and function of your brain.
“Throughout your life, your brain retains its ability to change, to rewire – a process known as neuroplasticity.
“Just as your brain has over learned how to communicate pain signals, it can be taught new, more adaptive ways to function.
“Let’s think of this strategy as initiating a brain reset.”
HOW DOES PAIN COME ABOUT?
Chronic pain is not a psychiatric disorder; inferring that chronic pain is masked depression or hypochondria is wrong.
It’s widely accepted that many people with chronic pain have a pain processing system in the brain that’s too sensitive and reactive.
It’s thought that such pain sensitivity is due in part to genetic and biological factors and the rest to environmental factors that stress the brain and body.
Adverse childhood experiences, trauma, toxic work environments, financial stressors, lack of exercise, poor sleep and substance use all impact the structure and function of the brain.
STRESS AND PAIN
Stress is part of everyday life, and not all stress is bad. In fact, some stress helps us perform better and succeed.
The key to remaining resilient is to recognise when stress has turned toxic and to strengthen the tools you need to regain balance in mind and body.
Consider the following questions.
- Can you identify the aspects of the stressor that you can control and do something about?
- Do you reach out to friends or family for support? They don’t need to solve the problem for you, but they can help you share the burden and brainstorm solutions.
- Does the stressor seem so overwhelming that you (want to) blunt its effects with unhelpful behaviours, such as eating junk food or substance use/abuse?
- When feeling intense stress, do you take care of yourself?
Remember, when stressed, we tend to skip activities and behaviours that support good health: regular exercise, eating healthily, sleeping adequately, or making time for relaxation and fun.
ACTIVITIES, PRACTICES AND SKILLS FOR A BETTER LIFE
1. Paced breathing
Paced breathing can help decrease pain with an endless array of benefits for body and mind, including improving brain activity related to emotional control and psychological wellbeing.
Try it
In a quiet place where you won’t be disturbed, either lie down or sit comfortably in a chair with your feet flat on the floor.
Place one hand on your upper chest and the other hand just below your rib cage.
Slowly breathe in through your nose deeply enough so you feel your stomach rise while the hand on your chest stays as still as possible. As you inhale, slowly count to five.
Exhale, feeling your stomach fall inward under your hand as you exhale through pursed lips, as you would blow out birthday candles. Count slowly to five.
Repeat these slow breath cycles for five minutes.
As you practise your breathing, you can direct your attention to your breath.
When your mind wanders, gently bring it back to your breath.
2. Healthy sleep habits
Research has found that sleep deprivation makes pain worse.
It also changes how the brain processes pain signals.
When sleep-deprived, the brain areas that help release dopamine and other neurochemicals that promote pain relief show less activity.
Try it
- Every day, wake and go to bed at around the same time, even on weekends.
- During the day, get lots of sunlight, especially in the morning.
- Consume no caffeine (including chocolate) within 10 hours of bedtime.
- Limit alcohol intake and drink none within a couple hours of going to bed.
- Follow a set nightly routine (put on pyjamas, stretch, brush teeth, read for 30 minutes).
- Half an hour before bedtime, dim the lights.
- Avoid all electronics, and instead wind down with relaxing activities for at least 30 minutes before bedtime.
- Only go to bed when feeling sleepy.
- Ensure your bedroom is quiet, cool, and dark.
- Your bed should only be used for sleep and sex.
- Before bed, use relaxation techniques such as taking slow breaths.
How mastering the art of ‘SPACE’ can ease your agony
PSYCHOLOGIST and pain researcher David Williams created the acronym SPACE to refer to a cluster of symptoms in chronic pain.
- Sleep
- Pain
- Affect (anxiety, depression, malaise)
- Cognition (poor concentration or clarity of thought, memory issues, brain fog)
- Energy (fatigue)
Here’s how it works.
Let’s say pain is your worst symptom, and you’re a “good patient” and follow doctor’s orders.
You eat well, get a bit of exercise daily, but still the pain persists.
