Coping With Chronic Pain and Hiding it

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You may want to hide the pain so that you will not impose or be a burden on others.

In a similar manner, you may realize that if you expressed pain whenever you felt pain then you would have few if any friends because no one would want to be around you.

You may say that you are “fine” or “better” but that may be because you are only “fine” or “better” in relation to yesterday or a few hours ago. You may say that you are “fine” because you truly want to feel fine and say this in the belief that it will be a self-fulfilling prophecy.

Also, contrary to what Bill Clinton said, no one can feel another person’s pain. If a family member or caretaker were to ask you to describe the level of pain that you are experiencing from 0 (no pain) to 10 (excruciating pain) then is there any accurate answer?

A few years ago, I experienced what I thought–at the time–was a heart attack. During this pain and discomfort, I consoled myself by saying that a doctor might have described this as a “mild” heart attack and that he may have given it a rating of “3”. When I did go to the doctor the next day (this had happened around midnight), there was no evidence of my having a heart attack. All that I know is that it was one of the greatest amounts of pain I have experienced and that I do not wish to have that again. Also, regardless of whether I gave it a “3” or “10” then it would be inaccurate so I might as well have said that I was “fine”.

Doctors do not help in the revelation of pain when they ask you to stay still even when going through procedures and tests that are painful. You may extrapolate upon this experience and learn to stay still through every painful event.

People who go through chronic pain often go through the classic stages of denial, anger, bargaining and depression. Theoretically, this should lead to acceptance, but perhaps some people accept it by ignoring, minimizing or trivializing it. Or, perhaps more likely and rationally, they have not left the first stage yet.

Effective ways to cope with chronic pain

Make a goal or vow. Preferably, this should be for the long-term, but it could also be a series of short-term goals. Write it down. Have at least one goal for each aspect of your life: physical, mental, social and religious (or philosophical, if you are not religious).

Make each day as productive as possible. You may be able to do just one thing, or even just part of one thing, but it is more than you would have done otherwise, and that is a good thing.

Write down your goals and write down your pain. Keep a journal/diary and refer to past entries. You may be able to learn how to cope with a new thing by referring to how you coped with a similar thing in the past.

Your doctor will find this helpful as well. Write down your daily “pain score” from 0 to 10 (although other sources say “1 to 10–regardless, just try to be as accurate and objective as possible) along with the activities you did that day. This will help the doctor to determine how well you are functioning and progressing (hopefully) and if you are on schedule for the lessening or removal of the pain.

Make value-based actions. You already know what worsens your pain and what makes it better. Use these as guidelines to structure your daily activity. Once you have more control over your pain then your pain will have less control over you. Of course, you will still have episodes of pain but they will be better managed and you will know even more about what to do and how to proceed.

Accept that there will be bad days. This does not mean giving up or being defeated. It simply may be a postponement of some things. Try to make such days better than they would have been otherwise but, even if you cannot, then try to look for the good during these times. There will be setbacks and new obstacles but try not to get discouraged. Try everything you can to make it “two steps forward, one step back” rather than “one step forward, two steps back”.

Make lifestyle changes. Reduce or eliminate bad habits, and incorporate or increase good habits. Reduce or eliminate alcohol, which can make sleep problems worse and do not smoke, as this activity is bad even if you are not in chronic pain. Eat healthier. A good and well-balanced diet will aid your digestion, reduce your heart disease risk, reduce your weight (which can, in itself, contribute to pain), and improve your blood sugar levels.

Reduce or eliminate corn, high fructose corn syrup, refined sugar, white flour and other refined grains, green peppers, food preservatives, saturated fats and caffeine as some people find that some of these things cause adverse reactions in themselves. If you are one of them then do reduce or eliminate those items.

You should include grains such as brown rice, whole wheat and pastas, soy products, fresh fruit, olive oil, honey, ginger and cinnamon. Have a low-fat, low-salt diet by including fresh fruits and vegetables; breads and cereals; low-fat cheese, milk and yogurt; lean meats; and tofu.

Use all of your resources. Most immediately, you have family, friends, a doctor and perhaps a caretaker, but you also have employers, colleagues, dietary changes (see above) and alternative therapies (acupuncture, chiropractic, yoga and biofeedback; biofeedback can take a very long time to learn and master well enough so that you can reduce your pain, but if you are going to be in pain for a long time anyway, then you have nothing to lose).

