Every week in my work as a counselor, I have the opportunity to talk with people who experience chronic pain, with the goal of helping them reduce their reliance on opiates and manage their life in a more positive way. For myself, as I’ve moved into my 60’s, I have learned that I can do less than I used to and that I often pay a price in pain as a result of – for example — an adventure in the woods with my chainsaw. I’m sharing here some of the things that I’ve learned from patients, doctors, and research about how to effectively manage pain in our lives.
Of the many different types of pain, the two that I would like to address are acute vs. chronic. All pain begins as acute pain, with stimulation to the local tissue and a signal communicated to the brain. As pain becomes chronic, individual receptors lose their ability to be specific (resulting in the pain spreading over a larger area) and the messages from the brain intensify in order to demand a response (typically immobility and inaction). For example, when I hurt my knee, my brain decided that I should never use it again and therefore keep my leg safe. Obviously, that’s not a solution that I want to live with and I’m left with managing the pain messages.
I would like to offer several hopeful recommendations about how to manage these pain messages.
— Maintaining a positive attitude and perspective is important to coping and also reduces actual pain messages. Focusing on our loved ones, pets, and favorite activities often provides relief from pain. Clearly, if we dwell on how bad we feel, the bad feelings seem to intensify. It does work to distract ourselves with grandchildren and other joys available in our lives.
— We need to be careful of medicines we rely on to combat pain. Our newspapers have carried stories about opiates/narcotics and the kind of risk they represent to us all. We know that long-term use will reduce the effectiveness of relief, opening the door to increasingly higher doses. This pattern of use can lead to addiction or dependency. Painkillers do not really kill or cancel out the pain; they only reduce our awareness of it.
— We need to help our body cope and heal by maintaining positive expectations for all of our attempts to help ourselves. Truly believing that something will work or heal goes a very long way towards actual healing. This is not magical thinking. We can’t “wish” our way to overcoming a problem, however, we can help the body heal and help medicines work more effectively by believing and reducing our panic or distress.
— Pain management and treatment options are important conversations you need to have with your primary care physician. Don’t expect them to have a medicine bottle or another answer in the closet ready to pass over to you. Instead, go to that meeting prepared to talk about what things you can do to help the problem as well.
We at AMHC have developed a four session psycho-educational series, along with a workbook called “Pain on the Brain”, as a starting point to help address pain issues. For more information, ask your doctor or contact me at AMHC (667-6890) or Bucksport Regional Health Center (469-7371). Blue Hill Memorial Hospital also offers a pain management group. For information on the next scheduled group, contact Patty Bergstrom, LCSW, at 374-2311.
David M Harlan, LCSW, Therapist/ Consultant, Aroostook Mental Health Center.
Aroostook Mental Health Center is a partner in Thriving in Place Downeast, a community collaborative coordinated by Healthy Peninsula, that includes medical, social service and community-based organizations working to support seniors and people with chronic conditions to stay healthy at home for as long as possible.