My 5 top tips for reducing chronic pain
By Fiona Symington
Chronic pain is said to affect 50 million people in the United States and cost the economy somewhere around $635 billion per year. Meanwhile, in the UK, about 5.5 million people live with chronic pain, and the economy suffers to the tune of around £10 billion per year.
Chronic pain: once you have it, you’re stuck with it.
It is something to be managed, to work around. To suffer.
This is what most people are taught and most people living with it believe.
I have personal experience of chronic pain. A horse-riding accident at the age of 10 left me with first knee, then back and then hip pain. Doctors tried repeatedly to help me but got nowhere.
My pain persisted and by the time I reached adulthood, I had tried multiple different treatments and had gained a long list of diagnoses from Ehlers-Danlos Syndrome and Reflex Sympathetic Dystrophy to Chronic Pain Syndrome and Fibromyalgia. Weakness and severe pain affected everywhere from my ankles to my elbows, my lower back and my neck to my sternum. I was using a wheelchair outside of the house and struggled to get around indoors on bad days. Most of my life was spent lying in bed.
Pain was an invisible enemy I had to consider before anything else in life and something I hated bitterly. I lost hope that I would ever be free of it.
But these days, I am completely pain-free.
I have been that way for five years.
I enjoy hiking, dancing and cycling. I have returned to horse-riding. I’ve gone sailing, ice skating and rock climbing. I have moved from being unable to work at all to working full-time. I take no pain medication and doctor visits are a thing of the past.
My recovery is thanks to the latest pain science.
These days, I share my recovery story via podcasts, YouTube videos and by giving talks. I am proud to say I have reached around 100k people through these activities. I have also completed an MSc in Health Psychology so as to more fully understand my recovery journey and use this understanding to help others find relief.
I share my story because the science that helped me is also helping many others and I believe everyone deserves a chance to know about it.
Everyone deserves the chance to reduce or eliminate their pain.
These are my top 5 tips to change your pain:
1. Understand that the brain creates pain to alert us to danger, but that pain is just the brain’s opinion. The brain sometimes gets things wrong
I used to believe that having pain meant that something in my body was injured or damaged.
It was sensible to think that because that’s what we’re taught. If your ankle hurts, it could be because it’s sprained or broken. If your head is thumping, perhaps you have eye strain or, in an extreme case, a brain tumour.
The first lesson I learnt on my recovery journey was that while pain is our brain’s way of telling us that something is wrong, brains can actually make the wrong judgement.
In my case, my body healed after I fell off the horse but my brain still felt the need to warn me that I wasn’t ok.
Why might it have done that? When I look at that period of my life, our family had recently lost a grandparent, one of my parents had been made redundant and I had just moved both home and school, among other things. When I had the riding accident, it was the last straw. My brain was trying to say to me ‘I don’t feel ok.’
A huge body of research has shown that pain is far more likely to develop and stick around if you have experienced trauma in childhood. By the time I had my accident, I had already experienced a series of other difficulties in my life. A very real physical process started in my brain and body to create my pain. This is a process that is a normal part of being human and which exists to help us take action to make ourselves safe. It is not under our control and it isn’t our fault.
“Once you’re sensitised, the threat doesn’t have to be about your body part. It just has to be a threat to you as a person’ Lorimer Moseley — Australian pain scientist
When scans were clear and medications didn’t help, I was accused by the doctors and teachers of making my pain up or exaggerating it because I wanted attention. But the pain was not only real, at times it was so bad I felt desperate.
“It’s all in your mind” is almost insulting, implying there is something strange or weak about you or that symptoms are in your imagination. This is most unfortunate, since the symptoms are very real, the result of a very physical process. — Dr John E. Sarno, ‘The Divided Mind’
If your pain has settled in for the long term, it might be that your brain and nervous system is also producing pain when it no longer needs to.
But what can we do about this?
2. Learning to feel safe can calm pain down
Once you understand that pain can simply be a primitive part of your brain saying ‘I’m not ok,’ taking steps to feel safe can calm the pain down.
What does feeling safe mean?
Safety means different things to different people. Perhaps you need to develop simple phrases to remind and reassure your brain that your injury has passed. In my case, I learnt to tell myself that my injury was in the past and I no longer had swelling. I would move my body and show myself that nothing was actually broken. My doctors had also reassured me that I was safe to move. Reflecting on things like this every time pain flares up can help re-educate the brain.
Safety can also come from changing your environment.
My recovery involved me asked myself whether my relationships were physically and emotionally safe. Some people might need to ask themselves if their job is manageable or whether they need help with debt. The question to start with is, ‘what might need to happen for your brain to stop asking for help?’
How safe we feel can be linked to our childhood
Perhaps, too, you never experienced feeling safe as a child. You might not be in any danger now, but you might need to learn how to feel safe for the first time ever in your body. Breathing exercises, meditation or therapy are all things that could help you learn how to take care of yourself. For me, mindfulness, walking in nature and even wild swimming have taught me my nervous system to find calm, meaning my brain no longer needs to resort to turning up any pain signals.
