A Holistic Overview Of Chronic Pain Management
Living with chronic pain is an ordeal, one that many of us fail to comprehend. As a society, we struggle to manage with chronic pain effectively, and part of the reason for this is that we often don’t take a sufficiently holistic and broad minded approach to its treatment.
A broad, flexible multifaceted approach is necessary to make a significant difference in most cases of chronic pain. Complex problems often require complex solutions. Outside of the treatment technologies and specific rehab that your pain treatment calls for, making necessary lifestyle adjustments can be a big help in getting n your pain under control.
Pain is a highly evolved form of physical feedback, designed by nature to tell us where we are going wrong. As we are growing up its pain that teaches us about ‘too hot. ‘too hard, ‘too fast’ etc., all the things we need to know in order to survive on this rough and ready physical plane. As adults, pain continues to try and help teach the best way forward, but the messages mostly differ in meaning. The stubborn pain that adults experience is just as instructive as the pains children go through when they are learning to play safe. Except due to the nature of the mistakes we make as adults the messages change from messages like ‘too hot’ to ‘too sedentary’, from ‘too high’ to ‘too stressed‘, ‘too weak’, ‘too much
The pains that children go through are feedback about the physical environment, they teach us about, too hard, too fast, too hot, too high, too careless.
The pains that adults go through, due to the differing nature of adult stupidity are physical feedback about lifestyle. Too sedentary, too fat, too much, not enough, too stressed, too tired, too codependent, too weak, too hunched. They are less about immediate feedback from the environment and more about the persistent mistakes we make that prevent our bodies from expressing their full potential for comfort, movement, health, and wellbeing.
The funny thing is though, the pains adults go through get wildly misinterpreted in our culture and our healthcare system. Medicine tends to treat pain signals as just another inconvenient ‘disease state’ and switch them off using pharmaceuticals, and the general public tends to attribute stubborn pains to aging or an absence of the right miraculous healthcare ‘cure’.
But once you remember and affirm that your pain is your body’s guidance/cry for help mechanism you might change how you approach your pain relief journey. Some of the best questions being along the lines of … what am I suffering from too much or too little of in my day to day life???
The modern landscape of sleep research is pretty terrifying for those of us who often come up short of a quality 7 hours plus. Even subtle reductions in sleep duration and quality are associated with increased risk of obesity, chronic disease states, and a host of sub-optimal well-being outcomes. Science is being revealed by the science to be a ‘vital sign’ just like blood pressure and heart rate etc.
The connection between chronic pain and sleep can be both a chicken/egg and an egg/chicken type scenario. Obviously, pain can interrupt your sleep in and of itself. But also, chronic forms of stress like overworking, over-training, over-worrying can erode your sleep; and thus impact the amount of pain you live with. Pain can impact sleep and sleep can impact pain.
If you are living with chronic pain learning about good ‘sleep hygiene’ may prove to be an excellent investment in your longer term wellbeing. And fortunately, there is a vast amount of high quality online information available on this vitally important topic.
The modern landscape of sleep research is pretty terrifying for those of us who often come up short of a quality 7 hours plus. Even subtle reductions in sleep duration and quality are associated with increased risk of obesity, chronic disease states, and a host of sub-optimal well-being outcomes. Science is being revealed by the science to be a ‘vital sign’ just like blood pressure and heart rate etc.
The connection between chronic pain and sleep can be both a chicken/egg and an egg/chicken type scenario. Obviously, pain can interrupt your sleep in and of itself. But also, chronic forms of stress like overworking, over-training, over-worrying can erode your sleep; and thus impact the amount of pain you live with. Pain can impact sleep and sleep can impact pain.
If you are living with chronic pain learning about good ‘sleep hygiene’ may prove to be an excellent investment in your longer term wellbeing. And fortunately, there is a vast amount of high quality online information available on this vitally important topic.
Research suggests that people with a higher BMI are more likely to suffer chronic pain. It is unclear why this is. Some evidence suggests that chronic pain itself leads to a maladaptive relationship to high blood pressure. On the flipside losing weight is associated with better pain outcomes. Acute pain puts the body in a fight or flight response and makes us more tolerant to pain. When the pain is chronic though, higher blood pressure increases pain sensitivity (Sacco, Meschi et al. The Relationship Between Blood Pressure and Pain).
As a patient, it can be very very frustrating to be told by your doctor that you need to lose weight, after asking for help with treatment if your chronic pain. This frustration is completely justified.
Weight gain can influence your pain levels for sure. But there is a lot more to managing and healing pain than simply losing weight. On top of this, if you are in pain and it prevents you from exercising effective treatments will be needed before you can start to reduce your weight effectively.
Weight loss should be considered a valuable and important ‘component’ of long term pain management – a piece of the jigsaw.
