Coping With Chronic Pain

Chronic pain is like another person living in your house, and that other person is not a cheerful, active, motherly type who scurries around getting you tea and washing your underwear. Pain is more like a grumpy, scolding old man who never wants to talk about anything but his own problems, whining for you to clip his toenails and shouting for you to empty his bed pan. It takes a lot of emotional energy just to meet his needs without having your own tantrum, let alone get a good night’s sleep, be kind to your spouse or accomplish some of your other goals in life.

This is the last in a series of blogs about chronic pain, and having had a hip replacement this fall, I was reminded about the practical nature of struggling well with constant discomfort. In this piece I want to offer some strategies that have been helpful to me, and I hope you will share your own tips. Everybody is unique, and every situation is, too, so it pays to have a lot of ideas in your toolbox when you are hurting.

1.  Know yourself. No one else can ever experience what you experience or cope the same way you do. Not even doctors or therapists know your inner world, so it is imperative that you know yourself.

  • Learn to use a pain scale. This is for you and also for your doctors.  You can use a standard scale like this one, but I prefer to make my own. For example, I know that my pain is about a 6 when I can’t sleep through it. It’s an 8 when I start screeching and gasping. But those things may not be an accurate measure of your pain at all. Use the same scale every time for consistency. A pain scale can help you plan your activity level, gauge your need for medication or note changes in your condition.
  • Separate your poor coping from your healthy coping. We all develop coping mechanisms over time when dealing with chronic pain. You may not even be aware of yours, so take some time to observe and catalog them. What is healthy coping for some (distractions like computer games, for example) may be addictions or unhealthy escapes for others. I like my clients to develop a list of ten things that, at least sometimes, help them cope in a positive manner.
  • Consider your unique circumstances. Pain isn’t your only struggle in life. If you have an unhappy marriage, a sick child, a stressful job, a mountain of debt, etc. your inner resources are stretched thinner than the next person’s. It’s too easy to compare yourself to someone who manages “better” than you do, who does more or talks less about it. Give yourself some grace. What is normal and what is possible for you will never be exactly the same as anyone else, because no one else is you, living your life.

2.  Be the best you can be.

  • Pain shapes you. It’s easy to see this as a negative, but it doesn’t have to be.  Pain can help you become a more compassionate, more patient, more spiritual person. Being your best is a conscious decision, discovering what you can do at your best and what you need to avoid to be your best. It’s deciding what to share with whom and where you can give back using your unique gifts. Again, it’s not about comparing but about living the life you’ve been given in the best possible way. Decide to do it well.
  • Your pain can make you stronger or weaker. You can be an agent rather than a victim in your own life. The pain doesn’t control you; the pain doesn’t make your decisions; you do. Pain itself isn’t weakness. How you handle it can be weakness or strength. Keep reading.

3.  Emphasize emotional well-being.

  • Sometimes it’s a trade-off with physical well-being. People will ask you to do things, even expect you to do things, that are going to make you hurt later. Make good decisions based on your own experience.  After breaking my foot doing something I knew I shouldn’t be doing, I have more freedom to say no to some things. Don’t wait till you break a bone to start saying no! If you want to pick some activities that are good for your emotional well-being (like a trip to the mall you know will exhaust you), plan for the aftermath and limit the activity with time-constraints or mobility aids or accountability with others.
  • Loving well depends on your heart, not your body. The most important thing in God’s Kingdom is not activity or knowledge or competence. It is love. And love doesn’t depend on your physical ability. Your emotional well-being and your mark on the world are both enhanced by the ways you give and share love. Get creative. Share your words, your prayers, your art, your encouragement, your joy, your life-lessons, your affection.
  • Self-care. Your emotional well-being is no one’s responsibility but yours. Others can help, and you can ask for what you need, but you are the only one who can provide rest, treatment, stimulation, distraction, etc. at the right time in the way that you really need it. Sometimes people feel that self-care is selfish. It’s not. No one feels loved by you when you are stressed, resentful, complaining or frustrated. Self-care helps you love the people around you well. Make a list of things you need to be doing regularly (see below) and practice those things.

