3 Myths About Pain

 Most people have experienced acute, or temporary, pain at some point. This is a protective response to tissue injury that usually resolves as the body heals. However, for 1 in 5 people worldwide (with 1 in 4 in Canada), pain persists for over three months, and it becomes chronic. 

When pain becomes chronic, it can be overwhelming, and there is no right or wrong way to act. People’s perceptions of what chronic pain looks like differ, and many come from simply not being educated about it. Since I’ve had chronic pain, I have come across many people who have made assumptions and passed judgements about me based on what they see in the media, and any other falsehoods, inaccurate information and opinions they may have about chronic pain. 

Here are 3 common myths that people living with chronic pain often face:

If someone doesn’t look or act like they’re in pain, it can’t be that bad. Chronic pain is an invisible chronic illness, an unseen demon, and to be in constant pain and at your lowest point, and not be believed by doctors or even loved ones, is one of the hardest things to experience. You may look the same, but you are not the same. I am lucky in that my family doctor did listen to me and believed me when things weren’t healing right. Most people who suffer from chronic pain, minimize the impact and severity that chronic pain is having on them. My doctor knew that if I was saying a, b and c, that it was affecting me 10 times worse than what I was saying. He was also very well versed in Complex Regional Pain Syndrome (CRPS) and knew just how bad it was. To look at me, I don’t necessarily look disabled, or that I’m in crippling pain 24/7. I shove all that distress down inside me so that I appear as normal as possible.  But, in doing that, it has not done me any favours. 

They went to work, or an event, so they can’t be in that much pain. There is no point in the day or night when I don’t feel pain. The result is I have to weigh every tiny decision in my life and ask myself, is it worth it? Is what I want to do worth the recovery time or added pain? That answer usually has to do with the kind of day that I’m having. If it’s a good day, and my pain is manageable, then the answer is almost always yes. If it’s a bad day, and I’m having to take things moment by moment, just to get through the day, then the decision is harder. I don’t like missing out on doing things, and on the bad days, sometimes the answer is to do something to take your mind off it. But other times, the fallout is just too much and I don’t have the mental capacity to manage the additional pain and recovery it is likely to cause me.

The impact of chronic pain is only physical. The thing with chronic pain is that it doesn’t just affect your body, it affects your mental wellbeing too. In order to survive, you’ve got to give both equal attention. It also impacts your relationships with people. Chronic pain can be caused by underlying diseases or disorders, or it may result from an injury or accident. Regardless of its origin, it can significantly disrupt daily life. Beyond physical discomfort, chronic pain can interfere with the ability to work, attend social activities, and have relationships, leading to feelings of isolation, frustration, and anxiety.

Living with chronic pain is a complex journey that requires understanding, empathy, and support. By challenging common misconceptions and recognizing the multifaceted nature of chronic pain, we can create a more compassionate and informed environment for those affected. It's essential to remember that chronic pain is not just a physical condition but also a mental and emotional burden. By advocating for increased awareness and access to appropriate resources, we can help individuals with chronic pain navigate their challenges and improve their quality of life.

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10 Buddhist Quotes On Growth

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A Breakdown Of Chronic Pain

Over the past week, I've been experiencing a significant increase in pain intensity, making it difficult to maintain my usual routines. The colder, wetter weather, combined with the pressure to achieve my summer goals before school starts, has triggered this flare-up. My body and mind are offering a preview of what this fall and winter might be like. When my pain reaches this level, it overwhelms my entire system, forcing me to shut down and lay in silence due to the sheer exhaustion.

In cooler, damp weather, my legs experience a deep, throbbing ache that seems to penetrate to the bone. This is accompanied by more intense symptoms, including a burning sensation from the inside out, stabbing pains that feel like hundreds of sharp objects piercing my legs, and electrical jolts that shoot up from my ankles. While my back and neck are less affected by the weather, they are more sensitive to physical activity and movement.

A bulging disc in C3, resulting from a bus accident, and torn neck muscles that failed to heal have contributed to ongoing neck and back issues. For years, I've struggled to stand for extended periods due to the pain in my legs and back. Currently, I can only stand for about five minutes before needing to rest by sitting or lying down. This limitation makes it challenging to perform household tasks, attend social events, and overall restricts my activities and their duration.

