The tips provided in this article aim to improve quality of life on a day to day basis for those experiencing chronic pain, by improving mood, mental wellbeing, and functioning.
Although some people may experience a reduction in pain by engaging in these activities, not everyone will, and it should be treated as a beneficial side-effect rather than the main purpose. Keep in mind that everyone’s situation is different, so how you apply these tools is up to you.
(If you would like more information on how psychology can help you improve your life while living with chronic pain, click on the link).
Tips for Chronic Pain Sufferers
Exercise and Stay Active
Exercise or physical activity is important for maintaining overall physical health, preventing secondary conditions as a result of muscle atrophy, and can also help with improving mood and mental wellbeing.
- Be aware of when pain or the fear of pain is getting in the way of you engaging in physical activity.
- Avoiding physical activity because of pain or the fear of pain can lead to muscle wastage, that can make it even more difficult to complete everyday activities like housework or shopping.
- Low impact activities such as swimming, walking and stretching are often good places to start.
- Remember that it may be difficult to exercise without any pain, the focus is on not doing anything that will cause damage or unbearable pain.
- Pace yourself. Understand your limits and recognise that pushing yourself too hard will likely leave you feeling sore and uncomfortable, and deter you from trying again. There’s no point doing lots of exercise on one day if it means that you can’t get out of bed for the next three days.
- Don’t be afraid to discuss any fears or concerns you have with your doctor or physio.
Stay Connected
- Connecting with others can help reduce and prevent depression and anxiety, as well as reduce feelings of isolation
- Call someone that you enjoy talking to, meet a friend for coffee, or invite someone around. Whatever you’re most comfortable with, but be careful not to keep putting it off.
- Notice if you are always delay things until you ‘feel better’ – when you don’t feel like reaching out to someone, it may be just what you need.
Schedule Regular Pleasant Activities
Many people experiencing chronic pain withdraw from activities that they used to enjoy, even those that they can still participate in.
Regularly setting aside time to engage in something enjoyable is a way of consciously making an effort to maintain a better balance between the good things and the bad things in life (it doesn’t have to be a perfect balance).
- Regularly engaging in a pleasant activity can help improve your overall mood, and help you stay engaged.
- In some cases an activity may not be physically possible anymore, or it’s not as enjoyable as it was previously. In these cases try and identify what you enjoyed about that activity and problem solve other ways that you might be able to bring that feeling into your life. For example, one of my previous clients used to enjoy hiking but could no longer do it, but we identified that a lot of the pleasure he gained from hiking was the connection he felt with nature. He identified that the physical aspect of it was also good, but he missed the connection to nature the most. So we discussed ways that he could engage with nature that didn’t involve such extensive walking.
- Set aside time for the activity and commit to doing something even if you don’t feel great.
- A good tip can be to use a rating scale to give yourself a more definitive way to decide if you go or not:
- Rate how you’re feeling (pain/mood/stress) on a scale of 1 to 100 and identify where you generally sit on the scale, I’ll use between 20 (curled up in bed) and 50 (feeling ‘okay’) for this example. Remember that you get to choose what the scale represents and what the numbers indicate so it’s highly individual and yours won’t necessarily be the same range as mine.
- Once you’ve identified where you normally sit on the scale select your cut off, let’s say 30, for the purpose of this illustration. Then anytime you have a planned activity and you find yourself thinking that you ‘don’t really want to,’ want to wait till you’re ‘feeling better’ or something similar, ask yourself where you are on the scale. If you’re above your designated cut off, you make an effort to engage in the activity anyway. If you’re below, reschedule it.
- The point of this is to take away some of the arbitrariness of phrases like ‘when I feel better’ and give you a more concrete way to make the decision. Also keep in mind that if you try this for a few weeks and realise you’ve set your cut off too high or too low, you can adjust it.
- Judge what is best for you. It may be a short excursion to a favourite local spot, a long walk, or dedicating an afternoon to the grandkids without worrying about how they’re messing up the house. Even something as simple as making time to enjoy a cup of tea or coffee without distractions can be helpful.
Recognise and Challenge Unhelpful Thoughts
There a number of unhelpful thought patterns that can crop up when we’re faced with challenges like chronic pain, which actually make it harder do the things we want to do.
- Three examples are filtering, catastrophising, and ‘all or nothing’ thinking.
- Filtering is the
- Catastrophising
- All or nothing
- Noticing when you are engaging in these unhelpful thought patterns and challenging them, can help to reduce overwhelming feelings so you can think more clearly about a situation.
