Chronic pain – how to break the cycle and take control

Chronic pain impacts upon life in many different ways. It can alter mood, disrupt sleep, and even cause anxiety and depression. For many people, long-term pain is a significant aspect of living with an autoimmune condition, such as scleroderma or Raynaud's.

Around 28 million adults in the UK are living with chronic pain of some kind, meaning that up to 43% of us could now be affected, although this may not always be obvious to others. In some cases, the pain itself may constitute a severe but invisible illness or disability; and chronic pain has now become a health issue on a global scale.

Chronic pain often exists on a spectrum, varying greatly in its intensity. There may be certain triggers, including disease activity, over-exertion and anxiety, that affect the pain and make it worse. Then, when pain flares up, this can exacerbate fatigue and cause further stress, prompting the cycle to continue. Taking steps to manage or interrupt this cycle of pain can be extremely beneficial in helping you to take back some control.

Breaking the pain cycle

Because chronic pain is long-term, you may begin to recognise early warning signs that it is about to flare up; and acknowledging these warnings can help you to feel more in control. There might also be certain triggers that make the pain worse; and taking action to avoid these can help to reduce major flare-ups, although this is only effective if you can control these aspects of life. Since the pain of many autoimmune conditions is exacerbated by activity and 'overdoing it;' you may benefit from taking steps to slow down, (if this is at all possible).

Making a pain plan

When pain flares up it can be difficult to think clearly. Drawing up a pain plan can help you to take control when a flare does occur. Use the plan to note down in detail anything that is likely to help, or at least make things easier, when the pain flares up. Making the plan well in advance to reflect your own individual circumstances means that you will already have the right measures in place when you really need them.

Practical support

A pain plan should list any medication to be taken and when, as well as the details of whom to call upon if you need any practical support, such as help with childcare or school pickups; or even just some company. Setting up these arrangements now will make it much easier to get help quickly if necessary.

Distraction

Distraction techniques can help by reducing your awareness of the pain, which may make it easier to deal with. There are various methods that different people find helpful, so think about what could work for you and note these ideas in the pain plan. Effective distractions might include playlists, classic albums, movies, box sets or books; or even a gentle hobby if you are able. Gather everything that you will need in advance so that it will be easy to find when the time comes.

Practicing mindfulness

Mindfulness has been shown to reduce the stress and anxiety that aggravate chronic pain, interrupting the pain cycle and helping to put you back in control.

Mindfulness is about paying attention to the present moment and to your own thoughts and feelings as they happen. This helps to improve the clarity of the mind and can enable you to see beyond the pain and develop resilience, so that you feel more in charge of the situation.

Once mastered, many people find this to be effective, not only in helping to control the pain but also its effects, such as fatigue, sleep deprivation and depression.

The following deep breathing technique will help you to focus on the present and to reconnect with your own sense of self-awareness. It may take a little bit of practice, however this can quickly become a powerful tool in helping you to deal positively with all aspects of chronic pain:

• Find a quiet, relaxed space
• Focus on your breathing, and with your eyes closed, breathe in slowly
• Think of your breathing and the breath filling your lungs
• Do not criticise your mind for wandering, simply acknowledge this and return to your breathing

You may need to come back to your pain plan and make some changes as you find out more about what works and what does not, and it may be necessary to try out several different approaches to identify what works best. Your doctor or nurse specialist may also be able to help in suggesting some alternative techniques to try.