Pain Management – All in the mind?

As I was listening to Radio 4 yesterday, my secret vice, the You and Yours discussion was around pain killer use. Everywhere I look at the moment there are pieces on the ‘Opiate Epidemic’ and ‘Pain killer addiction’. If you are interested in the discussions going on here are some good pieces at the end of this blog.

These pieces will talk about the science, the GP experience and personal experiences. Here I want to talk about my chronic pain, how I am now a pain manager and pain killer free, despite having several chronic pain conditions. What I have learnt managing my pain for the last 5 years and hope that it can give you hope, insight or a new approach to try.

A Brief History of Pain. Born with hip problems (CDH missed for 12 months causing muscle and ligament damage), I have experienced pain in my left hip my entire life. It has had peaks and troughs of pain occasionally leaving me on crutches, often leaving me reaching for pain relief. Soon opiates (Tramadol, codeine, morphine) were the pain relief of choice during flares. I managed the ‘normal pain’ through exercise and self-care.

Two pregnancies in two years (I fell pregnant again when my eldest was 5 months old) caused what can only be called a pain crisis for me. Crutches, wheelchairs, pain killers by the boat load. By the time my youngest was born I was on a regime of 2 x 500mg Naproxen a day, 8 x 30mg of codeine and 8 x 500mg of paracetamol. They barely touched the sides. The pain was now global. EVERYTHING hurt. I saw orthopaedic surgeons who found changes in my hip joints CAM impingement's, labral tears, bony changes and bursitis but not that would account for the agony I was experiencing despite the high pain relief regime I was on.

I was diagnosed with Fibromyalgia. I went to a clinic for 12 weeks on ‘how to manage my condition’. I had hydrotherapy. I took the tablets. I had physio. I took the tablets. I suffered fatigue, constipation, sluggishness, low mood, anxiety. I had come to define myself as a pain sufferer and stopped exercising, stopped doing the things I loved because it hurt. My pain ruled my life.

I no longer take pain killers. I still experience wide spread pain, I still have CAM impingement's and labral tears and wonky hips so what has changed:

I changed the label.

I saw myself as a pain sufferer, it was who I was. I had a chronic pain condition, or it had me. It defined my choices, my life. I am not a pain sufferer, I am a pain manager. I am in control of my pain, it can be there, but I can direct it, control it and live my life. Sound a bit far fetched? Being a sufferer implies that this is being done to you. The pain is happening as an external event that you have no control over, with no control you cannot turn it up or down. You are at it’s mercy, and as such feel powerless to do anything but ride the storms of pain flares and painkiller side effects. As a manager of your pain, you are exactly that, reclaiming control. It may not always do what you want it to, but you are in control of it, can implement strategies you know work, review when things aren’t going to plan and change tack. No one likes having no control over something being done to them. Taking control of your pain doesn’t mean it suddenly gets up and walks away, but you can manage it on your terms. It feels really empowering and that belief has drastically reduced my pain and improved my life.

I am kind to my body.

I know you’ve heard it all before, but it works. I do things that make my body feel good, exercise that works for me, I give it good food (and the occasional biscuit and vegan Magnum), I rest when I need to and I praise my body for what it does. I don’t berate it for what it cannot do. Like a good friend I big it up and tell it that it can achieve amazing things. Which it duly goes on and does. We become our internal dialogue, talk to yourself (and for that to your friends, children and passers by) like you are able to do anything and suddenly you will achieve amazing things.

I let go.

Like Elsa in her Ice Palace I belted it out of my system and ‘Let it Go’. For me it was the belief I was broken, malformed, defective and worthless. Those thoughts and beliefs trapped me in my pain, emotional and physical. It was really hard to let go. I didn’t really know how, I thought I had, but the beliefs returned. This is where the skill of Sarah and Trevor came into play. During my sessions they both pushed me towards what I needed to do to let go of the belief I was broken. This wasn’t an easy process or a magic ritual involving incantations and a special dance. I simply had to face up to my beliefs, challenge them and then really, truly Let It Go. I thought I had, able to say the right things, but the emotional feedback from Trevor ensured Sarah wasn’t fooled. I REALLY had to let go of that negative emotional energy and belief. Having tried many things I can honestly say since Trevor walked off with those negative beliefs when the voices pop up in my head they just disappear as if they have no power here. Having lived my life defined by these things this has been a profound, life altering change.

Pain is hard to live with, and sometimes harder to let go of. As pain suffers (not managers) we are questioned and react badly to the idea that the pain is all in our mind. It feels that it diminishes the very real suffering we are experiencing. The truth is, pain is in the mind. That does not stop the experience of it being excruciating. The nerves telling us where and what the pain is do so within our brain, and as such are ours to control. We can look at, let go of and move on from our pain. Emotional and physical. Changing the beliefs we hold about ourselves, our pain and our bodies can make lasting physical and emotional improvements. It may not be easy, but it is worth it.

I am a pain manager, rocking my body and walking into an exciting future ahead.

Want more information on pain management, pain relief and the power of the mind:

The You and Yours episode:

https://www.bbc.co.uk/programmes/m0003cz6

A BBC Report on the programme ‘Can my Brain cure my body?’:

https://www.bbc.co.uk/news/health-45721670

A Guardian article on the use of pain killers in managing Chronic Pain:

https://www.theguardian.com/commentisfree/2019/jan/21/opiods-chronic-pain-prescribe

For a more in depth (and more US-centric) piece on how we have arrived at a place where ineffective treatments are the norm for chronic pain this piece from Pharmaceutical Journal is balanced and well researched:

https://www.pharmaceutical-journal.com/opinion/comment/the-prescription-opioid-addiction-and-abuse-epidemic-how-it-happened-and-what-we-can-do-about-it/20068579.article?firstPass=false

(Please note the views in linked articles are those of the publications not Spirit and Soul. Spirit and Soul do not recommend making changes to prescription medication without the advice of your GP.)

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