Living with chronic pain

Chronic pain is different from acute pain. There’s no simple treatment for chronic pain. Finding the right pain management strategies can help you live better with your pain and hope for some recovery.

Traditional medical treatments, like pain medications, have limited benefit for chronic pain.

Finding the best strategies and techniques for you is the best way to manage your chronic pain. Learning to self manage can take time and might involve learning some new skills.

Managing your activities

Pain might impact your ability to carry out your normal daily activities.

Many people with chronic pain avoid being active because they’re worried it will make their pain worse. This is understandable. Being less active can make your pain worse. It might feel like it’s helping in the short term. But in the longer term, being underactive can make your pain worse.

Sometimes, being overactive and doing too much might cause flare ups of chronic pain.

It’s important to find a way to remain active in a way that’s safe for you. Being active is good for you and can help improve your quality of life.

Pacing

Pacing can gradually help you manage your daily activities in a way that’s right for your body and your condition, while reducing the risk of flare ups.

Chronic pain can cause changes in your brain and nervous system. These changes can cause the brain to continue to send out pain signals, even when there’s no harm or damage. The signal pathway to the brain can become over sensitive meaning the signals are amplified.

Pacing can help because it allows you to do things within your limits. This can help re-train the nervous system settle and be less protective.

You can practice pacing activities to prevent overactivity or underactivity. This means deciding how much you’re going to do and not pushing beyond your limit. You should practice pacing regularly to allow your body to adapt. You can add on small amounts as you feel able to.

Pacing encourages you to choose when to take a break from an activity before pain, tiredness or other symptoms become too much.

If you don’t pace yourself, it could slow down your progress in the long term. Regular, paced activity can help build your fitness over time.

Watch this video from Pain Association Scotland to learn more about pacing

Activity and exercise

Finding activities and exercises that are suited to your condition can help you manage your symptoms. It can also improve your overall health.

Knowing where to start can be daunting for some people with chronic pain. Any type of movement can be exercise.

To begin with your muscles might hurt so it’s important that you choose a level of exercise that suits you. Learning how to pace your activity and exercise can help. Most of all it should be enjoyable.

You might want to try:

• walking – start off with a short walk and if you feel able, continue to increase the length of your walk each day or week
• dancing or moving to music – this can be done either standing or sitting (or a mixture of both)
• exercising in the pool – water makes us feel lighter and can make movement and exercise easier than on dry land
• exercise classes – if you’d prefer to exercise with others, you can find out about classes from your local sports centre

Watch and follow this mindful movement video for some guided exercise

Set yourself goals

You may find you’ve had to give up going places or doing things that you used to enjoy because you’re afraid your pain will get worse.

Goal setting’s a bit like pacing. You can use it to find the right activity level for yourself.

Here are some tips to help with goal setting:

• make the goal something that matters to you
• make it specific and measurable; instead of saying, “I want to go out more,” you could say, “I’m going to meet a friend for coffee every week”
• choose something realistic and achievable
• make it time bound, like “I want to walk one mile every Thursday for the next month or “I want to walk for 10 minutes three times a week”
• choose something that benefits you and makes you feel good about yourself

Once you’ve decided on your goal, create an action plan to record how you’ll achieve your goals.

Relaxation

It’s important to regularly take time to relax or practice relaxation techniques to help reduce stress. Stress can make your symptoms worse or cause them to flare up more often.

Relaxation is a skill you can learn. It happens when you guide your mind to unwind the tension and tightness within your body.

Try to find time each day to do something that relaxes you. Taking time to relax before bed may also help you sleep better.

Find out more about relaxation techniques you can try

Mindfulness

Mindfulness involves paying attention to what is going on inside and outside ourselves in the moment. It helps you become more aware of the natural and automatic reactions to pain like difficult thoughts, emotions and worries.

An important part of mindfulness is reconnecting with your body and the sensations you experience. A simple way to practise mindfulness is to pay attention to the sounds, smells, sights and tastes of the present moment.

Another part of mindfulness is paying attention to your thoughts and feelings without getting caught up in them.

Mindfulness can help you enjoy the world around you more and understand yourself better.

Read mindfulness tips and exercises on Mind

Find out more about relaxation and mindfulness

Managing your sleep

Chronic pain can cause a lot of problems with sleep. You might find it hard to get to sleep, or wake up during the night because of pain.

Lack of sleep and struggling to sleep can also increase your stress levels, making it more difficult to cope with your pain.

Try our self-help guide for sleep problems and insomnia to help you sleep better.

Sleepio provides a 6 week digital sleep improvement program based on CBT (cognitive behavioural therapy).

Getting a good night’s sleep – Pain Concern

Medication

Most people with chronic pain will not benefit from using medication alone to treat their pain.

Medication can be part of a pain management plan alongside other strategies like:

• education
• activity management
• taking care of your mental wellbeing

As chronic pain affects the nervous system it can affect your mental wellbeing. This makes it a difficult condition to accurately treat with medication.

There are different types of pain medicines for different types of pain. You may be prescribed a combination. Your pain can also change over time. It’s important to get your pain medicines reviewed at least once per year to see if they’re still effective and safe for you.

All medications can have side effects. Sometimes this can cause more problems than the condition itself. It could make your pain worse or create a physical dependency. With chronic pain it’s good to consider whether you think you’re getting more benefit from your medicines than side effects. You can speak to your GP, a Pharmacist or Pain Specialist for a review of your medications.

Pain and work

Being in work is good for your physical and mental health. Living with chronic pain can impact your ability to find work, stay in work, and return to work.

There are different ways you can spend your time. This could include paid employment, self-employment, volunteering and education. You do not have to be 100% healthy to work.

If you’re struggling to remain in work, you could:

• discuss with your employer what you’re finding difficult about work
• think about what reasonable workplace adjustments like variations in job pattern or hours could help keep you in work
• speak to Citizens Advice Scotland about your rights to request flexible working changes
• get support through Access to Work

If you’re on sick leave and want to work towards going back to work, you can:

• start ‘stay in contact’ conversations with your employer
• start to explore a return-to-work plan with your employer even if the date might some time in the future
• consider ways for going back to work in a gradual way
• explore what current options exist for return to work
• find out what benefits you’re entitled to through Citizens Advice Scotland

Chronic pain and your mental health

Pain doesn’t just affect our bodies. It can also affect your mental health.

The close links between the emotion and pain centres in our brains make it almost impossible to have pain without difficult emotions as well.

Chronic pain can have a huge impact on all aspects of life, which can cause emotional strain on top of the pain.

Talking therapies, like counselling, can also be helpful in managing the impact of pain on your mental health. Speak to your GP to discuss your options.

You can also get help from the following services:

• Breathing Space
• Mental health services at NHS 24
• SAMH
• Samaritans