4.  What can I do, practically?

  • Find opportunities for worship. Pain IS an opportunity for worship. Jesus suffered terrible pain for me – I can just begin to understand some of that through my own pain.
  • Pray. Make your pain a subject of prayer. Less pain, more energy, but also God’s work through pain. Pick one person who is willing to pray for you that you can share with. Pray for the pain of others.  Keep a list or journal.
  • Keep doing. Make plans. Volunteer. Get out there every day you can – even when you don’t want to.
  • Watch your attitude. Be honest with some, especially those who will pray, but don’t let complaint become your defining characteristic. If it’s always coming out of your mouth, then it’s also living in your heart. That’s not good for you or your relationships.
  • Take your medicationMedication adherence is poor in people with chronic conditions. There are many possible bad outcomes from not taking the medications you’ve been given in the way you are supposed to, including over-medication, inconsistent pain control and mistaken assumptions on the part of your medical providers. Be honest with your physician about how you are taking your medications so she can adjust them in ways that are helpful.
  • Explore. Don’t give up. Try new medications when recommended, look at alternative therapies like massage, ice/heat, PT, acupuncture, etc. Different things help different people.
  • Exercise. The rest of your body still needs it, and some types of pain will benefit, too. Try swimming, walking, stretching, yoga, biking, Tai Chi. I have an arm-cycle at home that I use when swimming isn’t an option.
  • Find a group. Any kind of group. You need community!
  • Discover your heroes. Read a biography or memoir dealing with something similar to your condition. Join (or start) a support group. Find someone locally or online who is just ahead of you on the road.
  • Find creative ways to express your pain. Art therapy, journaling, writing a biography or blog…
  • Look out for depression. Depression and pain are comorbid. There are multiple reasons for that. If you are not sure whether you might be depressed, take a test or ask people who know you well. If you are experiencing both, be sure you are treating both. 
  • Try counseling. Find a counselor who knows about chronic pain (but not one who is a know-it-all). You need at least one place where you can talk honestly about your struggles and learn a few new coping strategies.

Your pain isn’t really a grumpy old man living in your house; it’s a part of the life God gave you. God knew everything about you before you were born, and He chose to allow you to walk this road. Everybody has their own kind of pain, but you have this. It is shaping you one way or another, and God’s purpose is always to create beauty. You don’t have a choice about whether you struggle. You only have a choice about whether you do it alone or in company with the One who knows and loves you best. Now for a little while … you have been distressed by various trials, so that the proof of your faith, being more precious than gold which is perishable, even though tested by fire, may be found to result in praise and glory and honor at the revelation of Jesus Christ. (I Peter 1:6-7)

Living with Chronic Pain


John Kennedy. Renoir. Benjamin Franklin. Lucille Ball. Herod the Great. These are just a few of the individuals throughout history who have suffered great pain (some of them coped better than others). Even today, pain affects more people than diabetes, heart disease and cancer combined, and chronic pain is the leading cause of long-term disability in the U.S., affecting one out of every four Americans. I am one of those people, having experienced some degree of pain from the time I was twenty-two. Physical suffering is also a spiritual and a psychological issue, famous for making people ‘stronger,’ and famous, too, for destroying lives. The next few blog posts will feature some reflections on pain and some practical suggestions for living with it. I would love to have your feedback and ideas along the way, especially if this is a problem you face.

Let’s start with some medical and theological basics.

The presence of all kinds of pain is a direct result of the fall. Both Adam and Eve are condemned to suffer pain (See Gen. 3:16, 17), which is probably a sign that all of us will struggle with some form of pain in our lives. It will be our curse until the day all tears cease (Rev. 21:4). We can find examples of pain throughout the Bible, particularly in the books of Job and Jeremiah. Psalms and the letters of Paul speak of pain, too, but they largely refer to emotional pain. Surprisingly, science has begun to show that emotional and physical pain are intimately related, sharing the same area of the brain. (As a result, acetaminophen can actually help relieve sadness!) Physical pain often causes emotional pain, and it can work in the reverse, too. So, it seems likely that many of our ideas about pain can apply to either variety.

Pain is not a punishment. At least, not for those in Christ. Pain is a result of the sin which caused the fall, and that sin belongs to all of us. But what has been decreed as punishment for all has been redeemed for some. There is therefore now no condemnation for those who are in Christ Jesus (Rom. 8:1). Sin does have consequences, and we sometimes, though rarely, suffer pain because of our specific sins, but God promises to transform all our pain into something good for us (Rom. 8:28). Punishment comes from anger and says, “I will make you pay.” Discipline comes from love and says, “I will make you beautiful.”

Pain has good purposes. Fire burns, tigers bite and men bleed. Pain is the body’s early warning system, the physical alarm to wake us from carelessness, and woe to those few who cannot feel it. I am alive because a small, troubling pain in one knee alerted my doctors to the presence of cancer while it was still treatable. Pain has been the motivation for the development of many curative medications and procedures, and pain also helps us grow. Without wishing suffering on anyone, it is generally true that the wisest, strongest, most patient people we know are some of those who have suffered. For example, the bravest person I know is someone who faces down many kinds of suffering every day. Pain holds the potential to teach us much about dependence, humility and strength in weakness; it can be a useful tool in the hands of a master carver who is in the business of sculpting beauty from ashes (Is. 61:3, Jer. 18:4-6). We tend to think the breeding ground for discontent is hardship, and pain, but it may actually be a comfortable life.