Unfortunately, I am not alone in this. An estimated 7.63 million Canadians aged 15 or older, or one in four, live with chronic pain. This is not a uniquely Canadian issue, as chronic pain is a global concern. The World Health Organization now recognizes chronic pain as a disease, not merely a symptom of another condition.

There are two primary types of chronic pain:

1. Chronic Primary Pain: This occurs when pain persists long after the body has healed or when there is no identifiable cause. Examples include fibromyalgia, pelvic pain, musculoskeletal pain, and lower back pain. My diagnosis of Complex Regional Pain Syndrome (CRPS) and neck and back pain falls under this category.

2. Chronic Secondary Pain: This occurs alongside underlying diseases or issues, such as cancer treatment, post-surgical pain, and rheumatoid arthritis.

   
   
   
   

When treating chronic pain, many healthcare professionals employ the "5 A's" framework to address and manage pain more effectively. These A's stand for Analgesia, Activity, Adverse effects, Aberrant behaviors, and Affect. Each represents a crucial aspect of chronic pain management. Recently, a sixth A, Adequate Documentation, has been added for review.

• Analgesia: Refers to pain relief and involves finding the most appropriate and effective ways to alleviate pain, such as medications, physical therapy, alternative treatments, or a combination of approaches.

• Activity: Encompasses daily tasks like bathing, dressing, eating, and mobility. Assessing how pain affects a person's ability to perform these activities is essential for adapting and optimizing daily routines.

• Adverse Effects: Involves carefully weighing the benefits of pain relief against potential side effects of medications or treatments. It requires constant monitoring and adjustment to minimize negative consequences while ensuring effective pain management.

• Aberrant Behaviors: Refers to unexpected or problematic behaviors related to the use of pain medications, such as misuse, non-compliance, or signs of addiction. Identifying and addressing these behaviors is crucial for safe and responsible medication use.

• Affect: Refers to the emotional and psychological aspects of pain, including mood, stress, anxiety, and depression.Addressing these emotional factors is integral to a holistic approach to chronic pain management.

  
  
  
  

There are also four P's that medical professionals use for the assessment of chronic pain:

• Pain: The nature of the pain, its possible mechanisms, and underlying pathologies.

• Pathologies/Past Medical History: Knowledge of the patient's comorbidities can improve their quality of life and enable better physical and emotional management of pain. It can also influence treatment options.

• Performance and Function: Understanding the patient's activities, level of deconditioning, and any fear or avoidance behaviors can help assess their physical and social function.

• Psychological/Psychiatric Assessment Status: Assessing for depression and anxiety is important for understanding the overall impact of chronic pain.

While many medical professionals use these four P's, another set of four P's can also be employed:

• Physical Reactivation: An exercise program can benefit chronic pain patients.

• Psychological Strategies: Pain education, management of poor pacing, fear avoidance, and anxiety and stress management can be helpful.

• Pharmacological Medications: Appropriate medication selection and optimization are crucial.

• Procedure and Intervention: Considering potential procedures or interventions that may benefit the patient.

  
  
  
  

Everyone experiences pain differently, so keeping a pain scale can help measure pain levels and guide treatment planning. Most pain scales range from 0 to 10, with 0 being no pain and 10 being the worst possible pain.

It’s broken down as follows:

• 0 = No pain. 

• 1 = Pain is very mild, barely noticeable. Most of the time you don't think about it. 

• 2 = Minor pain. It's annoying. You may have sharp pain now and then. 

• 3 = Noticeable pain. It may distract you, but you can get used to it. 

• 4 = Moderate pain. If you are involved in an activity, you're able to ignore the pain for a while. But it is still distracting. 

• 5 = Moderately strong pain. You can't ignore it for more than a few minutes. But, with effort, you can still work or do some social activities. 

• 6 = Moderately stronger pain. You avoid some of your normal daily activities. You have trouble concentrating. 

• 7 = Strong pain. It keeps you from doing normal activities. 

• 8 = Very strong pain. It's hard to do anything at all. 

• 9 = Pain that is very hard to tolerate. You can't carry on a conversation. 

• 10 = Worst pain possible.

Pain is a complex disease, and its treatment is equally complex. Living with chronic pain is a challenging journey. The physical and emotional toll it takes can significantly impact daily life. While there are various approaches to managing chronic pain, finding the right combination of treatments and coping strategies is essential for improving quality of life. It's important to seek professional guidance and support to navigate this complex condition effectively.

