Strategies for Coping With Chronic Pain

For many patients, chronic pain takes over their life, keeping them from doing the things they love. That can, in turn, make the pain worse. Here chronic pain sufferers and experts share techniques for controlling pain and enjoying life.

Distraction Actually Works

A soccer field isn't the first place you'd look for a woman suffering from intense, debilitating, chronic back pain, but that was where Jan, a 45-year-old mom from Boulder, Colo., went to get away from her pain. Coaching her son's soccer team took her out of herself and away from her pain. "I couldn't even kick the ball. I'd tell them what to do without being able to demonstrate," says Jan. "But it was good for me because it was a distraction. You want to do stuff and be active and be with your kids to distract yourself."

Jan's coping strategy taps into the gate control theory of pain, the idea that stimulating positive emotions and thoughts can actually stop pain signals from reaching the brain. As Duke University psychologist Francis Keefe, PhD, explains, "If someone has their grandchildren in their lap, and they're just totally preoccupied with their grandchildren, that activates thought centers and feeling centers in the brain that in turn can activate neural pathways going down the spinal cord. You may be able to close the gate in the spinal cord, and actually inhibit the transmission of pain signals to the brain."

Focus on Activities You Love To Do

Another approach is to set small but important goals, says Gabriel Tan, PhD, a pain psychologist at the Michael E. DeBakey Veteran Affairs Medical Center in Houston. One of Tan's patients with severe back pain found some relief in surgery and medication, but the remaining pain was still compounded by his inability to do the things he enjoyed doing.

"I asked him 'What would you really like to do?' He said he would love to be able to garden again." Tan and his patient started to work toward that goal using a technique called reconditioning—a gentle, gradual approach that involved practicing motions needed for gardening (like brief squats and bending at the waist) that did not persist beyond the point of tolerable pain.

"Eventually he was able to garden for five minutes, then 10," says Tan. "Now he can relax and bend down, and he actually reports that his pain intensity has decreased."

Make Time for Yourself

Working in some fun is often not a high priority for people with chronic pain. But that's a tactical mistake, says Keefe, who teaches chronic pain coping skills. Keefe finds that pain patients often eliminate pleasant things, strip their lives down to boring obligations, and accept few distractions.

"So we teach them to set goals for doing pleasurable activities," says Keefe. "Research seems to indicate, particularly for mood-improvement effects, that it's not so much a major activity like going to Disney World or something but the accumulation of minor things that give you a feeling of pleasure, of mastery."

Phyllis Talarico, 61, of Yorba Linda, Calif., who has fibromyalgia, has learned to focus on small things she loves doing.

"I'm a gardener, I love flowers, and I have a granddaughter," says Talarico. "I play with her, or we do things like read together."

Reach Out to Those Around You

People who live with chronic pain can also fall victim to personal isolation. Amanda, 39, of Manchester, N.H., makes a point to reach out whenever she has a severe migraine attack. "Just finding someone to listen to you for a few minutes," she says, "you can get relief from that."

Amanda attends a headache support group and finds it to be a lifesaver. "It's been a tremendous support for me, and I think for the other people in the group too," she explains. "It's just someone to acknowledge that what you feel is normal. It just feels good to be accepted."

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