Find a good support group. Of course, your family and friends should be considered and used. Seek out others, as well. One medical doctor, who himself experienced chronic pain, wrote that he found that people who expressed a desire to help were almost always genuine in their statements. Tell these people beforehand that you wish to speak to them (on an individual basis) if and when the need arises. Try to do this infrequently, for their sake and for your sake; after all, if they are indeed helpful and productive then your situation will indeed improve.

Just as you are going to a physical health professional (a doctor) for your physical pain, you can go to a mental health therapist for your feelings and reactions to that pain. You can get expert advice in how to cope better and avoid negative and counterproductive thoughts and actions.

Sometimes, though, it is good to communicate with others who are going through/have gone through what you are experiencing. 10% of Americans have suffered from chronic pain at some point in their lives. This is a greater number than of doctors so you have more resources here in a support group.

A support group will hopefully be voluntary without a membership fee, or have a free introductory period. Some support groups are simply places where members complain and moan. Although this may have some therapeutic effect, it will not necessarily lead you to learn and incorporate good and beneficial things. Thus, you should avoid remaining in such support groups. Whenever I want to find anything anywhere, I go to the “Local” tab at Google+. By searching for “pain support group” (or similar words) in your area you can find like-minded people.

If you cannot go out (or perhaps even if you can), you can join an online forum. There are some for specific pains (such as for back pain) but perhaps a good generic forum can be found here. Regardless of whom you engage with, engage with someone or some people; you will feel less lonely and will benefit from their wisdom in coping with chronic pain.

Exercise regularly. If you do not use it then you lose it. I am not in chronic pain, and I consider myself to be healthier and stronger than many, perhaps most, people my age, and I certainly was very healthy and active when I was young.

However, I recently learned of my limitations. I do walk a great deal, but I do not engage in other forms of exercise. A couple of years ago, I attempted to do strength training. I did some exercises for about 10 to 15 minutes and was very sore for about two days afterwards. Regardless, exercise does help you to maintain your mobility, to keep your muscles active and your joints flexible, all of which alleviates symptoms of chronic pain.

Exercise also releases endorphins and increases neurotransmitters, both of which alleviate pain by blocking pain signals–a natural and alternative opioid. Such exercise as be a brisk walk for 20 minutes, yoga, tai chi, pilates, aquatic aerobics or other exercise. It ought to be done daily (if I had the mental fortitude to overcome the soreness from my strength training then I would be extremely strong today), but if this cannot be achieved then 3 to 5 times weekly.

Even people not in chronic pain often work out with someone else. Especially in your case, you should find someone who will motivate you to accomplish what needs to be done; someone who will get you to find reasons to exercise rather than to make up excuses not to exercise.

If you do have diabetic neuropathy or other specific health conditions then you will need to exercise (psychologically, not physically) caution about the activities you can engage in. Tell your doctor the type of exercise you would like to try and listen to whether or not he or she agrees.

Pace yourself Do this not just in exercise but in all things. My wife and I both believe that moderation in things is the best option.

Sleep well Having deep and uninterrupted sleep replenishes the needed neurotransmitters (see the section on exercise) and other elements that are used during the day and that are helpful in the alleviation of pain (again, see the section on exercise). Sleep for 8 hours a day. Periodically, throughout my life, I have heard reports that older people do not need as much sleep. Now, however, I can find no evidence of that. In short, the standard is to get 8 hours of deep, restful sleep.

You can use earplugs and eye covers but if you have small children then their needs should outweigh yours. If you have sleep apnea then there are devices that can help. If you still do not sleep well, then see your physician; there are medications and treatments that can be helpful to you.

Concentrate on what YOU can do. Do not care about things that are out of your control. Although you can do things that may influence others, the actions of other people are outside of your control. ALWAYS seek out alternatives if something is not working; there are ALWAYS choices. Concentrate on the solution, not the problem; prioritize; and keep things in perspective

Let yourself be weak and tired (or not). Again, I do not have chronic pain and I am almost always very active. However, sometimes I feel sick or weak. During those times, I allow myself to rest when I normally would not rest. During this time, I do virtually nothing but find that I soon become 100% healthy again.