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Finding Comfort Amidst The Complexities of Living With Chronic Pain

Living with chronic pain can be incredibly challenging, and finding comfort can feel elusive, even impossible. Over the years, I've discovered that a combination of pleasant childhood memories, multiple creative pursuits, and a few treasured supportive relationships with family and friends provides the most solace. However, my definition of comfort is significantly different from someone without chronic pain. What I consider a good day might be a nightmare for someone else.

Certain activities, foods, books, and TV shows from my childhood and young adulthood bring me comfort. This familiarity provides a sense of calm and helps me navigate the challenges of chronic pain.

I also find solace in adapting to do a lesser version of some of the things I enjoyed before chronic pain became my life. Mild impact outdoor activities like walking at Bellhouse Park with my best friend, enjoying ice cream with family at the marina, and exercising and doing arts and crafts with my mother-in-law, are particularly enjoyable. When Paul is home, we play crib, work on our laptops, projects around the house, and recently started playing retro video games on a new console I got for something for us to do together that we both enjoy. We like to hide out in Paul's parents' camping trailer for a change of scenery to have a break out of the house. We have great conversations and we have our shared dreams and goals, as well as our own.

Another source of comfort is after years of struggling to read due to difficulty retaining information, I discovered that reading graphic novels was easier. Seeing the story visually helped me retain more of what I was reading, and I was able to follow along. Reading graphic novels based on my favorite childhood books has become a comforting pasttime. It brings back fond memories of reading for hours in my bedroom Sunday mornings as a child.

Creative projects and hobbies provide a sense of calm and distraction from the unrelenting and overwhelming pain. These activities keep me engaged and focused, preventing me from hyperfocusing on my pain. The support of loved ones is also invaluable. Feeling loved and valued for who I am, not just what I can do, is reassuring, especially when dealing with the low self-esteem that often accompanies chronic pain.

Self-soothing when my anxiety and panic start is essential for my mental health and well-being, especially when living with the burdens of chronic pain. My body is pretty much always in fight or flight mode. Some of my self-soothing strategies involve tapping my fingers while counting, playing with my rings, taking medication at the same time and in the same order each day to manage my pain and mental health issues, and using habit-tracking and CBT apps to process the difficult emotions and to keep my recovery going in a positive direction. I also plan soothing and calming ways to do chores and tasks that increase my pain, I have regular times I visit with family and friends, and comfort activities of self care like making art and writing in my journals. I try to do these activities and tasks at similar times every day to create structured routines. I do better when my days have structure to them. When I’m going about my days in a routine manner, the sameness of knowing what’s next is of great personal comfort. So much is unknown and out of my control with respect to my pain and other physical and mental health issues that cause distress, that my brain craves the structure and knowing what’s next that my routines provide.

This summer I’ve been working on creating a calm and organized haven in my creative workspace. Having a space where I can find peace and focus and have all my art and journaling supplies close at hand is crucial during challenging times. When we feel uplifted and motivated, comfort can be a buoy keeping us afloat. When we're feeling disconnected, it can be a sheltering point to retreat to.

When designing our living spaces, we often focus on aesthetics and how we want things to “look”. However, by considering how we want to feel in our spaces, we can create environments that promote comfort and well-being. I aim for a calm and inspiring atmosphere where I feel like I'm able to accomplish my personal and creative goals. By incorporating elements that soothe you into your living environment, you can create a space that supports your recovery and healing. My living room, which currently doubles as my temporary studio, is my safe space. It’s where my magic happens. However, I'm excited to move my craft and art supplies into the fifth wheel we were gifted that we are renovating for a dedicated studio and sewing space for myself, Paul’s mom, and Kiersten..

Over time, we can identify what brings us comfort and discomfort in our daily routines. By making intentional changes to our environments, such as adding artwork, painting, getting a piece of furniture, a plant, or doing something creative with your space, we can foster hope and inspire ourselves for personal growth. It's okay to let go of things that no longer bring comfort and replace them with something new. Our homes can be ever-evolving spaces that support our changing needs.

For me, creativity is a primary source of comfort. Immersing myself in the creative process provides a sense of inner calm and relaxation. I get into a meditative state, which decreases my heart rate, relaxes my body, and brings a sense of inner calm. Listening to meditations while engaging in creative activities is particularly comforting. I use apps like Apple Fitness Plus and Balance for guided meditations.