The same degree of pain can seem to be worse depending on its cause. Pain can feel more severe and be harder to bear when it is maliciously inflicted. Which could you tolerate more easily – receiving a life-saving vaccine or being deliberately stabbed with a large pin by a spiteful sibling? Unexpected pain can be worse than expected or chronic pain. Doctors know that it is important to give patients a realistic description of pain following surgery in order to increase their pain tolerance. Pain is also more debilitating when we do not know its source; it becomes a focus of worry, and we find ourselves sensitively attuned to the slightest changes.

Pain can turn us TOWARD God or AWAY from Him. Contributing to our discomfort is the modern, Western entitlement to physical well-being. When we assume we shouldn’t have pain (physical or emotional), pain becomes a place of frustration and anger. The story of the Bible calls us each to follow Christ in our own way, to enter “the fellowship of His sufferings” according to that which is given us. Christ has shown us how to bear great pain and has promised to be with us in all circumstances so that our suffering can draw us closer to Him in intimate relationship. When the pain has chased away every other succor from our conscious existence, then it has driven us straight to the cross. In my very real experience, God is the only thing which can co-exist with overwhelming pain because He is indeed everywhere and in everything, having overcome every tribulation of the world by His own suffering (John 16:33).

If Christ is our example, then pain is to be born in humility rather than anger or entitlement. Certainly, we should seek out the remedies available to us, but when God has not made an effective therapy available, we must look differently at the life He has given us. Where are the opportunities for grace? Where can we find wisdom, strength and love in a different degree than we might know without our pain? Where is there room for service, worship and the gifts of the Spirit inside the circumstances we would shed in a heartbeat?

We do not have a choice about struggling in this life. The thing we do here which cannot be done in Heaven is struggle, so it must be that we need it. We will all suffer in various ways, and we cannot choose to avoid all of it. We can only choose whether we do it with God as Great Physician, Friend and Comforter – or without Him.


The box quotes throughout this post have been contributed by real sufferers. Please contribute your own thoughts and ideas, especially if you live with chronic pain, by clicking the “Reply” link at the top of the page or the “Comment” box at the bottom.

Next blog in series

I Will Not Forget You

The following post is a letter to my children which I have included with my will and other end-of-life information.


Elderly manLong after Alzheimer’s disease ravaged my grandfather’s confidence, his humor and his past, it finally drained his body of breath and life. Once he died, his wife began the same, slow descent, and I went to her, hoping to comfort her with Christ while she still knew me. However, in human terms, it was already too late; a sweet, vacant smile was her only response to love or logic. So I left her with a Bible, which has now come back to me, unmarked and unruffled, and she left me with a new struggle of my own. Can God’s word sustain those who are beyond words? Does His Spirit indwell those whose spirits are vanishing? Because I became a Christian as an adult, the specter of returning to childhood, of forgetting the best news I ever heard, weighs heavy on my mind. There are a thousand losses in that possible future.

 

Yet, if I should experience the slow, sad leave-taking which is Alzheimer’s, I would not wish anyone to grieve over-much for my sake. Whatever else it may be, the disease is surely a metaphor.  It leaves behind what cannot be taken forward. As perception, kindness, the fruits of faith, a loving heart and the twinkle of an eye fade from our sight, they cannot be lost. Those are the elements of a child of God which will never be lost but will be infinitely improved. Just out of sight, those pieces wait for the final exhalation of the last remnant of a soul which has been yearning toward God all along. We will all leave behind a dry husk of flesh and sin, a seed “sown in dishonor.” It is no necessary thing for us. A thousand years from now, will it matter if I shed my skin more slowly than you shed yours?

 

Psalm 139 speaks eloquently of the omnipresence of God not only in the world, but in all the days of our lives which are ordained and written in His book. Are some of the pages blank?  If they are, it must be those pages that I have wasted on myself, taken hold of and shared with no one, refusing the difficult prose of God. Those are the meaningless pages, the ones that will burn in the fire of salvation. The pages which God alone has written with His own finger, like those days in my mother’s womb, those nights of mysterious slumber, those years which may be lost in confusion or delirium, must not be waste. The script on those pages is gibberish and foolishness to the wisdom of this world, but waits like mirror-writing to be revealed in the perfect light of grace. He who is familiar with my going out and my lying down will write on all the pages just as He wishes until that glorious morning when I arise to His call and behold the glory of His face. (Ps 17:15)

 

I do not wish to forget my children or my parents or my husband. I do not wish to drop my sword while still on the field of battle. But I will be yielded to His will and used to His purpose. And even if I forget God, He will not forget me. Having forgotten that there is hope or life or a beautiful God, I will still wake one day to the most breathtaking of all surprises: to hope and to life and to my beautiful God.

 


Can a mother forget the baby at her breast and have no compassion on the child she has borne? Though she may forget, I will not forget you!  See, I have engraved you on the palms of my hands. Isa 49:15-16