Chronic Pain Chronicles: A Personal and Professional Quest for Relief
Years of battling chronic pain from sports injuries have taught me resilience in the face of relentless adversity, transforming my struggle into a tale of survival and determination. Pursuing relief without the crutch of medication has been my steadfast aim, yet this path brims with its own daunting trials. Accustomed to the sting of injury, I've honed a keen sense for gauging and taming my pain in its early stages. However, as the years etch their passage–with arthritis weaving its constricting web and menopause looming like an uninvited guest–this dance of pain management grows increasingly intricate, testing my resolve with its ever-shifting rhythm.
Fast-forward to my tenure in wellness as a massage therapist and eventually back to nursing school. I then was offered a nursing residency in the operating room as a perioperative nurse right after graduation eventually specializing in joint replacement and spinal surgeries. This enriched me with invaluable clinical insights. The blend of professional expertise, personal experience, and a passion for wellness seamlessly transitioned me into my current role as Team Coaching Lead at a Physical Therapy start-up in healthcare tech.
My engagement daily involves empowering my patients to master their own pain. It seems only fitting that I, too, should excel in this arena. This professional backdrop casts a personal spotlight on me, amplifying the expectation to navigate my pain with adept precision.
However, not an exact science.
Let me share a brief history of my injury resume for context:
Wrist surgery at 15 years old
Broken ankle and broken wrist at 12 yrs old
Three compressed vertebrae at 21 yrs old
Dislocated shoulder
Separated shoulder
Two more compressed vertebrae
Surgery on ring finger with pins
Countless other broken toes.
Admitting this in writing feels like a stark revelation, but it's a truth I embrace. My journey as an athlete, tough on my body, naturally steered me towards the healing arts of bodywork and self management.
At this company, we focus on non-surgical approaches to chronic pain, such as injections and physical therapy, supplemented by health coaching. This multifaceted approach is crucial, and here's why:
Incorporating health coaching into our treatment protocol means we don't just treat; we guide and personalize. Our team of experts, including doctors, physician assistants, physical therapists, health coaches and care coordinators all work together to devise tailored self-management plan for our patients. These plans are holistic, addressing critical lifestyle changes – from weight loss and nutrition to stress management and sleep hygiene – all aimed at directly influencing and mitigating pain but more importantly having the patient gain back control of their pain management.
Here’s how you can take back that control:
First, assess where you are:
Diet Self-Assessment
Variety of Diet: How often do you eat a variety of fruits, vegetables, whole grains, and lean proteins?
Hydration: Do you drink at least 8 glasses of water a day?
Processed Foods: How frequently do you consume processed foods, sugary snacks, or high-fat foods?
Meal Regularity: Do you maintain regular meal times, avoiding long periods without food?
Sleep Self-Assessment
Sleep Duration: Are you getting 7-9 hours of sleep regularly?
Sleep Quality: Do you often wake up feeling rested and refreshed?
Sleep Environment: Is your sleeping environment conducive to rest (dark, cool, and quiet)?
Pre-Sleep Routine: Do you have a calming pre-sleep routine, such as reading or meditating?
Stress Self-Assessment
Perceived Stress Level: On a scale of 1-10, how would you rate your daily stress levels?
Coping Mechanisms: Do you regularly engage in activities that help reduce your stress (e.g., exercise, hobbies)?
Relaxation Techniques: How often do you practice relaxation techniques like deep breathing or meditation?
Professional Support: Have you sought professional advice or therapy for stress management?
Social Support Self-Assessment
Social Interactions: How often do you interact with friends and family?
Supportive Relationships: Do you feel you have supportive relationships that you can rely on during tough times?
Community Engagement: Are you actively involved in community activities or groups?
Expressing Needs: Are you comfortable expressing your needs and asking for help from others?
Movement Self-Assessment
Exercise Frequency: How often do you engage in physical activities like walking, swimming, or yoga?
Stretching and Flexibility: Do you include stretching or flexibility exercises in your routine?
Physical Activity Enjoyment: Do you enjoy the physical activities you participate in?
Posture and Ergonomics: Are you mindful of maintaining good posture throughout the day, especially if you have a sedentary job?
Second, is your pain acute or chronic?
Acute Pain
Definition: Acute pain is a type of pain that typically starts suddenly and has a specific cause, like an injury or surgery. It acts as a warning signal to the body.
Duration: This pain is usually short-term, lasting for a few moments to several weeks or months. It generally subsides as the underlying cause heals.
Characteristics: It's often sharp or intense but resolves with healing.
Chronic Pain
Definition: Chronic pain is pain that persists beyond the usual course of an acute illness or healing of an injury. It may not always have an identifiable cause.
Duration: This pain lasts for months or years, and can continue even after the injury or illness that caused it has healed or gone away.
Characteristics: It can be constant or intermittent, mild or severe, and can impact quality of life significantly.
Third, Pain Journaling
Pain journaling can be an effective tool for both acute and chronic pain management, but its role varies slightly between them.
In Acute Pain Management
Tracking Progress: Journaling helps to monitor the progress of healing. For instance, noting improvements in pain levels can indicate effective healing.
Identifying Triggers: It can help in identifying activities or movements that exacerbate pain, which is essential for avoiding re-injury.
Communication with Healthcare Providers: Accurate records of pain can assist healthcare providers in tailoring treatment and determining when an individual is ready to resume normal activities.
In Chronic Pain Management
Understanding Patterns: Chronic pain sufferers can use a journal to identify patterns or triggers that worsen their pain, which might include activities, foods, weather changes, or emotional stressors.
Emotional Processing: Chronic pain often has a significant emotional component. Journaling provides a way to express emotions, which can be therapeutic.
