Chronic pain is pain that persists beyond tissue healing. Unlike acute pain, chronic pain is not a normal protective mechanism and does not correlate with the degree of tissue damage. Furthermore, it does not diminish in intensity as healing progresses and does not serve a useful protective purpose. The Pain signals keep firing in the nervous system for weeks, months, even years.
Despite these facts, chronic pain is too often treated as if it were the result of ongoing tissue damage, as if the healing process were still under way, as if it will diminish as healing progresses, as if it does provide a protective purpose, and as if it were just like acute pain that has simply lasted for a longer period.
But there is hope. Effective therapies to manage persistent pain are becoming increasingly available. Healthful changes to one’s lifestyle, and, if necessary, medication can help control pain and leads to more active and productive life.
Phase 1:
Less activity
Because of your pain, just getting the yard rake down from the garage attic seems like a huge task. So instead, you let the leaves fall. But every time you see the leaves, you’re reminded of what you can’t do.
Phase 2: Increase in activity
When the day arrives when your pain seems to be improving, you rake the yard. But you also run errands, clean the garage. You try to catch up on all the things you’ve been putting off.
Phase 3: More pain, decrease in activity again
The next day, you can hardly move. You feel worse than you did before your superheroic day. You are mad at yourself for trying to do too much at one time and spend the next few days resting and trying to recuperate.
Eventually, you begin to feel better. But as you start to become more active, your pain worsens. Thinking that the only way to control your pain is to limit all physical activity, you spend more time in bed or on the couch.
Phase 4: Weakening strength and physical deconditioning
You get more tired the more time you spend lying around, weaker and less able to finish up those leaves. Due to your long stretch of inactivity, you start losing your stamina. You get fatigued easily and thought of physical labor is daunting.
Phase 5: Withdrawal and isolation
You find yourself spending most time alone and less time with those who care about you. Because you’ve stopped going out with your friends, they’ve stopped calling. People close to you has become used to doing things without you.
You retreat even further from your family, friends and favorite activities. Eventually, a few days come when you begin to feel a little better and you feel optimistic. But once again, your pain flares, and the cycle repeats itself.
Phase 1: Fear and concern
You are fearful and concerned When you first experience your pain. The worse it gets, the more you worry about it, and in turn, the harder it becomes to ignore.
Phase 2: Hope and promise
When you finally learn what’s triggering your pain, your fear and concern are replaced with hope that your doctor will be able to make the pain disappear and your life will soon return to normal. When the pain continues to linger despite repeated trips to various doctors, your hope starts to diminish.
Phase 3: Anger and frustration
You become dejected and depressed over the state of your life. You feel as if you’ve done something wrong and now you’re paying the consequences.
As your life feels less and less your own, you may seek to gain control in other, destructive ways, such as increasing your pain medication or using alcohol. You may become more irritable with the people who are trying their best to help you.
Phase 4: Guilt and withdrawal
You feel guilty over the things you’ve said and done. Instead of communicating this guilt, you withdraw from people so you won’t take your anger out on them. You also feel guilty because you aren’t able to do your full share of duties anymore.
Phase 5: Renewed hope, followed by depression
Gradually, or perhaps rather suddenly, you feel better. You’re optimistic that your condition is finally improving or the new treatment you’re trying is working. Excitedly, you start getting back into your old routine. But after a time, the pain returns and you become deeply disappointed and lose all hope of recovery.
You begin to feel as though you’re no longer loved or needed, and your self-esteem hits an all-time low. Your pain becomes the focus of all of your attention. Fear, isolation and depression, coupled with days with nothing to do, make the pain feel even worse. The severity of your pain finally forces you to look for other forms of treatment, setting you up for a repeat of the cycle.
Tearnan, Blake H. 10 Simple Solutions to Chronic Pain. Oakland, CA: New Harbinger Publications, 2007.
Chino, Allan F.& Davis, Corinne D. Validate Your Pain! Bloomington, IA: AuthorHouse, 2004.
This page was first published on May, 15th, 2008 and was last updated on May, 15th, 2008