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Source: Unsplash

This past week I had a flare up of a condition I have that causes episodes of pain. To cope with the discomfort, I've used lots of strategies I know from my training, and was reminded that I should share these!

Here are my personal favorite tips for managing physical pain using psychological skills.

1. Remind yourself that you can cope with what you're experiencing.

My latest episode of pain was the worst I've had since May of 2015.  My episodes can last anywhere from days to months.  Since I don't know how long an episode will last or how bad it will be, I noticed myself feeling a sense of panic about having the pain. Unsurprisingly panicking about pain makes it worse.

If I start to feel panicked, I take slow breaths and imagine myself breathing into the pain location.  I also remind myself that if my pain starts to feel intolerable I have various things I can do.  I actually list a few of these to myself.  For example, I remind myself that, if I needed to, I could: go on daily medication aimed at preventing episodes, get help with housework or childcare, or even go to the emergency room.  Reminding myself that I have these options makes me feel less helpless and out of control.

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Source: Unsplash

2. Don't opt out of all fun.

I had a few days this past week when I couldn't do anything other than look after my child.  I couldn't concentrate enough to work, and was tempted to think that if I improved enough to be able to do anything, I should be catching up on work.

A friend sent me a txt inviting me to an hour of Halloween trick or treating with our toddlers.  I wasn't sure I'd be able to go, but in the end I went.  It was one of the best things I could've done for breaking my cycle of pain! Yes, I was uncomfortable, but it was still fun.  The distraction and boost of positive emotions was just what I needed.

It's easy to feel social anxiety when you're experiencing pain. For example, I fear that I'm going to do something embarrassing, like cry in front of others or grimace/wince when meeting new people. 

Although it's highly unlikely to happen, I also worry that my pain will get suddenly worse to the point that I can't safely drive home.   

Knowing what I know from my training, I'm aware that these thinking patterns are very similar to the thinking patterns (some) people with anxiety disorders experience.  For example, these types of thoughts are common among people with panic disorder.  It's common to fear becoming out of control of your body, or being trapped and unable to escape in a social situation.   Avoiding social situations tends to make these anxieties worse rather than better.

As is typical for me, even going out once socially had a positive flow-on effect.  The next day, I felt better and went out to a social event again.  I took my daughter to a 30 minute music event at our local library.  This is the type of activity that's pleasantly distracting but not over doing it. 

3. Pain medication can be a double edged sword.

Uncontrolled pain can be such a stressful experience that the stress generated  perpetuates and amplifies your pain.  Therefore taking pain medication can both feel better and make you more likely to recover quickly.  

However, pain medication can also cause rebound pain in some cases.  Pain medication can also cover up pain enough that you can "keep going" when what your body actually needs is some rest and recuperation.   

Therefore, you may end up needing to balance these pros and cons.  Of course, you should discuss your individual situation with your medical doctors (and make sure they listen to you!)

Use multiple methods to manage your pain rather than solely relying on pain medication e.g., heat/ice packs, meditation, yoga, breathing techniques, or whatever is recommended for your condition.  

Learn whether you tend to be too hesitant or too eager to reach for medication and attempt to adjust for whatever bias you have.

4. Re-evaluate what truly needs to be done.

I enjoy working hard and often push myself beyond what's truly necessary.  Check if you have any self-imposed rules along the lines of "I have to get X done today."

I hate losing income because I'm unwell, but I'm also in no danger of not being able to pay my bills.  Therefore, there isn't much that truly urgently needs to be done if I need to take it easy for a few days.  

If I find myself thinking "I need to reply to ...." or "I need to call ....,"  I remind myself, that no, I really don't have to do that.

5. Find idiosyncratic methods of coping that work for you.

Experiment with different types of coping to see what you find most calming and useful.  There might be particular kinds of self-talk you find useful.  For example, I find it calming to say to myself "My child is fine, therefore everything's fine."  That might work for you, or it might backfire.  Everyone is individual, so you'll need to experiment for yourself. 

Anything that involves a small amount of physical exertion and is methodical provides a helpful distraction for me, especially if it's not mentally taxing.  For example, doing laundry.

Something else I know is important for me is eating enough.  Pain makes me not feel like eating. However not eating makes me feel much worse overall.  Sometimes I need to eat whatever I feel like I can eat (even if that's junk food).  That energy boost then makes me feel better to the extent I can eat something more nutritious. 

I've already mentioned that short bursts of socializing are helpful to me. They're also the hardest thing to get myself to do when I have the urge to retreat and stay home.

6. Remind yourself of what resources you have at your disposal.

I have limited social support available because my family live far away but, on the other hand, I live in a city and have easy access to any kinds of delivery services I might need.  For example, if I don't feel up to going out grocery shopping, I can order Uber Eats.  I don't typically do that because restaurant meals are expensive, but I did do it this week.

Whatever resources you can access, whether it's support from friends or utilizing various services, make sure you use what you need and is available to you.

7. Enjoy moments when you have less pain.

For a couple of days this past week, I had no time (that I can recall) of being completely pain free. However, I did have periods when my pain was only mild rather than intense.  During these moments, I try to relax into them and enjoy the relative calm.   This is a similar principle to relaxing between contractions when you're in labor.  Make sure you notice when you're feeling good, or at least less terrible.  

If you find yourself catastrophizing and thinking your pain is going to last for a long time, also consider the opposite - your pain episode might be shorter than you're expecting.  If you're going to consider the worst case scenario, make sure you consider the best case scenario too.

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