Research suggests that people with a higher BMI are more likely to suffer chronic pain. It is unclear why this is. Some evidence suggests that chronic pain itself leads to a maladaptive relationship to high blood pressure. On the flipside losing weight is associated with better pain outcomes. Acute pain puts the body in a fight or flight response and makes us more tolerant to pain. When the pain is chronic though, higher blood pressure increases pain sensitivity (Sacco, Meschi et al. The Relationship Between Blood Pressure and Pain).
As a patient, it can be very very frustrating to be told by your doctor that you need to lose weight, after asking for help with treatment if your chronic pain. This frustration is completely justified.
Weight gain can influence your pain levels for sure. But there is a lot more to managing and healing pain than simply losing weight. On top of this, if you are in pain and it prevents you from exercising effective treatments will be needed before you can start to reduce your weight effectively.
Weight loss should be considered a valuable and important ‘component’ of long term pain management – a piece of the jigsaw.
A healthy diet is paramount to avoid chronic disease. Depending on the kind of pain, different approaches are promising. Increased omega-3 intake might help with inflammatory pain; avoiding polyamines (as found in soy and nuts) can reduce hyperalgesia; broccoli, spinach and vitamin E have a possible effect on diabetic neuropathy. Fasting shows evidence to help improve mood in pain patients who also suffer from depression but regular caffeine consumption can influence how some antidepressants are taken on by the body.
Chronic pain is associated with increased cardiovascular risk and a balanced diet helps mitigate that.
If you suffer from other chronic conditions, such as coronary heart disease, or obstructive pulmonary disease, you are more likely to report chronic pain than the general population. One suggested mechanism is the added challenges for people with chronic pain to exercise, increasing their cardiovascular risk. Other considerations are chronic conditions turning up the volume and making pain more intense in an already challenged body, and the influence of stress and disability from other diseases. Chronic pain cannot be treated in isolation; the whole person with any other illnesses needs to be considered.
Along with scar tissue, emotional and psychological stress may be the most underestimated factors in all chronic pain management. The vast majority of stubborn pains are underpinned in part by patterns of stress and trauma held in the body’s tissues and the central nervous system.
To add insult to injury pain itself compounds and exacerbates stress, forming a negative feedback loop. The more pain I get the more stress I experience so the more pain I get. Many chronic pain sufferers find that the uncertainty of being in pain is more stressful than the stressors that lead in part to the pain in the first place.
Certain kinds of exercise might be more useful for certain pain conditions. Personally tailored advice with relevant movements are more successful than general exercise.
For many people with chronic pain it is important to be able to return to their preferred activities of daily living, may it be returning to work, playing team sports, or getting out into nature for gardening, a walk, or a multi-day tramp. Many studies show improvements in mood and sleep with increased exercise, and doing what you love surrounded by friends, family, and/or nature further helps with co-morbidities and perception of chronic pain.
Certain kinds of exercise might be more useful for certain pain conditions. Personally tailored advice with relevant movements are more successful than general exercise.
For many people with chronic pain it is important to be able to return to their preferred activities of daily living, may it be returning to work, playing team sports, or getting out into nature for gardening, a walk, or a multi-day tramp. Many studies show improvements in mood and sleep with increased exercise, and doing what you love surrounded by friends, family, and/or nature further helps with co-morbidities and perception of chronic pain.
Certain kinds of exercise might be more useful for certain pain conditions. Personally tailored advice with relevant movements are more successful than general exercise.
For many people with chronic pain it is important to be able to return to their preferred activities of daily living, may it be returning to work, playing team sports, or getting out into nature for gardening, a walk, or a multi-day tramp. Many studies show improvements in mood and sleep with increased exercise, and doing what you love surrounded by friends, family, and/or nature further helps with co-morbidities and perception of chronic pain.
The most common downstream risk of suffering with pain is more pain. If you already experience pain, you are more likely to develop pain in other areas and more likely to have relapses of the pain you suffer with now. It is important to address your pain as soon as possible to avoid tissue atrophy and changes in the brain to make you more susceptible to pain.
Pain is a symptom. Symptoms are the feedback that the body generates when it faces problems with its delicate internal balance (homeostasis). Without symptoms like pain, thirst, nausea and fevers, it would be very difficult for us to maintain a healthy body in the same way that it would be hard to drive a car safely with no dashboard display.
John is one of those rare gentlemen who has continued to play competitive soccer well into his late 50s. He is in really good shape, which you need to be to play football at that age—good shape except for his left leg. His left leg is not in good condition at all. In fact, once you get to know his left leg a bit better, it becomes apparent that it’s miraculous that he’s able to run at all, Let alone the type of running required to play competitive soccer against younger men.
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