Chronic pain is an unpleasant sense of discomfort that persists or progresses over a long period of time. This is in contrast to acute pain that is sudden and in response to a specific injury. While neither experience is pleasant, injury healing tends to bring relief from the discomfort of acute pain experiences.
So what happens with the chronic pain experience? Chronic pain can be frustrating to all concerned, including the pain sufferer, family, friends, and medical providers. Less informed medical providers may treat the patient as an annoyance, complainer/hypochondriac, drug-seeker, malingerer, or other disparaging viewpoints. This can exacerbate the experience of the chronic pain patient, who then find themselves on the defensive, and constantly trying to prove that their pain is real.
For the blessed chronic pain patient that does have knowledgeable and compassionate care providers, their further challenge becomes life-management. They become as attuned to the weather forecast as farmers, self-schooled pharmacists, experimental physical therapists, and so on. Yet, chronic pain is a semi-predictable phenomenon, at best, and a depression inducing, demoralizing, and nearly ‘paralyzing’ experience, at worst.
Behavioral responses, generally speaking, are at extremes from one another. On one hand, the chronic pain sufferer may have decreased activities of daily living to the extent that there is an inordinate amount of time spent in bed/recliner/sofa. Even though there may be the physical ability, fear/anxiety/concern of increased pain or further injury becomes self-limiting. On the other hand, some individuals will go all-out on their “good days,” when pain is less, and wanting to make up for lost time. They feel good enough to be active and productive, and go beyond what the body will tolerate, due to lack of conditioning to that particular level of activity. Still others may take on a sense of being a valiant warrior in combatting their chronic pain experience, not wanting to be weigh down.
As the human body seems to favour routine and consistency, a moderate approach to one’s activity level is optimal. The phrase “working smarter, rather than harder,” comes to mind. Even though a good day may seem to promote energy and motivation, pacing oneself, as well as knowing limits and boundaries, becomes essential. Patients who effectively manage their chronic pain experience of fibromyalgia, for example, have come to appreciate this approach. This also means that on a bad day, one should avoid being completely sedentary. There can be a level of activity, again within limits and boundaries.
No, we’re not talking about building your next fantasy sports team…but, building an effective chronic pain treatment team. This team may include a number of providers, among and including; primary care physician, physical therapist, specialty provider(s), behavioral health therapist, and in some cases vocational rehabilitation counselor/caseworker. The behavioral health area is sometimes overlooked, as the individual does not want to give the appearance of being “crazy,” or that the pain is somehow not real, or all in their head. The behavioral side of treating chronic pain can include mood changes that naturally occur with the changes of activity level, working with family to better understand chronic pain, non-judgmental support, as well as techniques of relaxation strategies, biofeedback, and cognitive behavioral strategies among others.
Rosario Counseling & Associates remain available to talk with you for further information and support of your needs, and can be a part of your team.
~Author: Mr. David Wiley, MS, LPC with permission to post on Rosario Counseling & Associates
Mr. David Wiley, MS, LPC is a Licensed Professional Counselor at Rosario Counseling & Associates. He has practiced in a variety of behavioral health settings in the Triangle area of North Carolina since 1981, including innovative approaches to substance abuse and chronic pain management, crisis intervention. He also has expertise working with relationship issues with couples and families. Areas of interest, and expertise include: mood disorders such as anxiety and depression, substance abuse, ADD/ADHD, relationship counseling, and co-therapy. His other areas of interest are: stress/pain management including biofeedback modality, life transition issues especially with college students.
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