My wife, who does have arthritis in her knee (and for which she takes daily treatments), on the other hand, is very proud of always being active even when she has overdone things. She is never at 0% productivity, but it does take her longer to return to her 100% form. In the end, in terms of productivity, it may be six-of-one, half-a-dozen of the other. I still prefer my method, as I enjoy being at 100% more often, and from what I have read, most people agree with me.

Smile and laugh, even when you do not feel like it. My wife is a firm believer in this. Even when she is very tense and inundated with stress and problems, she always puts a smile on her face and in her voice, and has fun with other people. She appreciates people who do likewise, and at all times.

For chronic pain sufferers, the more you smile and laugh the more endorphins and neurotransmitters your body will produce, alleviating your pain. When you’re smiling, the whole world smiles with you, the better you will be greeted, and the better you will feel emotionally (if not physically).

Decrease your stress Anxiety, stress, tension and anger can lower your body’s tolerance to pain, resulting in more episodes of pain. The more stress you are under, the more your muscles will be adversely affected.

Stress is basically your own reaction to certain things and is thus within your control. Of course, there are some things that logically and rationally result in stress on your part. If you have many bills, both medical and non-medical, and you have little monetary resources then, again, seek out alternatives. Contact the companies and agree on a mutually beneficial payment plan.

More formal ways of reducing stress can be obtained from practicing tai chi, yoga, meditation, guided imagery, and even aromatherapy. You can engage in relaxing activities such as listening to peaceful and soothing music.

Deep breathing is an often touted (and free) means to avoid and combat stress. There are many methods to accomplish this, some (or all) of which may be best explained, described and done in a class (which may not be free, though) but one method found is to

1) Sit or lie down in a comfortable position. If you are sitting then keep your back straight but allow your shoulders to droop.

2) Close your eyes.

3) Place a hand on your stomach and the other on your chest,

4) Breathe normally. If your belly rises and falls with your inhalations and exhalations then that is the natural and good way of breathing. If it is your chest that rises and falls with your breaths then adjust your breathing so that it is the belly that is affected.

5) Continue such deep breathing, ensuring that only your belly moves, and continuing for as long as you would like or are able.

Educate yourself Be careful of unreputable websites. Just like the “Wild West” of the american frontier, in which there were people selling “snake oil” so too are there many reputed cures and treatments available for virtually every condition on the Internet. Be careful of reputable websites. A very recent study reported that 90% of the health-related articles on Wikipedia contained factual errors. Of course, you have to rely on something, so go to reputable websites and sources of information, and if something sounds right or seems reasonable, then double and even triple-check that information.

In conjunction with your doctor, find the right medication for you and seek out appropriate complementary and alternative medicines/treatments (also known as CAM), such as acupuncture, herbal medicine, massage, magnetic therapy, energy medicine and others.

Educate others Tell others that you have chronic pain, but chronic pain does not have you; you are not chronic pain, there is still everything else about you. At times, you can talk about your pain, and to get out your grief. This will help you to accept your pain (see the final step). However, your pain ought not to be the sole and overriding source of conversation when people see you.

Find something inspirational or motivational. It could be a song, movie, video, person, quote, poem (personally, I like William Ernest Henley’s Invictus) or other thing that will help you with accomplishing your short-term and long-term goals (see the first step).

Accept (or not). It is the final, classic DABDA stage in dealing with grief (see the image above). However, it may seem like giving in. I think that this is the incorrect viewpoint. If you are studying in school and you can a low grade then you have to accept that because it is objective reality.

However, that does not mean that you can not change things for the future. You can study more, faster and more effectively to make sure that the low grade is not repeated and that you are improving. Similarly, you can accept your pain by deciding how you will change that. How will you do this? What will be your goals in accomplishing this? Write them down (see the first step).

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Martin Nance
Hello, I am Martin Nance. I have recently retired after a lifetime of working as a pharmacist. I now live with my wife in Texas. In my 37 years of helping people manage medications and health, I know the meaningful impact a trusted pharmacist can bring to people's lives. I still love helping people and hope to provide information that can protect and help people in need.