Pain management, ways forwards

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The previous post; “pain what’s really going on?”.Discussed pain from a medical and scientific point of view. It aimed to give you an understanding of how pain can be categorised, the variety of words to describe pain, and the regular healing times, which may help people avoid slipping into persistent or chronic states. This post will look at current best practices in treating ongoing pain and includes some videos links at the end.

Ways forward in pain management?

Over the last 15 years or so, many new and emerging approaches to treating pain are reaching a wider audience. As research shows, education is crucial to help people understand why we feel pain and how the brain reacts to pain. This should be patient-centred and easy to understand because it is critical in its self and can be transformational to recovery.

Unfortunately, these new management strategies and treatment options don’t seem readily accessible to all in the UK. Most people will have slipped into a persistent or chronic pain state before these options are suggested, if possible at all. This means inadequate and outdated advice and treatment is still being given, putting people at risk of chronicity and a Yo-Yo cycle of suffering.

This is the only time I will use the word ‘suffering’ on the same page as pain because, in my opinion, it is not helpful or empowering. While I acknowledge its association, and for some people, it’s essential because I hear it daily, there is more beneficial language to use.

Side note: The language used to describe physical pain is essential for understanding another person’s discomfort or hurt. Pain is a subjective experience that is challenging to convey to other people, especially if there are no obvious outward clues such as crutches. As someone who has lived through several (too many) severe physical traumas, and the subsequent long periods of debilitating, often poorly managed pain and the associated emotional fallout. 

The dark humour on a smiley face and my jokey references to being ‘broken’ often used to get through the challenging days, weeks and sometimes months did not, on reflection, aid my recovery. Or get me the help and support I needed. All this confirmed a belief that pain was my frenemy and complete recovery was not possible. Nor did being put into the “broken healer tribe” by some well-meaning educators when I was well enough to retrain and change my career. Worse, though, I wore the broken healer badge with pride; well, it was hard-fought-for, seemed to define me, helped me find a new tribe, a place of belonging and was the catalyst for change. Why would I want to give that up?!

My experience of living with persistent pain was the foundation on which I base my current work! It gave me insight, resilience, and I believe in genuine compassion for others who live with pain. I have a no-nonsense; let’s keep trying pragmatic belief that things can change for the better; call it to hope if you like.It [persistent pain] made me go looking for answers, spend seven years retraining, and now I have the enormous privilege of sharing the best of what I learnt with the people who cross my path in need of help. 

Many years later, with more knowledge and an increased understanding of pain science, my mindset shifted, but it was a slow change, followed by a series of synchronicities. Over a few weeks, several people gently challenged my “broken self” belief, and I kept seeing Janine Shepherd’s quote “, A broken body isn’t a broken person.” The simple truth is alongside the different educators and influencers who crossed my path, I wearily needed to change my mind, talk, and language. I had never been comfortable with the word suffering, which is why I opted for ‘broken’, but perhaps it was worse.

For those ready to step into the journey of improving their wellbeing with me, you won’t hear me use broken or suffering, and I might gently challenge you if I hear those words. It’s cliche, but recovery usually involves some navigating because it’s rarely a straight path. You’ll need serious negotiation (with oneself) and, like off-road adventures, perseverance and courage. I appreciate that I say this now from a place of awareness, knowledge, self-reflection, and with tremendous resources at hand. Yep, hindsight is wonderful and sometimes very annoying.

Did you know –

That an over a sensitised nervous system can also cause symptoms in other parts of the body, which makes sense when you think about the number of people who experience abdominal pain or irritable bowel syndrome (IBS) symptoms when they feel stressed or get headaches when the pressure builds to meet a deadline.

Healing Pain – 7 facts & tips

  1. While it’s important to acknowledge that pain is an actual sensation, try not to give it too much attention, as this can make discomfort feel more intense.
  2. The association between pain and damage is not helpful and is not valid in almost all cases.
  3. Injured tissues will heal within six weeks to 6 months.
  4. Emotions may come up, so observe and acknowledge them, but you can choose not to give them too much meaning or space.
  5. Be engaged and active in your activities; it might be a cliché, but “motion is the lotion to health”.
  6. Create balance by noticing the parts of your body are at ease, feel comfortable and pain-free.
  7. Pain recovery education is a brilliant and meaningful way to build resilience and understanding that recovery from chronic pain is possible.

 

Self-help strategies 

There are lots of simple self-empowering strategies and tips which can help people recover from ongoing pain. Even if you have tried them all without success, it’s always worth another go. The recovery process requires some trial and error, and dedication too. I know from personal experience that some options that didn’t work the first time around or I dismissed were more successful on another occasion–right time, the proper support and the right mindset.

Using a multi-factorial approach is often the most effective way forward. Studies and clinical experience show that people achieve the best results with a holistic mind-body approach. Set some goals with a health professional to help you gain back control. Eat well, move daily, and get enough rest. Work with a movement or physical therapist to develop your movement confidence. Get emotional or psychological support if needed. Don’t expect a quick fix cure-all result, but understand that full recovery is possible.

Goals should include the following considerations:

  • Reprogramming the nervous system to dial down the pain signal and create more appropriate internal conditions.

  • A graded exercise programme or movement practice to restore confidence, balance, and strength to the whole body.

  • Hands-on treatment such as osteopathy or massage can be helpful too. Releasing tight and contracted muscles can aid circulation and blood flow. While treating sensitised trigger points can help flush out and reduce inflammation. 

  • Cranial osteopathy can be beneficial to address underlying physical stress and help people who struggle to get comfortable or relax.

  • Meditation, mindfulness and clinical hypnotherapy can be brilliant ways to manage underlying stress, negative beliefs and fixed or closed mindsets; they are profoundly relaxing options too.

More information 

Where do you find more information that will help you navigate this complex field? The resource I reach for time and time again is the book Explain Pain by Prof. Lorimer Molesley and Dr David Butler. The print version is expensive and sometimes tricky to find, but worth every penny at between £50.00–£90.00, and the digital copy will cost you less than a round of drinks at £18.00. 

Fortunately, both authors also have reams of information on the web, usually as filmed talks and lectures, including meaningful case studies and peppered with lots of Aussie humour, making listening to this complex subject more enjoyable.

Summary 

Pain is an unpleasant sensory experience ranging from mild localised discomfort to whole-body encompassing physical and emotional agony. Understanding how this complex protective system can go haywire and push people into chronic pain states can help find lasting solutions and recovery. I hope this article answers some questions and helps you on that journey.

Video links 

Note: Each link will open in a new tab on YouTube.

Professor Lorimer Molesley, “Why things hurt?” 

Dr David Butler “Treating Pain Using the Brain” 

Here is a link to a short animation, “What is Chronic Pain?

 

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