Chronic pain management: 10 proven ways to manage - or even overcome - chronic pain
(approx six minute read)
Millions of Brits are living with debilitating chronic pain. But Charlie Goodchild, founder of health clinic Better, is adamant those experiencing long term pain should remain hopeful that things can improve.
It’s estimated that around a third of adults (about 28 million people) in the UK are affected by chronic pain. Eeekkkk.
What is chronic pain?
According to John Hopkins Medicine ‘chronic pain is long standing pain that persists beyond the usual recovery period or occurs along with a chronic health condition. Chronic pain may be "on" and "off" or continuous. It may affect people to the point that they can't work, eat properly, take part in physical activity, or enjoy life.
Mental health and chronic pain
It’s no wonder, then, that chronic pain can lead to depression. Interestingly, studies have also shown that physical symptoms are common in depression, and, in fact, vague aches and pain are often the presenting symptoms of depression.
“The brain is making the decision about how much pain you are feeling,” says Charlie Goodchild, founder of London-based physiotherapy and health clinic, Better.
“It’s why psychology is the most important thing I consider when treating my patient’s pain.”
Biopsychosocial model of pain
Goodchild focuses his approach to treatment on the Biopsychosocial Model of Health and Wellness which looks at the biology, psychology and social environment of an individual (often not in that order).
“When there are negative stressors in your life, pain can often feel worse.
“If you’re in a shitty relationship and you’re experiencing chronic pain, it’s not unusual for the pain to feel worse. If you don’t like your job, you’re working night shifts or have a terrible manager, then you are susceptible to chronic pain.
“I spend a lot of time trying to encourage people to change behaviour. It’s vital I understand the full picture of a patient’s life to help them make that long lasting change.”
Proven tips for how to manage chronic pain
Good news, Goodchild believes there are ways of managing, maybe even overcoming, chronic pain.
“Can chronic pain be cured? I would have an unfulfilling job if every patient I saw continued to suffer and made no improvement. In many cases there is a way forward with chronic pain, there are lots of chronic pain treatment options,” encourages Goodchild.
1. Don’t give up hope
“I want this to be a message of hope,” says Goodchild.
“I’ve treated countless patients who have suffered chronic pain for years, even decades, who go on to live completely pain free lives. Not everyone is pain free, of course, but many learn how to manage it better. They get to a point where they live a great life despite chronic pain. I don’t want people to lose hope and give up, there’s always hope.”
2. Get a second opinion
“I’d always recommend people get a second, third, or even fourth, opinion,” explains Goodchild.
“If you get a diagnosis, query it, you’re within your rights to do so. Keep looking until you think you’ve found all the information you need. There will be someone out there who can help you make sense of your chronic pain.”
3. Starve your brain of unhelpful thoughts
“Have you heard of The Chimp Paradox by professor Steve Peters?” says Goodchild.
“If not, it’s well worth a read. Imagine that your pain is your chimp screaming at you. If you’re listening to the chimp all the time, you keep giving it attention, then its role in your life grows. But if you starve it of attention, close the door on it, the chimp might eventually get bored.
“If you’re in pain, distract yourself from it, find a way not to listen. Stop stretching your neck every five minutes. Choose an activity that you enjoy, something requiring your full attention, something purposeful.
“Often people become identified by their pain, they become known as the person with back pain. With some mental work that negative habit can be changed. To be clear, this change can be hard, and can take many months.”
4. Put the work in
“You have to put the reps in,” says Goodchild.
“You have to commit to something, and commit for however long it takes. You wouldn’t expect to go to the gym and get strong overnight.
“It’s the same with chronic pain. That could be gym work, stretches, therapy, diet, sleep, whatever. But, and this is the hardest thing, sometimes there’s no timeframe on when you will see change.
“It could take days, it could take years. If you feel that it is working for you, and it makes sense to you, just keep going, give it enough time.”
5. Move, move, move
“It’s vital, even if you’re in a lot of pain, that you move regularly. It should be one of your pain management strategies. It could be walking or gentle stretching. Every 30 minutes or so for a minute or two. The price of sitting is a heavy one,” warns Goodchild.
“The only caveat is that you might need to take it easy for one to two days after an acute flare up of pain, beyond that, the rest is more likely to be harmful than helpful.”
6. Get the basics right
“Are you eating right? Are you sleeping seven or eight hours a night? Are you doing any exercise? If the answer to those questions is no, you’re not doing all you can to manage your chronic pain,” says Goodchild.
“Getting all of this stuff right can make a huge difference. If you do regular exercise you will notice improvement; to begin with it will be strength and fitness improvements.
“When your brain senses strength it senses safety. When it feels safer it might start to trust you to do more things without experiencing as much pain, the metaphorical pain dial is turned down by your protective subconscious pain system.”
7. Make time for self-reflection
“Meditation, breath work, knowing what your values are (read our story on the science of knowing your values), journaling - all this stuff is scientifically proven to improve your wellbeing,” says Goodchild.
“If you’re experiencing chronic pain you have to look at your life as a whole, not just the physical pain. Meditation might not be for everyone but there are many different ways of meditating, journaling, reflecting. Try and find an approach that works for you.”
8. Create good habits
“Journal, go to the gym, meal prep, schedule in movement, do your physio exercises at the same time everyday,” Goodchild suggests.
“Habits are hard to stick to, we start them, a week later we stop them and then we chastise ourselves for ‘failing’. But that’s okay, just keep starting new habits, even if it’s every week. Eventually some, one, or all of them will become sticky.”
9. Expose yourself to pain
“If you’ve seen a physiotherapist and they’ve not found any structural problems, it’s safe to start exposing yourself to that pain, but be sure that it is tolerable to you,” says Goodchild.
“If there is no flare up the next day, then you have tolerated that activity, and you now have more evidence that it was safe after all. If there is a flare up, take it easy for one to two days then try again at the same, or at a slightly lighter intensity.
“If you’ve got back pain, start doing things that create a bit of pain, slowly and gently. We know it’s safe to do so, now we have to convince you and that protective pain system of that.
“Overtime, your body and brain may become desensitised to the pain. Again, it could take months, or years, that’s the difficult thing.”
10. Go to a therapist
“I am not a trained psychologist or therapist, everything I talk about is what I’ve learned over the years. If you’re really suffering mentally with your chronic pain, please go and talk to someone,” says Goodchild.