Living with Chronic Illness and Pain
Chronic pain
Acknowledgment:
Source - Pain Management and
Research Centre, Royal North Shore Hospital, Sydney, NSW.
Good management of chronic pain
Pain is described as chronic when it lasts for more than 3 months, despite appropriate investigations and treatment.
If your doctor has told you that you have chronic pain and that you will have to learn to live with it, what should you do? The best evidence available at present is that you should do the following things:
Come to terms with it - No one wants to live with chronic pain. But some pain problems have no cure at present. Accepting that the pain you have is chronic and has no 'quick fix' is the first step to living with it.
Reassure yourself - Finding out your pain is going on and on may help, but your doctor may not be able to give you a full explanation. S/he should be able to reassure you there is nothing seriously wrong with your body. In your case, when pain gets worse it is likely to be due to more damage. Increased pain may be due to the long-term effects of inactivity and increased sensitivity in your nervous system, so that previously normal activities are now able to stir up your pain.
Stop seeking more treatment! - This risks making things worse, keeps the focus on pain and raises unrealistic hopes. Patients often tell us that each time a new treatment fails they are left feeling a little more helpless. A better use of your time and energy would be finding things that you could do to improve the quality of your life. Seeing your doctor every couple of months will often be enough for him/her to keep your progress under review and reassure you.
Use as little medication as possible - Pain killers may take the edge off the pain but they will not cure it. Many people don't like the side-effects of medication either.
Expecting medication to solve the problems of chronic pain is unrealistic. If medication is not helping then it is better to take none. If 'pain killers' do help, then taking as few as necessary on a regular basis rather than 'as needed' is recommended. A medication plan should be discussed with and monitored by your doctor.
Learn ways to lead a normal life despite the pain - Avoidance of activities you expect will worsen pain can result in a very restricted life. It is likely you will have some limits, but letting pain determine what you do risks allowing pain to run your life. You may need to do things a little differently, like take short breaks and take longer to do things. You may regain many normal activities or find new ones by taking a step-by-step approach. Make realistic goals and develop a plan to work towards them. Your goals should be things you want to achieve. It can also help if you focus on things you can do and not on what you can't. Best of all, find a job you can do.
Keep as fit as possible - You are not training for the Olympics but if you lead as healthy a lifestyle as possible, your pain will be less of a problem. This means getting regular exercise, good sleep, eating a balanced diet, and finding a balance between work and leisure activities.
Deal with depression - Feeling depressed makes living with pain that much harder. Seeking help from a psychiatrist or clinical psychologist may be useful. Medication is often not needed; talking things over and learning better ways of dealing with your pain and other difficulties is often more effective.
Where can I go for help?
- Your local doctor
- Pain Management Research Institute
Royal North Shore Hospital
St Leonards NSW 2065
Phone: (02) 9926 7676
On the web
Pain Management Research Institute website:
http://www.painmgmt.usyd.edu.au/
Further reading
Notes on the book 'Manage Your Pain' by Dr Helen Hanson, DVA Senior Medical Adviser.
This self help book was published in June 2000 by ABC Books and is available through ABC shops or via mail-order or online sales.
It is written by a panel consisting of Dr Michael Nicholas, a clinical psychologist who established and directed the ADAPT (Active Day Patient) program at the Royal North Shore Hospital (RNSH), Dr Allan Molloy, an anaesthetist who works at RNSH and teaches in the field of chronic pain, through the University of Sydney, Lois Tonkin, a physiotherapist and academic in the field of pain management, and Lee Beeston, a registered nurse specialist in pain management at the RNSH pain management program.
The book provides sensible information about an integrated pain management program, combining careful use of medication with a balanced approach to exercise and psychological therapy. Veterans suffering from chronic pain who are interested in the program described in the book should talk to their own doctor, for more information about resources available in their region.