Maybe your other significant SPACE symptoms are sleep and affect (depressive symptoms).
Here’s how you execute a sneak attack on the pain.
If you improve your sleep, you likely will find that your pain and mood improve, too.
The same goes for improving your mood. Inject a little more happiness into your day, and you likely will sleep better and, in turn, experience less pain.
When you sleep better and feel happier, you tend to engage in more enjoyable activities and generally get more exercise.
Over and over, we see clear patterns of symptom change in relationship to other symptom change.
Better mood leads to better sleep; better sleep results in less fatigue; less fatigue makes concentration easier; and better mood and sleep result in less pain.
The combinations are many, but the results are the same.
Your physical and mental wellbeing can improve if you improve even just one of these symptoms.
3. Walking programme
Your brain needs physical exercise as does the rest of your body.
Walking improves heart health, regulates blood pressure, benefits circulation, strengthens muscles, increases lung capacity, reduces stress, supports weight loss and helps you feel happier.
Try it
Plan a brisk walk for 10 minutes each day.
You can start with less time if you need or more time if you want.
If you would like to use steps as your guide, about 1,000 steps will work — for the walk, not for the whole day.
4. Take a nature break
Spending time in nature has health benefits for people with chronic pain.
Try it
If you live in the suburbs or a more rural area, go to a nearby forest, meadow, mountain, or beach.
If you live in a city, visit green spaces such as parks or riverbanks.
If you have outdoor space in the city, such as a balcony or even just one planter, fill it with local plants and flowers.
Studies indicate that two hours spent enjoying nature seems to be the right “dose.” If that’s not possible, aim for 30 minutes.
If the weather looks lousy, gaze out the window at the nearest green spaces or put on a nature documentary.
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5. Self-soothe
Many people with chronic pain have sensory sensitivity, so what might smell delightful to one person seems like an assault on the nose to another.
This principle holds true for all the senses, so pursue what sounds best to you.
Try it
Vision, perhaps your most complex sense, can be calming.
Watch a sunrise, clouds floating by, a sunset, or stars in the sky.
Find photos of the most beautiful places on earth.
Many sounds enhance relaxation. Listen to a favourite piece of music; a recording of rain, waves crashing on a beach.
Go outside and listen for birdsong and other sounds of nature.
Left to its own devices, chronic pain can cheat you out of the life you envisioned before it came along
Afton L Hassett
A powerful sense, smell can transport you to moments when you felt calm and safe.
To delight your nose, put on a favourite lotion or cologne; light a scented candle or slice open a lemon, lime, or orange and rub its oils on your skin.
Given that you live with chronic pain, your sense of touch matters.
Wrap yourself in a fluffy blanket, take a bath or pet an animal.
For stressful situations, touch a stuffed animal or piece of soft, velvety fabric that puts you at ease.
To engage taste, which ties to memory, slowly eat a handful of raisins; drink a cup of tea or decaf coffee; let a small piece of chocolate melt on your tongue or chew some minty gum.
6. Listen to music
Music affects how we feel, what we remember, and even what we do.
It can improve your mood and decrease your pain.
Try it
Select and listen to two or three songs or pieces of music that make you feel invincible, proud, optimistic, or strong.
When you hear these songs, they should make you feel good.
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7. Daily connection
Building healthy and fulfilling relationships takes time and effort.
Although it can be a challenge if you’re living with chronic pain, it’s worth the investment.
Try it
Text to connect: Scroll down your text message list and find someone with whom you have a positive relationship but haven’t spoken to in a while. Send a warm text letting them know they are in your thoughts.
One more question: Asking people questions shows that you’re listening and interested. It’s a gift and a skill. Wow someone with one more question that shows you heard and care.
Heartfelt compliment: You can demonstrate genuine interest in others by offering compliments about something meaningful to them.
This is an edited extract from Chronic Pain Reset: 30 days of activities, practices and skills to help you thrive by Afton L Hassett (Quercus, £16.99).