If I do ever get twinges of pain these days, I look inwards.
What is going on in my life or my thoughts that could be my brain saying ‘help?’
3. Social connection promotes healing
Research has explored the difference that relationships make to pain. The findings have repeatedly shown that spending time with other people and building rich connections helps to ease our pain.
Pain often forces us to isolate ourselves.
In my case, my pain often eased when I rested. Dropping out of school to stay in bed turned into falling behind with my work and losing confidence in my friendships. When I was an adult, I had times when I would start studying or volunteering but soon enough a bad day would make me stop what I was doing. The bad days would turn into weeks and then months and sometimes I wouldn’t talk to anyone or see anyone outside of my parents for long stretches of time. I would dread going back to pushing myself because I knew the pain would increase again.
My pain was severe. There were danger signals coming from every direction.
In fact, if you live with pain, it is crucial to plan things that will regularly get you out the house and most importantly, around other people. Many areas these days have groups that will soon help you make friends if your pain has left you isolated.
Personally, I went to a ‘knit and natter’ type group where I knew I could leave early if I wasn’t coping and where I could start a conversation about what I was crocheting if any social anxiety kicked in. And in those groups I found other people who lived with pain but who were also keen to build new friendships and have some fun.
If you check in with yourself, spending an hour or two talking or laughing with people about anything other than pain is likely to make you realise that not only have you not thought about pain in that time, you also haven’t felt it. This is not because you are faking your pain or that it isn’t real. It is due to the fact that your brain has had some time feeling safer and so in that moment, doesn’t need to alert you to any danger.
“You may think that you’ll be able to enjoy things more when the pain goes away. But the irony is, when you’re able to enjoy things more, that’s when the pain goes away.” Professor Alan Gordon, ‘The Way Out’
4. Understanding your emotions can help reduce your pain
It is common for people who live with pain to end up feeling depressed and anxious.
This is a natural response to the huge challenge of living with pain. If you deal with these issues, it is important to have compassion for yourself.
It helps to go further than being kind to ourselves, however. It’s also worth giving some thought to the messages you got about your feelings when you were growing up and how you deal with them now.
Perhaps your parents struggled to deal with their negative feelings like anger, worry and shame? Perhaps they didn’t teach you how to deal with them. By not actually sitting with, and feeling our feelings, the brain can end up producing more pain.
Your job now is to show your brain that emotions are safe to experience.
I grew up thinking I was in touch with my own feelings but my recovery has shown me otherwise. As a child who, in fact, didn’t know how to safely feel things like fear and anger, I ended up in pain but then I also had to deal with the difficult feelings that came from living with pain. The pain snowballed the more I pushed them away.
Recovery has involved taking time to regularly tune into my body and see what feelings I might have missed. Perhaps a conversation has triggered a small flash of fear that has got buried in a busy day. I attend to that now by letting the feeling sit there while I go through steps to reassure myself.
If you do this, your brain will learn to send out fewer pain signals over time.
“All emotions are safe” — Professor Alan Gordon, ‘The Way Out’
There are many different ways of coping with our feelings, if you don’t know where to start.
Some people find journalling helpful. Evidence suggests that writing our feelings down helps us to process them. Others find talking to a therapist or a trusted friend helpful. Acting as a parent to ourselves and repeating words that we are safe and that we are going to be ok can also be soothing. The important thing is finding something that works for you.
5. Repetition is key
Because chronic pain is often a brain issue rather than due to structural abnormality, recovery involves work that retrains our brain.
Research into neuroplasticity tells us that new habits are formed by repeating them every day and recovery is helping our brain form a new habit of not being in pain.
If you want to see changes, you need to work a little every day on teaching your brain to calm down.
That might mean taking all the tips above and repeating them. It might mean telling your brain every single day that it is safe. It might mean journalling or meditating in bitesize sessions. For me it meant finding ways to connect with others and laugh every day.
Being perfect at repeating these exercises isn’t necessary — small changes soon add up. Busy days or setbacks where your pain flares and you struggle to work out what your brain needs some help with are common.
The important thing is to keep trying.
In my case, putting the work in soon meant my severe pain dwindled to nothing.
It meant being free to start walking again. It meant starting to build up some basic fitness, and doing the exhilerating thing of digging a bike out of the shed that I’d last ridden at the age of 10 and realising I was free to ride it. It has meant holidays and adventures and new friendships and opportunities.
My recovery was worth every bit of work I put in.
It has led to a life that is pain-free.
And the changes I have seen have been permanent.
Want to learn more about how I recovered from 25 years of chronic symptoms? Follow me on Twitter @Fionas_Story
Advice in this article is provided from the point of view of having lived experience of chronic pain and recovery. Readers should always consult their physician when making decisions about their healthcare.