Successful treatment of chronic pain relies on a combination of multi-disciplinary treatments and an individual being a proactive member of the team, taking responsibility for their own lifestyle changes.
So, while checking in with your healthcare team regularly, what you do at home and on your own is vital to decreasing your pain levels and getting stronger and healthier.
Utilising the “Three P’s”: Pacing, Prevention, and Practitioners in your approach to managing your chronic pain can have an enormously positive result.
Let's unpack what the three P's are, and how you can bring them into your daily life in small ways to make a big difference.
1. Pacing for chronic pain management
Pacing simply means taking a measured, conservative and broken-up approach to activity as part of your self-management.
Did you know that in general, small bits of movement or activity alternated with shorter rests, rather than intense exercise and long periods of rest, are much better for your body? The pacing approach is good for your heart, metabolism, and more.
“Overdoing” it with exercise in chronic pain: Gently does it!
Sometimes when you exercise or participate in your daily activities like you used to before you had chronic pain, or you try to “push” your body too much while exercising, you trigger an “alarm” - giving you pain and danger signals which may increase cortisol, the stress hormone, which can in turn increase pain levels.
Exercise or physical activity that’s spread out, less intense, or broken up still counts!
Whether you walk for 10 minutes twice a day or 20 minutes at once, you’ll still get stronger. When your pain threshold is lower, breaking up exercise into smaller bite-size bits allows you to still exercise, despite your pain.
BUT: “Sitting is the new Smoking” and Movement is Medicine!
One of the essential pillars in chronic pain treatment is movement. In the same way that you’d be advised at a gym to do exercise in whatever way you can rather than not exercising at all, your occupational therapist and physiotherapist will recommend that you keep moving in small doses, even when you have some pain.
Resting for smaller periods of time helps to avoid a build-up of stiffness in your muscles and joints, which often, in fact, presents as pain. Sometimes pain from muscle stiffness feels bad – even though it’s not damaging. By keeping muscles warm and relaxed through regular activity, your body can more easily stay strong, and avoid injury, too.
This is why the phrase “sitting is the new smoking” has become popular. Sitting down for many hours at a time has proven bad for your health. Can you imagine cavemen sitting for hours on end? It was impossible, as they had to hunt and forage for fresh food (no fridges in those days) as well as make fires, escape predators, and so on. Humans simply weren’t made to stay still for long periods of time!
2. The role of Prevention in Chronic Pain Management
Your healthcare team has probably recommended a wide range of things you can do at home to help manage your chronic pain. Along with exercise, diet, stress-management, and medication go a long way in preventing flare-ups of more acute pain (worse pain than usual).
Some things that can help to prevent a flare-up:
- Taking your medication as prescribed: at the right time, using the correct dosage, and avoiding things like alcohol (and in some cases certain foods) where indicated on the pamphlet, or by your doctor
- Making sure you sleep well: sleep is vital for recovery and will have a huge impact on how your body processes pain. Follow good sleep hygiene practices, take naps, sleep in separate bedrooms if you have a snoring partner – do whatever you need to do, but get your beauty sleep!
- Rest and digest: allow time and space for your body to rest and digest its food while you’re awake, too. Maybe this is meditation outdoors, watching a series, chatting to a friend who relaxes you... whatever helps you as an individual to relax.
- Getting to know yourself and your body: what are the things that make you feel stressed? What strategies do you need for the symptoms of your condition? (heat, icepacks etc.)? Which type of exercise is an absolute no-go for you? What fills your happiness cup?
- Identifying your triggers: if you suffer from chronic migraines, you might find that alcohol, a certain brand of coffee or a strong perfume tends to bring them on; if you have lower back pain, you might find that sitting on a bench with no back support for longer than 2 hours may increase your pain levels; etc.
- Moving your body regularly and gently throughout the day, as well as incorporating some structured exercise such as a walk, dance class, or strength training into your routine
- Put strategies in place for dealing with stress and depression: anxiety and depression CAN make your pain worse, and we all know that having chronic pain may very well create stress and depression! There are ways to break the cycle: Seeing a psychologist regularly, getting the right medication to help you (consult the psychiatrist in your pain management team), and learn self-regulation techniques for anxiety. These support methods can assist your body in processing and diminishing danger signals. Sometimes these may even be big lifestyle choices or changes that may decrease your stress and therefore your pain dramatically, such as turning down a job that you know is going to drive you crazy (if you can afford to, or can find an alternative).
- Create a routine that works for you, and follow it: after getting to know yourself, your body and what you need, create an individualised routine that helps you, incorporating the ideas above. If it seems strange to others – for example if you need to go to bed at 8pm - let them think what they want! Your health is a priority, and the only person who can really keep yourself well is YOU. Following your tailor-made routine might be the thing that adds years to your life.
The Role of Practitioners in Chronic Pain Management
Consulting a team of specialists in chronic pain management has been found to have excellent results. It will usually include a primary care case manager, a medical doctor, physiotherapist, occupational therapist, psychiatrist, psychologist, and others depending on your condition.
1. Specialist practitioners, who have studied and worked in a certain field for many years, can assist you in getting an accurate diagnosis, which means the correct treatment plan for your condition and a better chance of living as close to pain-free as possible.
2. Together, this team of specialists help to guide and support your journey from every angle, working as a collaborative team, rather than working in silos. This means all information is shared between them and they can get a fuller understanding of your case and how to treat it in a holistic and cohesive manner.
3. Remember to consult the relevant specialist before you make any adjustments to your treatment plan. For example, perhaps a friend has told you about a new exercise machine at the gym or a new workout routine that they love. Before you try it, check in with your physiotherapist or biokineticist to make sure it’s safe and right for you.
4. Practitioners are not just case-solving magicians – they’re also people! Having regular, knowledgeable support while dealing with chronic pain can also lift your spirits and help you feel proactive. You’re in the right place with the right people on the right track towards a healthier future, and that creates hope!
5. Practitioners can connect you with a like-minded community. Did you know that chronic pain is quite common? Your team can introduce you to online communities, events, and other opportunities to connect with those who have similar experiences. Who knows, maybe you could even help support someone else!