How to Deal with Chronic Pain

Four Methods:Dealing With Chronic Pain MedicallyDealing With Pain By Staying ActiveDealing With Pain By Relieving StressDealing With Pain Through Alternative Means

Chronic pain is defined as pain that lasts longer than six months.[1] Pain is always a difficult problem. It is obviously difficult for the person with the pain, but medically, it can be very difficult to determine the level of pain and treat that pain appropriately because it is very subjective. If you are dealing with chronic pain, there are some methods you can use to help.

Method 1
Dealing With Chronic Pain Medically

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    Talk to your doctor. Start with your primary care doctor who can initiate an evaluation with blood work, imaging, and a trial of some medications and refer you to the right specialist. Let your physician know if you have a history of addiction, as you may be at higher risk for addiction to painkillers.[2]
    • If your pain is due to the aftereffects of cancer treatments, talk to your oncologist. Pain specialists and oncologists have the most experience dealing with the many complex issues surrounding the treatment of pain.
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    Determine the cause of the pain. The first step in the medical management of pain is to determine the cause of the pain. The pain may be from disorders such as arthritis, fibromyalgia, cancer, and more. It might take additional studies, evaluation, and time to find the source. Once the underlying cause is determined, then treatment can be discussed.[3]
    • You may need to see a number of different doctors, including a rheumatologist, orthopedic, neurologist, and/or physical medicine and rehabilitation specialist.
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    Decide on a medication. After you determine the cause of your pain, you and your doctor can discuss the use of medication. In general, acetaminophen (Tylenol) or NSAIDs (Aleve, Advil, aspirin) are used first. The idea is to start first with medications with the fewest side effects.[4] For all these pain medications, it is very important to follow the instructions exactly as written. If the instructions are not clear, make sure you ask your doctor, nurse, or pharmacist to explain them until you are very clear on when and how to take the medication. Report any side effects or problems with the medications right away.
    • Under some circumstances, tricyclic antidepressants such as amitriptyline may be used to control pain.
    • A third class of drugs that may be used are the Serotonin and norepinephrine reuptake inhibitors (SNRIs) such as duloxetine (Cymbalta).
    • Corticosteroids are primarily used for inflammatory rheumatology and autoimmune disorders. Sometimes a short course is ordered to treat acute pain as well.
    • Anticonvulsants such as gabapentin (Neurontin) or pregabalin (Lyrica) have been shown to be useful for some types of nerve pain, including fibromyalgia and neuropathies.
    • Opiates are generally reserved for pain that doesn’t respond to other pain medications. They should be used only for a short period of time and/or after you and your doctor develop careful treatment plan, as opiates are highly addictive.
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    Follow medical dosage instructions. It is very important to be aware of and stick to the dosage recommended by your physician to minimize the chances of developing a problematic tolerance to the pain medication. Tolerance is defined as “a phenomenon or adaptation of the body over a period of time in which one or more effects of a drug become less with repeated use at the same dose.” This is often referred to as becoming “immune” to the action of the drug.[5]
    • It is important to understand that tolerance is not addiction. Tolerance is the body’s adaptation to the drug. The problem with tolerance is that more and more drugs are needed to achieve the same effect, and increasing doses also means there is an increased risk of dangerous or unacceptable side effects and the chance of an accidental overdose. Following the dosage schedule can slow down the tolerance process.
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    Work with your pain management team. More and more pain management programs are interdisciplinary and utilize many different professionals with a wide diversity of skill sets that can help you deal with chronic pain in the healthiest way possible, improving your quality of life as much as possible.[6]
    • This team first includes you. The pain management team can also include a physician and nurses, in addition to physical, massage, occupational, recreational, and psychological therapists. There may also be social workers, nutritionists and other support staff.
    • The important thing for you to remember is to access the team and make use of the services they have to offer you.
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    Get physical therapy. You should consider including a physical therapist as part of your pain management team. A physical therapist can help you manage pain by giving you bodily treatments catered towards relieving your pain. These exercises include strengthening exercises, flexibility exercises, manual therapy, posture help, and body mechanics instruction.[7]

Method 2
Dealing With Pain By Staying Active

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    Stay social. Try to stay as active and as socially engaged as you can. When you are dealing with chronic pain, sometimes having people around you can be the very last thing you want; however, having people around can also distract you from the pain and allow you a few moments, or maybe more, to forget the pain. Humans are social creatures and while you may not always want to have people around, and don’t need to 24/7, it has been shown that social contact can have significant effects on pain perception.[8]
    • Socializing can help alleviate loneliness and depression, which can negatively affect chronic pain.
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    Seek out support groups. As social creatures, finding others who truly understand what you are dealing with can be a significant comfort. Support groups also help you not to feel so alone. The people in the group may be able to offer advice and coping techniques.[9]
    • To find a support group for people dealing with chronic pain, start by looking at the groups at the American Chronic Pain Association or the National Fibromyalgia and Chronic Pain Association.
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    Exercise. Exercise has been shown to increase the production of endorphins, which naturally reduce pain. Exercise also strengthens muscles along with reducing the risk of obesity, heart disease, and diabetes.[10][11] Try low-impact activities, such as yoga, Tai Chi, walking, swimming, cycling, or strength-training.[12]
    • You will need to talk to your physical therapist and other members of your pain management team to determine whether stretching exercises, strengthening exercises, aerobics, or weight training is best for you.
    • Make sure to find the right level of activity for you. If you do too much, you may have increased pain the next day; however, staying inactive for too long can lead to further problems with pain and mobility. Find the right exercise and amount of activity for your condition.[13]
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    Distract yourself with activities. Staying busy and engaging your mind and body in activities that distract you from the pain can be an effective management strategy. Try reading or listening to music.[14] These activities may not be able to let you forget the pain, but it can help you take control of your life.[15]
    • Consider finding a hobby that lets you get out of the house and connect with other people.[16]

