What can I do to manage pain?

In order to manage pain, you have to look for the source of the pain. Most people blame their illness for their pain. The illness may be partly responsible for the pain. Other factors also contribute to pain.

Physical pain is caused by inflammation and by damage. The pain is how your body tells you that something is wrong. It is a warning designed to get your attention and protect you from further damage. Your doctor will prescribe medication to try to minimize the cause of the pain. You may also get a prescription for medication to reduce the pain. Sadly, for many people with chronic illness symptoms often go untreated, and the patient goes undiagnosed for years because of medications that only masked symptoms. Nothing was done to address the root cause.

Pain rarely occurs in isolation. Pain brings other problems. These problems in turn worsen pain. Depression can cause real physical pain. If you have chronic illness you are living with pain, fatigue, uncertainty, worry, loss of identity, and loss of control, to name just a few unpleasant feelings. Who wouldn't be depressed? Treating depression in whatever way is appropriate for you is likely to result in less pain. Muscle tension can also cause physical pain. Muscles become tense as a result of worry and anxiety. Lack of use also causes muscle pain. Fatigue brought on by the disease itself can cause pain. Pain can make sleep difficult or impossible, resulting in more pain.

Depression, fatigue, anxiety, fear, and muscle tension all contribute to the pain and the pain contributes to them.

Managing pain is a team effort that requires work on your part and help from your health care providers. If you don't explain your pain clearly, in language they can understand, your doctors won't be able to give you the right help. Keep a symptom journal for your pain. Include answers to these questions. When did the pain start? How often do you have pain? How long does it last? Does it vary in intensity? What makes it better? What makes it worse? On a scale of 1 to 10, with 10 being the worst, how much does your pain interfere with your ability to carry out basic activities of daily living? Describe the pain. Is it throbbing, stabbing, sharp, dull, cramping, aching, etc.?

You have a part in managing your pain. While the doctor can prescribe something to address the source and the symptom, you can work on the pain from your side. Depression, fatigue, anxiety, fear, and muscle tension all contribute to the pain and the pain contributes to them. Pick any one of these items and begin to work on it. Consider professional help from a counselor who specializes in pain and chronic illness. Counselors or psychologists who work with oncology practices are good choices. They work with people undergoing cancer treatments, so they understand the nature of chronic conditions.

Distraction is a valuable tool in managing not only pain, but the emotions that contribute to the pain cycle. Your mind can only concentrate on one thing at a time. If you become deeply engrossed in a movie, book, activity that you enjoy, or another person, you will find that you have forgotten your pain for that period of time. Meditation reduces stress and anxiety, leading to reduction in pain. Mild to moderate exercise releases muscle tension. Exercise also lubricates the joints, gets more oxygen into the body, removes waste, and makes your body create endorphins. All of these things reduce pain.

What is the role of humor in managing chronic illness?

Two nursing students were assigned to observe a disease support group as part of their studies. They came to a lupus support group. Afterward, they expressed their amazement at the amount of laughter in the group. The students had listened to the patients sharing the challenges that they faced and the many ways that lupus can affect a person's body. The patients explained that the disease had already stolen enough; they were not giving up their right to laugh. Laughter made everyone feel better.

If you have been suppressing all of the difficult emotions that travel with chronic illness, you probably haven't laughed or cried in a while. You can't suppress emotions selectively. Either you allow yourself to feel or you don't. Laughter makes you feel better. Letting yourself laugh also means you have to let yourself cry. Both are good. Difficult emotions that are kept inside make your disease worse and make your relations with others go sour. Unpleasant emotions are like radioactive waste. Each time you express them they lose half their power.

Norman Cousins, a journalist, developed ankylosing spondylitis. This is an autoimmune disease that causes arthritis or joint inflammation in the spine. It is very painful and can result in the spine fusing itself together. In his book, Anatomy of an Illness as Perceived by the Patient, Cousins chronicles his hospitalizations and struggles with the disease. In addition to traditional medical care, Cousins watched countless comedy movies, notably the Marx brothers. He laughed. He recovered. On the topic of laughter, Cousins said "It has always seemed to me that hearty laughter is a good way to jog internally without having to go outdoors."

Laughter reduces stress and helps manage pain. It improves mental and physical health. Humor and laughter can be used anytime and anywhere by anyone. It's free or very low cost. According to Laughter Rx, "[Laughter] is especially beneficial for those who are homebound, lack the financial resources for more expensive forms of psychotherapeutic care, do not have a strong support system, or live in areas far from pain clinics and mental health outpatient clinics." A good dose of humor can even reduce dependence on prescription painkillers and antidepressants! (A word of caution: Never stop antidepressants unless you speak with your doctor. Doing so could be very dangerous to your health.)