How can I find a way to live
with chronic pain?
«Back or knee pain prevents me from playing
sports»
It is difficult to live with chronic pain. We feel that it
dominates our life: we tend to think only about pain and
thinking about pain contributes to the pain! As a result, we
feel stiffer, more tense physically but also mentally. It is
difficult to live with pain and we may realize that it influences
our mental attitude and body language. Let’s see how we
can learn to deal with pain based on the following facts:
We should be aware that pain is not only physical. Pain
has an emotional and a mental component. Negative
emotions (anxiety, fear, tension, depression) and thoughts
(focusing on pain, boredom) increase our perception of
pain. This is good news in a sense, because it means
that we can have a certain amount of control over pain. It
means that our perception of pain can be altered: we can
learn to influence our perception and thus our pain.
Knowing that pain is not always at top intensity (10/10)
but that it sometimes varies according to our mood, our
activities, and our diet can be reassuring. Sometimes our
pain may be at 8/10 intensity and at other times, it’s intensity
has decreased to 4/10. We must learn to recognize what
has contributed to its decrease or increase.
Pain is personal: what is painful for someone is not
necessarily painful for somebody else. Our genetic makeup influences our perception of pain. But there are other
factors! Our expectations also influence our perception of
pain. Studies have shown that the less we anticipate pain,
the less we feel it.
If I am being provided with this document, it is because:
• I am in too much pain to exercise
We can learn to live with pain without being
overwhelmed by pain. We can modulate and manage
it. “Pain is part of who I am, I acknowledge it, but I won’t
let it take over my life”. The more we fight it, the more
tense and cranky we become and the worse we feel.
Therefore, we must accept that pain is part of our daily
life and find ways to live with it, without letting it take
over our life.
Writing down the intensity of our pain on a scale of 0
to 10 depending on our activities, our moods and our
emotions helps us identify what decreases or increases
our level of pain. For instance, Martin has severe
backache. Noting the intensity of his pain associated
with various activities during the day as well as his
thoughts and emotions led him to realize that when he
keeps thinking about his pain, its intensity increases to
9/10 whereas when his attention is focused on something
that he loves doing (reading a good book or cooking, for
example), the pain decreases to 3/10. It is the same
backache, but now Martin realizes that his perception of
pain varies depending on what he is doing.
Is pain usefull?
• It informs us about the aggressions that our body feels
• It allows us to learn what our body tolerates (and does
not tolerate) so that we can avoid as much discomfort as
possible
• It periodically throws messages at us so that we can
change our ways (either our activities, thoughts or
emotions) in order for our body to work better and keep
us as healthy as possible
How can I find a way to live with chronic pain?
Tool # 43
43
How our thoughts influence pain:
Pain
«IT HURTS!»
How can I find a way to live with chronic pain?
“I feel really bad. It proves that
this pain is really serious. I am
not in shape, I am discouraged.”
43
AVOIDING
ACTIVITIES
MUSCLE TENSION
Disastrous interpretation:
“If I exercise, it’ll be bad for my
health.”
PAIN
Pain journal:
In order to live better with our pain, it is important to identify what decreases or increases the pain depending on our activities, our moods and our emotions. At
different times during the day, take the time to complete this chart for at least one week. Try adding healthy activities, mini-moments of relaxation and realistic
thoughts.
Inaction
“I move less; I am
protecting myself by being
less active.”
Emotions
“I won’t move because I am
afraid that the pain will worsen.”
STRATEGIES to decrease our pain:
• I take my mind off the pain (it allows us to concentrate on
something else and may decrease the pain)
• I identify activities which I find pleasurable (or which
previously gave me pleasure)
• I change my negative thoughts (“I am no longer able to…,
it is awful”) into realistic thoughts (“I can live with the pain
if I find the right balance”)
• I take deep breaths on a regular basis during the day.
Call these mini-moments of relaxation. Taking these
mini-moments of relaxation will release stress-reducing
hormones. These hormones will decrease the perception
of pain or of physical discomfort (see Relaxation tool).
Research has shown that relaxation can decrease the
level of pain sensitivity by 50%. Find out how stress and
anxiety also have an impact on your pain.
MONDAY
DATE
TIME (8 am)
TIME (12 am)
TIME (14 pm)
SITUATION
PAIN LEVEL
(0-10)
Breakfast
Lunch
Paying bills
6
8
9
DESCRIBE SENSATION
Stiffness
Pulsating pain
Severe pain
DISTRESS
LEVEL
(0-10)
5
8
10
DESCRIBE DISTRESS
ACTION TAKEN
Frustrated
Mad
Helpless
Nothing
Ibuprofen
Relaxation
MONDAY
DATE
TIME
TIME
TIME
How can I find a way to live with chronic pain?
Conséquences
STRESS
ANXIETY
43
TUESDAY
DATE
TIME
TIME
TIME
© Institut de recherches cliniques de Montréal
Writing: Lysanne Goyer, PhD, psychologist
Graphic Design: Hélène Lambin, PhD
Photography: Fred Goldstein - fotolia.com