Managing Chronic Pain

Chronic pain is both a sensory and emotional experience, both perceptual and subjective. It is experienced as both pain (sensory) and suffering (emotional). Chronic pain is defined as pain lasting over 6 months and is present in 30% of people. Acute pain is less than 6 months and is a signal (gift) that something is wrong. Pain in general is seen as an enemy and is unwanted. Assessment of pain. Take a full history of the pain and treatments tried and currently receiving. There are pain gates (pain control theory) which can close (stop or lesson the pain sensory experience) if you send more neurologic signals to the brain. Treatment includes both control of pain and coping with pain. Pain management includes: 1. Medical: including use of analgesics (pain medication), but not recommended indefinitely 2. Surgical methods 3. Medical also includes sensory modulation, that is changing the signal to the brain. This can mean temporary hyper-stimulation of pain that will result in less pain. 4. Pain clinics that are a multi-disciplinary treatment approach 5. Hospice care for end of life pain management 6. Cooperate with medical treatment (no fool proof cure) Coping with pain includes psychological, spiritual, and psychosocial approaches to deal with suffering. Suffering means there is a lot of attention to the pain, rumination, and even reinforcement by others of the unwell behaviors. Being passive and staying in bed does not help. Movement and activity can close the pain gate and decrease perception of the pain.

1. Relaxation techniques like progressive muscle relaxation, deep relaxation, and visualization.

2. Self-talk about the pain by changing awefullizing to calming, self-soothing talk, stress inoculation, bio-feedback, hypnosis*, prayer, homework.

3. Psychotherapy for deeper issues.

4. Support groups.

5. Distracting by getting involved in other activities, fantasy, and imagery.

6. Convert thoughts to change use of language like hurt to stiff. Speak differently about the pain.

7. Reinforcement by having others only reinforces healthy pain responses and not the pain behavior and complaints. They still show compassion and empathy though.

8. Family therapy with focus on goals for getting well.

*The brain thinks in words and images.

Use of a Psalm like 23 can be very helpful as can visualization. See Dictionary of Biblical Imagery. Spiritual view of pain and prayer. Prayer is for healing. It is a mystery how prayer works for pain. Pray for the grace to bear the pain. Pain is part of the struggle of life. See II Cor. 12:9 & 10. As for God allowing pain, we are in an already/not yet state and we know that in the eternal life there won’t be any pain. Focus on ‘top down’ living. God is always there. Prayers of faith are in God’s will. Sit and be with those in pain. Pray for grace, healing, strength, and wisdom.

 

Try to live as normal a life as possible.

1. Accept the fact of pain.

2. Set specific goals for work, recreation, hobbies.

3. Anger-be honest with God about the pain like expressions of anger in the psalms. Cry out to God. Is 53. Pray the presence of God in the pain.

4. Try not to stay on medication forever; depends on the doctor and the condition.

5. Get in the best shape possible and keep fit.

6. Learn and practice relaxation regularly.

7. Keep busy (distracted), but not too busy (over tired).

8. Pace activities and rest (balance).

9. Family and friends should support only healthy behavior and can provide both prayer and support.

10. Be open with the doctors.

11. Practice empathy with others who are also in pain.

12. Remain hopeful, even for good moments, hours, days.

13. Remember God is with you.