ANECDOTALLY: how I manage chronic pain

Chronic pain is a bitch.

I’ve been dealing with pain for about 15 years now. About a year ago, I got a diagnosis of fibromyalgia. Fibromyalgia is a ‘syndrome’ with a group of overlapping symptoms, and nothing specific found in medical tests. I always have pain – and it was only in recent years that I realized this is not normal for everybody.

I am fortunate that the pain I feel is usually manageable and bearable – for me, fatigue ends up being a larger issue impacting my daily life. But after a while, pain really wears you down.

Chronic pain can lead to depression – and depression can cause pain, or intensify the sensation of pain.

Chronic pain can make exercise seem impossible at times – and lack of exercise can make chronic pain worse.

Chronic pain may be the result of “rewiring” the brain to create a feedback loop where less stimulus is required to fire pain receptors – over time you become more and more sensitive to pain, as more and more pain-causing neurotransmitters build up in your nervous system.

The cliche’ is reality: It IS all in your head.

The body-mind connection is real, and this is supported by the weight of the scientific & medical evidence.


So what do you do to stay sane when the pain in your head reaches out to your body?

I have suggestions. You can take them or leave them, but this is what I’ve found helps me.

Moderation is key.


EXERCISE is number one.

Dammit, but I said above that pain can make exercise seem impossible.

Yes, but NOT MOVING feels even worse.

First thing in the morning, I have the most pain. Often, it’s what wakes me up. When I get out of bed, I spend about 5 minutes just gently stretching & working out the kinks.

If I sit for too long, my entire body feels stiff & sore. I regularly get up and move a bit, if I am sitting for an extended period of time.

I WALK. Walking is fabulous exercise – and a HUGE help when I am feeling worn out from pain. I have a regular route I walk around my neighborhood – it’s a one-mile circuit, on a good day it takes 15 minutes. My overall pain is usually noticeably improved after this walk.

I teach yoga (hence the name of the blog), and despite the fact that I regularly teach a 90 minute hot class, I find that a practice of 30 to 60 minutes in a slightly warm room is what works best for me.

Extremes of temperature do not help, extremes of practice do not help, extremes of fatigue-creating activity do not help.

Weightlifting is something I really love. I love getting stronger and feeling more capable. I think the benefits of strength training far outweigh the downsides of it for people with chronic pain conditions. And there really aren’t many downsides, if you are well-trained and take it slowly.

One of them is the potential, if you are prone to pain and you are using progressive training (increasingly heavier weight lifted over time), that you may be at more risk for severe DOMS (delayed onset muscle soreness). As I mentioned above, if you experience chronic pain, you are more likely to feel more of a sensation of pain at a lower level of stimulation – it’s my experience that I’m more prone to severe DOMS after lifting at a lower threshold than other people, so I don’t push to my absolute limit.

I do not push as hard as I could, because overdoing means I won’t be lifting again for a while. I need a lot of recovery time if I push beyond my own appropriate and reasonable boundary from ‘challenging and beneficial’ to ‘TOO MUCH’. ‘Too much’ means increased pain and fatigue, and reduced activity for days or weeks.

I usually stop one set before muscle failure, or before exhaustion would hit me. I stop when just begin to get tired, not when I’m well & truly wiped out. Managing my fatigue, managing my recovery … that’s how I maintain a regular exercise & training schedule, which ultimately manages my pain.

My experience is this: if I am regularly exercising and regularly training at a reasonable level, I still have some pain … but it feels DIFFERENT than the pain I feel when I am inactive. Yes, my arms and chest will be sore after bench press day – but the pain I *always have* everywhere else is less noticeable.

It’s like having a volume control button for my chronic pain: exercise turns it down, or shifts my perception to other areas of soreness. Post-exercise muscle soreness is a very different type of pain for me than the chronic pain I experience in the rest of my body.

Which leads to the next topic …


RECOVERY.

If I overdo any kind of exercise, my recovery will be impaired. And compared to a person who does not have the issues around pain & fatigue that I have, my recovery is impaired.

Especially in the case of weightlifting, recovery is king.  Your body needs to repair & rebuild … and for that it needs REST.

If inactivity is unhelpful, so is overexertion. I have had to learn to maintain a balance between ‘too much’ and ‘not enough’ – it’s called ‘moderation’.

I need to MOVE everyday. But I don’t need formal exercise everyday. I need to stretch and walk daily to manage pain. I need ample rest between lifting sessions to manage fatigue.

I don’t need to practice yoga every day, especially if it’s a more vigorous practice.

I lift two or three times a week, depending on how I feel. I pay very close attention to whether I am staying sore and fatigued longer than I should. If I am staying sore and fatigued all week, that means I need a week off from workouts (or maybe two weeks).


MEDICATION.

The pain and fatigue I need to manage seem to be associated with something faulty in my brain’s metaphorical wiring. I take a low dose of an anti-depressant/anti-anxiety medication that works on two neurotransmitters: seratonin & norepinephrine. The evidence shows that antidepressants help with chronic pain. My experience so far agrees with the evidence.

Occasionally, I take Advil (ibuprofen) or Aleve (naproxen sodium). But only when pain gets above a certain ‘volume’ and interferes with me being able to think or sleep.


 

MEDITATION.

Yoga is a method of meditation, of course.

Focus on the movement of the body, or the stillness of the body. Focus one’s eyes and focus one’s attention. Chant mantra. Breathe.

Outside of yoga, I practice an informal style of mindfulness meditation.

Learning to be still and breathe, allowing whatever thoughts to arise, and then allowing them to pass on by without attaching to them … is helpful for managing the types of anxious thoughts that tend to show up when you have chronic pain.


I’ve learned to listen to my body. I respect its limitations – they are boundaries that help to teach me balance & moderation in all things.

Do you have thoughts to share about managing chronic pain or chronic illness in a health-supporting way? Join the conversation on my Facebook page.

 


 

 

 

REFERENCES: Psychology Today, National Institute of Mental Health, WebMD

 

 

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