Treatment Effectiveness: Recording responses to different treatments or medications helps in determining what works best for long-term pain management.
Communication with Healthcare Providers: A detailed pain journal provides healthcare providers with a comprehensive view of the chronic pain experience, aiding in effective treatment planning.
Asses your pain using the Biopsychosocial model of pain
Components of the Biopsychosocial Model
The biopsychosocial model of pain is a holistic approach to understanding pain, recognizing that it's not just a physical sensation but also influenced by psychological and social factors. This model suggests that effective pain management requires addressing biological, psychological, and social aspects.
Biological (Bio-): This aspect focuses on the physical or physiological factors contributing to pain. It includes genetic predispositions, injuries, diseases, and neurological conditions.
Psychological (Psycho-): This component deals with the emotional and mental influences on pain, such as mood, personality, behavior, and coping strategies. Stress, anxiety, depression, and one's attitudes towards pain play a significant role here.
Social (Social-): This aspect considers the impact of societal and environmental factors on pain. It encompasses the influence of relationships, family, work, culture, and socioeconomic status.
Self-Assessing Pain According to the Biopsychosocial Model
To self-assess if pain is biological, psychological, or social, consider the following questions:
Biological Assessment
Physical Symptoms: Are there specific physical symptoms or conditions (like inflammation, injury, chronic diseases) associated with your pain?
Medical History: Does your pain correlate with any past injuries or medical procedures?
Medication and Treatment Response: How does your pain respond to medical treatments or medications?
Psychological Assessment
Emotional State: Do you notice changes in your pain with different emotional states (like stress, anxiety, or depression)?
Coping Strategies: How do you mentally cope with your pain? Do certain thought patterns seem to influence it?
Behavioral Changes: Have you noticed any changes in your behavior (like withdrawal from activities, irritability) in response to pain?
Social Assessment
Relationships and Interactions: Does your pain change with different social interactions or environments?
Work or Daily Activities: How does your pain affect your ability to work or engage in daily activities?
Cultural and Societal Influences: Are there cultural or societal beliefs and attitudes that influence your experience of pain?
Ways to manage at home: heating pad, ice packs, epsom salt baths, cold plunges, sauna, ointments etc, breathing meditation, positive self talk.
Quick tips to improve each area of lifestyle based on patient conversation.
Diet
Anti-Inflammatory Foods: Incorporate foods that reduce inflammation, such as leafy greens, berries, nuts, and fatty fish like salmon.
Hydration: Stay well-hydrated. Dehydration can exacerbate pain and stiffness.
Limit Processed Foods: Reduce intake of processed foods, sugars, and unhealthy fats, which can increase inflammation.
Regular Meals: Eat regular meals to maintain stable energy levels. Skipping meals can lead to fatigue, worsening pain perception.
Sleep
Routine: Establish a consistent sleep routine, going to bed and waking up at the same times daily.
Sleep Environment: Create a comfortable sleep environment - cool, dark, and quiet.
Limit Stimulants: Avoid caffeine and electronic screens at least an hour before bedtime.
Relaxation Techniques: Practice relaxation techniques like deep breathing or progressive muscle relaxation to promote better sleep.
Stress
Mindfulness and Meditation: Incorporate mindfulness practices or meditation to manage stress levels, as stress can amplify pain.
Time Management: Prioritize tasks and delegate when possible to reduce overwhelm.
Hobbies and Enjoyment: Engage in activities that you enjoy and that provide a sense of accomplishment.
Professional Support: Consider counseling or therapy, especially cognitive-behavioral therapy, to develop coping strategies.
Social Support
Stay Connected: Maintain a healthy social network. Regular interaction with friends and family can provide emotional support.
Support Groups: Participate in support groups where you can share experiences and strategies with others facing similar challenges.
Communicate Needs: Be open with loved ones about your pain and how they can support you.
Volunteer: Engaging in volunteer work can provide a sense of purpose and community connection.
Movement
Regular Exercise: Engage in regular, gentle exercise like walking, swimming, or yoga to maintain mobility and reduce pain.
Stretching: Incorporate daily stretching to maintain flexibility and reduce muscle tension.
Posture Awareness: Be mindful of your posture, especially if you have a sedentary job.
Physical Therapy Exercises: Follow through with prescribed physical therapy exercises, which are tailored to your specific needs.
This journey through the challenges of chronic pain, guided by personal experience and professional insight, illuminates the multifaceted nature of pain management. The resilience forged in the crucible of sports injuries has not only shaped a career devoted to healing others but also highlighted the importance of a holistic approach to pain. By embracing the biopsychosocial model, we recognize that pain is not merely a physical phenomenon but a complex interplay of biological, psychological, and social factors.
Our exploration has underscored the significance of individualized assessment and intervention in each key area - diet, sleep, stress, social support, and movement. These are not standalone factors but interwoven elements that collectively influence our experience of pain. By conducting self-assessments in these areas, we empower ourselves to understand the underlying causes of our pain, whether they be acute or chronic, and to implement strategies that address our unique needs.
Moreover, the practice of pain journaling serves as a critical tool, providing insights into the patterns and triggers of pain, aiding in emotional processing, and enhancing communication with healthcare providers. This personalized record becomes a map guiding us through the complexities of pain management.
In essence, the journey through chronic pain is as much about discovering resilience and self-awareness as it is about finding physical relief. It teaches us to listen to our bodies, to understand the intricate language of pain, and to respond with a comprehensive, compassionate approach that encompasses all facets of our being. By doing so, we not only manage our pain but also reclaim control over our well-being, step by resilient step.