Chronic pain. A condition that affects over 20% of Americans and over 1.5 billion people worldwide and the numbers continue to climb. In fact, one study found that three out of four Americans have either experienced chronic pain themselves or have a close family member or friend who has. 

As a clinical psychologist, I have run a weekly chronic pain group for almost a decade and continue to be struck at how clients who have struggled with chronic pain for years will come to my group, usually after being referred by their physician, and never knew there were alternatives to treating their pain aside from medication! 

So, here are some big ideas that every person struggling with chronic pain should know:

1) Lifestyle upgrade

It’s vital to recognize that chronic pain is very different from acute pain. How do you distinguish between the two? There is no hard definition but most say if you struggle with ongoing pain for more than 3 (to 6) months, you dip into the chronic realm. More importantly, the approach one takes between the two needs to be different. For example, if you fall and break your leg, you rest and let your body recover. Soon, your bone has healed and you’re back to the old you. With chronic pain, however, if you take this approach it can not only backfire but can become more damaging to your body. When we move less, over time our muscles atrophy and our pain increases as movement stiffens. We also become more prone to depression. The take away? This concept of a lifestyle upgrade or adaption refers to a conscious commitment we make to have a more active and alternative approach than what our default stance might be towards our pain. We have to recognize we’re living ‘Life 2.0’ and have to honor the fact that our body is not what it used to be. A specific example of this new lifestyle commitment is the next point.

2) “Life within your 70%”

If you struggle with ongoing pain, when you have a “good” day there is a natural inclination to want push yourself to check off more of those boxes on your daily to do list. Those dirty dish? Vacuuming? Finishing all those loads of laundry? Heck, why not do all of them today. We feel proud of ourselves in the moment, catching a fleeting feeling of what a “normal” day was like before our pain began. But what happens to our functioning level the following day? It plummets from the increase in pain we now feel! This is called the Boom-Bust Cycle and it is not only deceiving but can actually be dangerous to our health. Research shows our average functioning level actually decreases the more we get caught up in this trap. 

So the way out is through pacing. You have to recognize that on those days when you’re full of energy and your pain levels are lower to not push yourself to the max. I often say in group, “Live within your 70%.” This means you monitor your regular activities on a number of different days to find an average of how long it takes you to complete those tasks and then scale back. Let’s take washing dishes. If, on average, it takes 10 minutes to clean all those plates but then you’re fried and your back is on flames afterwards from standing that long, you’ve gone past your ceiling. Experiment with scaling back to 6 or 7 minutes and then pause to take a break. While it will take you longer to complete the activity, chunking the task with rest periods can be an absolute game changer.

3) “Close the gate”

When we experience pain, what’s happening is there are signals from various parts of our body that are being sent up electrically through the spine and into the brain where the pain is then processed. So the spinal column acts as a highway sending these messages to and from the body.

But here’s a secret: we have more control over this flow of information than we might think.

If you imagine that there is a gate that can “close” the flow of this information then the theory is you experience less pain. There are four factors to keep in mind with this theory: physical, emotional, mental, and behavioral. We can “open” this gate, for example, when we overexert ourselves (physical), struggle with negative emotions like stress or depression (emotional), focus our attention on the pain itself or continue dwelling on negative aspects about life (mental), or withdraw from positive activities in life and participate in poor health habits (behavioral). So the mantra here is that we want to “close the gate”! We successfully do this through a number of ways in these four areas. We close the gate when we practice relaxation skills or get a massage (physical), manage our stress and strive to experience positive emotions like love and gratitude (emotional), distract ourselves from the pain and work on pursuing a positive attitude (mental), and participate in more social activities and eat healthier (behavioral). The take home message? Learning all you can about strategies that close the pain gate will help you feel more empowered and in control with your pain.