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 medication. Medication 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)