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What is pain management?

Chronic Pain | Last Active: Nov 22, 2021 | Replies (51)

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@krisjb1

I watched the video about central sensitization syndrome and feel as if there is something missing between the "causation" portion of the discussion and the part where the patient is desensitized to pain. I can't understand how pain caused by an illness or disease that has no cure such as arthritis or terminal cancer can be alleviated by a course of therapy which appears to be akin to mental health work. While a serious disease or injury is present pain is a warning signal. What am I missing?

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Replies to "I watched the video about central sensitization syndrome and feel as if there is something missing..."

I am living proof that pain from an incurable illness (osteoarthritis from head to toe) can be eased by therapy. It is not only mental health work, but that is part of it. And it is not only desensitization, but includes physical work to alter some habits which increase pain. Finally, the pain is not necessarily cured, but managed in order to improve quality of life.

There are incurable, intractable pains which are not caused by Central Sensitization, such as some end stage cancers, severe infections, or postoperative pain. Opioids are then a logical choice.

But when chronic pain sets up residence in the body, all kinds of muscles tense, we alter our body mechanics, related nerves react, we tense further and hurt more...the vicious cycle is initiated.

Pain management or desensitization teaches us to break the cycle using physical (PT, stretching, exercise, massage, acupuncture...) mental (counselling, visualization, meditation, faith practices...) medical (meds, injections, braces, surgery) dietary and social strategies.

Do I still hurt? Yes. Does pain affect my life? Some days. Am I glad I learned about it? Yes, I wish it had been around 30 years ago to help my Mom!
Sue

With chronic pain, the body part that hurts is often just the tip of the iceberg. Underneath lay various impacts that often accompany, and may worsen chronic pain, including:

- Emotional distress
- Physical deconditioning
- Fatigue
- Sleep disturbance
- Thinking and memory problems
- Poor nutrition

Lifestyle changes do make a positive impact. Retraining the brain (neuroplasticity) does make a positive impact. No, they do not remove all the pain, but they create healthier ways to approach pain, and recreate pathways in the brain.

An example I learned at pain rehab was to think of a little boy (we'll call him Timmy) who goes to the grocery store with his mom and wants a free cookie at the deli. TImmy throws a HUGE tantrum in the middle of the store, begging for a cookie. His mom has two choices:

1. give in to Timmy and let him have a cookie
2. stand her ground and say no because he has not had lunch

Pain is like a tantrum. If we continue to give in to it and let it have its way, we will lose control and create bad habits. We will not allow ourselves to live our best life possible.

No matter how long you've lived with chronic pain, you can take steps to manage it more effectively and improve your quality and enjoyment of life. Your attitude and lifestyle play key roles in how well you cope with pain.

If you have a negative attitude and view yourself as a victim of pain, pain will continue to control you and consume your energy. If you approach your condition with a positive outlook and openness to change, you're more likely to manage pain successfully.

Some key lifestyle choices to help you live well with chronic pain may include:

- Becoming more physically active
- Practicing techniques that relieve stress
- Focusing on your abilities, not just your limitations
- Improving communication with family members and friends
- Learning to shift your focus away from pain
- Reducing or stopping reliance on pain medication and medical solutions to pain
- Eating a nutritious diet, and getting the sleep you need
- Speaking to a psychologist
- Scheduling your days, for accountability
- Setting goals

No one says this is easy, it takes diligence. I certainly have my difficult days where I must go back to the drawing board and pull from these tools I've outlined. Regardless of individual underlying causes, chronic pain presents the same for us all, chronic, its never going away, but can be managed.