Method 3
Dealing With Pain By Relieving Stress

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    Try deep breathing exercises. Deep breathing is one relaxation technique that can help reduce stress.[17][18] Learning to relax may help decrease pain.[19]
    • Lie flat on your back. Use pillows under your knees and neck to make sure you are comfortable. Put your hands palm-down on your stomach, right below the rib cage. Place the fingers of your hands together so you can feel them separate and know you are doing the exercise correctly. Take a long, slow, deep breath through your nose by expanding your belly. This ensures that you are using your diaphragm to breathe rather than your rib cage. Your fingers should separate as they lie on your belly. Exhale through your mouth. Do this as often as you can.[20]
    • Use a variation of a Chinese Qigong breathing exercise. Sit down comfortably. The lungs' natural rhythm will take over immediately. Take three short inhalations through the nose. On the first intake, lift your arms, reaching in front, keeping the arms at shoulder levels. On the second intake, move your arms to the side, keeping the arms at shoulder levels. On the third intake, lift your arms over your head. Repeat 10 to 12 times.
    • If either exercise causes any dizziness, stop. Do these exercises as often as you need.
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    Do progressive muscle relaxation. Another way to decrease stress and cope with pain is through progressive muscle relaxation.[21] Start with your toes. Tighten them by curling them under your feet. Hold for five to 10 seconds. Then slowly relax the toes.
    • Move on to the feet next. Tighten all the muscles in your feet and hold for five to 10 seconds. Then slowly relax the feet.
    • Move up through your legs, thighs, abdomen, arms, neck, and face, tightening the muscles in each area. Relax slowly every time.
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    Use positive visualization. Positive visualization can be a form of meditation. Positive visualization and meditation can help relieve stress, which can help ease discomfort and lessen pain.[22][23]
    • Pick a favorite spot and get comfortable. Remember a favorite place. Close your eyes and picture that place. Keep the image in your mind.
    • Breathe deeply as you keep the picture in your mind. Don’t worry if you lose the image. Just take a breath and start again.
    • Until you have some practice, you may need to start again a few times.
    • Try and make sure you do this during a time that you are least likely to get interrupted.
    • Look into doing guided imagery through YouTube videos or apps.
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    Say positive affirmations. Using positive affirmations may be effective in helping change your mentality about the pain and lift your mood.[24][25] Publically say positive things about yourself and your pain. Positive self-talk can help boost your mental perception of the pain. Some people write down their positive affirmations on sticky notes and post these notes everywhere they can. Use the present tense and repeat as often as you can. Examples of positive affirmations are:
    • Yes, I can.
    • I can get through the pain.[26]
    • I am getting better.
    • I feel better every day.
    • I can control my pain.

Method 4
Dealing With Pain Through Alternative Means

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    Try chiropractic care. Chiropractors work with the alignment of your musculoskeletal structure to encourage healing and pain relief. Chiropractic care generally is an alternative treatment for pain in your muscles, joints, bones, cartilage, ligaments, and tendons.[27] Chiropractic care is used most often for back, leg and neck pain.[28]
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    Consider acupuncture. Another common alternative therapy for chronic pain management is acupuncture. Acupuncture can be very beneficial for arthritic pain, migraines and other forms of chronic pain.[29][30]
    • Before getting acupuncture, take the time to learn about acupuncture, where to find a reputable, experienced practitioner, and think about whether it is a treatment for you.[31]
    • Talk to your pain management team to get recommendations for either an acupuncturist or a chiropractor.
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    Get a massage. Getting a massage will not only help relieve tension, but also help relieve stress. These two things can lead to increased pain. Massages are good for all pain, especially back and neck.[32]
    • Find a massage therapist who specializes in chronic pain.
    • For patients with fibromyalgia, normal massage can be very painful so make sure to let the therapist know and to ask for light, gentle techniques.
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    Try biofeedback. Other alternative treatments can include biofeedback techniques and other newer medical devices, including neurostimulators and drug pumps. You can talk to your physician about which might be right for you.
    • When using biofeedback, you wear sensors on your body that lets you track body functions. As you study the beeps or lines the sensors report to you, you can learn to control certain bodily functions and impulses.[33]
    • There are also newer “wearable” devices and patches that can provide pain relief for a variety of conditions.[34] There are headbands for migraine, patches for muscular pain, devices for joint pain and electrostimulators (often known as TENS devices).
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    Try an anti-inflammatory diet. Research is showing that inflammation may play a part in chronic diseases.[35] Though research is ongoing, it may be that diet can help — by avoiding certain foods, and including those with anti-inflammatory properties, you may be able to reduce your pain.
    • An anti-inflammatory diet is similar to the Mediterranean Diet. Emphasize lots of fruits and vegetables, snack on nuts, eat fish packed with omega 3's, and healthy fats (monounsaturated and polyunsaturated).[36]
    • Include these anti-inflammatory spices in your cooking: turmeric, ginger, cinnamon, garlic, cayenne, black pepper, and clove.[37]
    • Foods to avoid or minimize include sugar, saturated fats, trans fats, excessive omega 6 fatty acids, gluten, casein, refined carbohydrates, mono-sodium glutamate (MSG), aspartame, and alcohol.[38]
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    See if medical marijuana is available. If medical marijuana is available to you, that is an approach that has proven very effective for many people. Studies are indicating that medical marijuana is a safe and effective approach to pain relief.[39][40] Discuss this option with your pain management team and find out if it is legal where you live.

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