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Coping With Chronic Back Pain
Coping With Chronic Back Pain
By Brennan Howe
There is not a single definition of pain that is appropriate for
everybody because it is a highly subjective experience. What,
to another person, is excruciating may be nothing more that a slight
discomfort for you. Not only do views of pain vary among
individuals, your own perception of it can change over time.
Even when you do have a clear perception of what pain means to you,
there is not an objective way to measure it you can use to convey
your impressions to somebody else. It is not unusual for
patients in a doctor’s office, who have come in because pain is
severely impairing their day-to-day lives, to have great difficulty
describing it clearly.
One thing we do know, however, is the difference between when we are
hurting and when we are not. In the case of acute pain, you
may cry out from it and experience terrible suffering for a time,
but it ends eventually, and usually the sufferer returns to their
normal activities and way of life. Chronic pain is different.
A sufferer of chronic pain not only hurts, but they keep on hurting.
Indeed, the psychological impact of chronic pain can be worse than
the physical sensation itself, especially when the daily grind of it
wears you down and turns the world grim. Acute pain usually
does not change one’s personality. Chronic pain, if not addressed
properly, can alter it drastically.
Chronic pain may have a physical basis, a psychological basis, or
some mix of the two. Maybe it comes from an injury.
Maybe it comes from stress. Maybe the two factors are
interconnected. People who cannot pinpoint a clear physical
connection often say, or are told, that it is “all in their heads.”
But that is not how it feels. Chronic caused by
stress can hurt just as badly as chronic pain that resulted from
falling off of a roof.
It has been estimated that over 34 million Americans suffer from
chronic pain, be it from arthritis, migraine headaches or their
backs (with lower being the most common). 15 million
people experience chronic pain at work on a daily basis. So if
you are a sufferer of chronic pain you are not alone – though it can
certainly feel that way.
What Can You Do About It?
To begin with, you must make sure clear lines of communication have
been established with you physician(s) and any other health care
providers being seen for chronic back pain. Do not just assume
it is your cross to bear and suffer in silence. Though it is
true that the majority of in general is not symptomatic of
serious illness, do not assume you are therefore free from all risk.
There have been cases of people whose backs’ hurt persistently and
they just mistook it for a fact of life and went on the best they
could, only to discover that “bad back” was really a sign of
something much worse, like cancer or otherwise damaged internal
organs.
In order to facilitate communication to a health care professional
it is a good idea to spell out some specific things to yourself
first as a means of organizing your thoughts and presentation.
For example, asking yourself and answering the following questions
can go a long way toward clarifying what you are experiencing:
How bad, on a scale of 1 – 10 is my pain?
How long have I had this pain?
What words can be used to describe it (tearing, burning, throbbing,
etc.)?
What could have caused my pain? Is there an injury, psychologically
stressful event, or activity I can link to its onset?
Are there any other health problems I am having?
In addition to pain medication, what other medicines am I taking?
What kinds of things have I done to try alleviating the pain? Have
any helped, even some?
Both emotionally and physically, how has pain affected my daily
life, be it at work or at home?
The questions do not have to end with the examples above, of course,
and asking a few may help you zero in on more specific inquiries –
just as the information provided will help your physician to get a
clearer picture of what is happening with you. Once the
chronic pain is described, a variety of approaches, alone or in
combination, are available to treat it.
Medications
A wide range of drugs are available for the treatment of chronic
pain. Most commonly used are aspirin, acetaminophen, and the
anti-inflammatory drugs like ibuprofen. Then there are the
more powerful narcotic analgesics, such as morphine
and codeine.
People respond to these differently and there is no one medication
that is right for everybody. Only a physician who knows your
medical history and what other medications you might be taking is
truly qualified to make the best recommendation for you. And,
after beginning to take one, it is important to keep your physician
updated on their effectiveness, not only if they are working or not,
but also about any side effects you might experience.
Do not fall into the trap of thinking that a lack of effectiveness
or the experience of side effects are things that must be tolerated
without question. Many different drugs are available and
improvements in pharmacology bring us more and better alternatives
as time goes one. Regular contact with a physician is necessary to
make sure the course of medication one is on is indeed the best
available.
Psychological Approaches
Psychological approaches are best for chronic pain where a specific
physical cause has not been identified or, when it has, is used in
conjunction with a sensible course of medical treatment. The
strategies used generally fall into four categories, with plenty of
room for overlap and the use of more than one technique at a time.
These categories are: relaxation, imagery, hypnosis, and
biofeedback. Though it is best to seek the advice of experts
to ascertain what, or what combination, is best for you, below are
examples of some things you can do on your own in the effort to cope
with chronic back pain.
Splitting: Separate your experience of pain from the pain
itself. If the pain is throbbing, for example, focus on the throb
and not the hurt. Another variation is to separate the painful
body part (your back) from the rest of your body.
Numbing: Imagine an injection of a powerful medicine that
numbs the area of your back that hurts.
Projection: Imagine yourself at a time in the past or future
where you are free of pain. A pain-free location, like a
favorite vacation spot, may also work.
Movement: Visualize the pain moving from your back to another
area of the body where it is easier to handle. An alternative
is to imagine it leaving your body and taking up residence somewhere
else, like the ground.
Be aware that psychological approaches are particularly helpful when
stress is suspected as the culprit in your experience of chronic
back pain. Our daily lives are constantly subject to stress,
be it from work, relationships, or simply new and different
experiences. People react to stress in different ways.
Some individuals feel tired, others get upset stomachs, and many of
us show our tension in the form of back pain. Instead of a
psychological technique that focuses on pain management, then, a
more sensible approach could be the identification and treatment of
the factors that cause you to experience stress.
A Physical Approach
Most chronic is the result of activities that have an
adverse effect, such as lifting heavy objects improperly or simply
sitting in a chair for long periods with bad posture. Changing
our habits, therefore, can have a significant impact. Below are some
of the most commonly advised physical measures to take. As
always, see a physician or other qualified professional for
assistance in deciding what is best for you.
Weight loss: approximately 67 percent of Americans are
overweight. These extra pounds put pressure on the back and
strain both back and abdominal muscles, which can weaken these
muscles and compound the problem.
Improve Posture: Bad posture means your body is out of
balance. When it comes to your back this means that only a small
number of muscles and joints are doing most of the work.
Proper posture will spread out the task and relieve the intense
pressure on small areas of the back.
Exercise: A good exercise program, designed by a
professional, will strengthen muscles in your back, keep them
limber, and increase endurance. Though our instincts may tell
us to rest until the pain passes, the proper exercise can be an
effective means of pain relief or reduction.
Movement: Simple measures, like using your leg strength,
instead of back muscles, to lift heavy objects can make a big
difference. Whether at work, home, or engaged in leisure
activities, be aware of how you can alter you movements to avoid
unnecessary stress on your back.
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