My workspace is also a comforting space. I've recently rearranged it to better suit my needs, including making space for my small Buddhist statues and knick-knacks and computer equipment for creating video content. Having a designated area for work helps me feel organized and focused.

Physical comfort is also important. I enjoy relaxing in my recliner, reading, watching TV, and using my back massager. Going into our hot tub regularly and cuddling with my dogs also provide comfort.

Certain foods, like my mom's turkey and mashed potatoes or Paul's chicken soup dumplings, Kiersten's mac and cheese, and Paul's mom's cheeseburger casserole, are my comfort foods. Things like cereal, breakfast for dinner and right from the oven banana bread, also bring me comfort. Having the comfort of a favourite home cooked meal is something I make a point to mindfully eat and enjoy, while being surrounded by my loved ones.

Ultimately, the most important source of my comfort is the support of loved ones. My family and friends each play a vital role in my well-being, and I'm grateful for their support. I honestly don’t know if I would be doing very well or even alive still if I didn’t have that strong sense of support I feel from my loved ones.

By cultivating comfort in our lives, we can navigate the challenges of chronic pain with greater resilience and hope. Through intentional self-care, supportive relationships, and a nurturing home environment, we can find solace, inspiration, and a renewed sense of purpose. Remember, comfort is a journey, not a destination. As our lives evolve, so too will our sources of comfort. By remaining open to new experiences and embracing self-care, we can continue to find comfort and joy, even in the face of adversity.

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Keeping A Pain And Symptom Tracker

Understanding and Managing Chronic Pain: The Importance of a Pain Diary

When I was first diagnosed with complex regional pain syndrome (CRPS), my doctor recommended keeping a pain diary. At the time, I wasn't sure how helpful it would be, but it quickly became an invaluable tool for managing my condition. A pain diary is a detailed record of your pain experiences, including when it occurs, its intensity, and how it affects your daily life.

Benefits of Keeping a Pain Diary:

• Accurate Communication with Healthcare Providers: A pain diary provides your doctors with specific information about your symptoms, allowing them to make more informed treatment decisions.

• Improved Understanding of Your Pain: By tracking your pain patterns and triggers, you can gain a better understanding of what factors contribute to your condition.

• Effective Treatment Monitoring: A pain diary can help you track the effectiveness of your medications and therapies, enabling you to identify what works best for you.

• Legal and Disability Support: A well-maintained pain diary can be valuable documentation if you need to apply for disability benefits or pursue legal action.

Key Elements of a Pain Diary:

• Date and Time: Record the exact time and date of your pain episodes.

• Pain Intensity: Use a pain scale (e.g., 0-10) to rate the severity of your pain.

• Pain Location: Identify the specific areas where you experience pain.

• Pain Description: Describe the sensations you feel (e.g., throbbing, aching, sharp, tingling, shooting, burning).

• Triggers and Exacerbations: Note any activities, emotions, or environmental factors that seem to worsen your pain.

• Medications and Side Effects: Record the types and dosages of medications you are taking, along with any side effects you experience.

• Sleep Patterns: Track how pain affects your sleep quality.

• Mood and Mental Health: Document any changes in your emotional state or mental health.

Tips for Effective Pain Diary Keeping:

• Consistency: Try to record your pain experiences daily, even if you don't have significant pain.

• Detail: Be as specific as possible in your descriptions.

• Review Regularly: Periodically review your diary to identify patterns and trends.

• Share with Your Doctor: Bring your pain diary to your appointments to discuss your observations with your healthcare provider.

  

While keeping a pain diary may seem time-consuming, the benefits can be significant. By tracking your pain experiences, you can gain valuable insights into your condition and work with your healthcare provider to develop a personalized treatment plan.

Conclusion

A pain diary is a powerful tool for individuals living with chronic pain. By meticulously recording your pain experiences, you can gain a deeper understanding of your pain, communicate more effectively with your doctors and specialists and make informed decisions about your treatment. While it may require initial effort, if you do it regularly, the benefits of maintaining a pain diary often outweigh the time investment. I found that I became quite efficient writing my pain diary’s entry at the end of the day. By consistently tracking your pain, you get better at it and faster, and it allows you to take a more active role in managing your symptoms and improving your overall quality of life.

PS - I am in the process of creating a free printable pain tracking diary template that I will be posting soon!

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