- Examples of questions to ask yourself when you notice yourself engaging in these thought patterns include:
- How realistic is that thought?
- Am I blowing this out of proportion?
- Are there other ways of looking at this?
- What would [insert friend/hero’s name here] do if they were in this situation?
- What advice would I give a friend if they were going through this?
Be Mindful
Mindfulness is a bit of a buzz word these days, but there is evidence that engaging in mindfulness can help reduce perceived pain, and increase quality of life in people experiencing chronic pain.
Mindfulness at its core is about paying deliberate and non judgmental attention to the present moment.
- We often try to ignore, control, or distract ourselves from pain and everything that goes with it. But struggling with the pain and the negative thoughts and feelings takes a lot of mental energy and sometimes only makes it harder to manage the pain.
- For example, if I tell you not to think about penguins, what’s the first thing that pops into your mind? Penguins!
- Mindfulness is a tool that helps us take a break, by dropping the struggle and focusing on the here and now in a way that doesn’t try and get rid of the pain or the unhelpful thoughts.
- Think about it like a Chinese finger trap. The more you try to pull your finger out, the tighter the trap gets and the harder it becomes. But when you stop trying to pull your fingers apart and do the opposite, the trap loosens.
- For chronic pain, struggling with the pain and what comes with that can leave you feeling tense and stressed or drained. Dropping the struggle, even for just a short time, you may find that some of that tension, stress and pain goes away by itself.
Basic Mindful Meditation
Here are simple steps to help you become more mindful.
- Find a comfortable position. If sitting or lying for a long period is particularly uncomfortable for you, try standing or even walking instead.
- Begin to take deep breaths and shift your focus to the sensation of breathing, noticing things like your chest expanding, and how the air feels as it moves through your nose.
- Let your eyes slowly close if you like (unless you are walking, then I recommend keeping them open to prevent injuring yourself unnecessarily).
- While you’re focusing on your breath like this, you will notice that thoughts pop into your head and take your mind away from your breath. This is normal and will happen often; however each time you notice that your thoughts have wandered away, all you have to do is gently bring your attention back to the present moment by focusing back on your breath.
- Remember, you want to try and be non-judgmental about what you’re experiencing (ie thoughts and sensations), which just means that you want to try and experience things as they are, without getting caught up in labelling them as good or bad.
- An easy way to be less judgmental is to be curious, try observing the sensation or thought as if you’re a scientist, or a child noticing it for the first time.
- When you feel like you’re done, just slowly bring your attention back to the room around you and open your eyes.
Mindfulness is an exercise for your brain, and just like exercising any other part of the body you will only see results if you stick with it and do it regularly.
Note: Mindfulness doesn’t have to be done in meditation. A mindful attitude can be adopted during almost any activity including everyday tasks, such as washing the dishes, eating, or taking a shower. The key is simply to bring your attention back to what you’re doing each time it wanders away.
Author: Nikki Crossman, B Psych Science (Hons).
Nikki Crossman is a Master of Psychology (sport and exercise) candidate at the University of Queensland, passionate about the benefits of sport and exercise for mental health. She takes a holistic approach to wellbeing that recognises the strong connection between our body and our mind, and draws on evidence-based therapies such as CBT and Interpersonal therapy.
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References:
- Butler, D. S., & Moseley, G. L. (2013). Explain Pain 2nd Edn. Noigroup Publications.
- Hilton, L., Hempel, S., Ewing, B. A., Apaydin, E., Xenakis, L., Newberry, S., … & Maglione, M. A. (2016). Mindfulness meditation for chronic pain: systematic review and meta-analysis. Annals of Behavioral Medicine, 51(2), 199-213.
- Hannibal, K. E., & Bishop, M. D. (2014). Chronic stress, cortisol dysfunction, and pain: a psychoneuroendocrine rationale for stress management in pain rehabilitation. Physical therapy, 94(12), 1816-1825.
- Otis, J. (2007). Managing chronic pain: A cognitive-behavioral therapy approach. Oxford university press.
- Quartana, P. J., Campbell, C. M., & Edwards, R. R. (2009). Pain catastrophizing: a critical review. Expert review of neurotherapeutics, 9(5), 745-758.
- Veehof, M. M., Trompetter, H. R., Bohlmeijer, E. T., & Schreurs, K. M. G. (2016). Acceptance-and mindfulness-based interventions for the treatment of chronic pain: a meta-analytic review. Cognitive behaviour therapy, 45(1), 5-31.