Practical Tips for Managing a Chronic Pain Flare-up

What you Weren't Taught About Chronic Pain

Pain is a bio-psycho-social phenomenon, meaning that we need to target all 3 in order

to recover from chronic pain. Modern medicine has taught us to view the mental and physical health as two separate things, but this does not match the biological reality of how the nervous system, pain, and the brain are all intertwined. While this does NOT mean the pain is "all in your head," the solution is likely not going to be solely in addressing the body either.

Therapy can be greatly beneficial for chronic pain and chronic illness by working through unprocessed trauma, regulating the nervous system, and working towards living a life that feels more meaningful. While I completely support getting a medical workup with your doctor, the brain science proves that this alone may not be enough for healing chronic pain. Your mental health matters!

Trauma and Chronic Pain

Did you know that about 80% of people with chronic illness have also suffered from past trauma? This isn't a coincidence. The same regions of the brain (i.e. amygdala and limbic system) that react to trauma and stress are also heavily involved in emotions and pain. This means that pain, trauma, and emotions are highly connected.

When people have lived through trauma, they typically become more hyper-vigilant, or on edge as a nervous system response to protect them. Although this is an entirely unconscious mechanism, it means that we also are more likely to perceive neutral bodily sensations as dangerous, and fire off a false alarm. Chronic pain and other chronic health symptoms become that false alarm, and can become perceived as more painful over time, even after the initial injury has healed.

How to Rewire your Brain in Response to Pain symptoms

Now that we are aware of the role of trauma and emotions in the processing of pain, the next step is to build a coping plan for when symptoms arise. Again, this might look different for each individual, but here are some ideas that help many of my clients:

Step #1: Create a Pain Coping Toolbox

• Paced breathing : inhale for 4 counts, hold for 4, exhale for 8. Repeat for

  3 minutes

• 5 senses: Notice how you experience each of the senses. What do you see? Smell? Feel?

• Temperature: Changing your state through heat or cold exposure. Take a warm bath, use a heating pad, or splash cold water on your face

• Positive Coping Mantras:

  • Instead of panicking --> "I don't need to respond with fear to my symptoms"

  • Instead of catastrophizing --> "I thank my fear for trying to protect me, but I no longer need to think of every worst case scenario."

  • Instead of self-blame --> "I allow myself to be present with my pain without adding unhelpful interpretations to it."

  • Instead of Googling symptoms --> "I allow my symptoms to come and go. This too shall pass."

Step #2: Take action!

• Take one small step: Find a small way you can take action by sitting

  outside, taking a shower, or walk to the kitchen for a glass of water

• Connection: When the urge is to hide away, instead try to move towards social connection. E.g. Try just texting one person back

• Self care!! Arguably the most important tools. Making sure your basic needs are being met such as:

  • getting enough sleep

  • eating nutritious meals

  • drinking water

  • limiting social media, etc.

Step #3: "Befriend" the Pain

I know for people with chronic pain & chronic illness that the idea of “Befriending” the pain sounds ridiculous and even scary. After all, the symptoms have tortured you for so long, how could you possibly learn to practice compassion towards them?

The reality of pain (and all symptoms) is, that our body is only trying to keep us safe from harm. Pain developed through evolution to be an alarm system to make sure we seek help and get an injury taken care of. Seeing it as a protective mechanism is key to this process.

• Give the pain a name! Naming it something like “Pain voice”

  helps to remove ourselves from the pain, and all the fear that comes with it

• Sit with the pain: Rather than fighting against it (which only makes it worse), spend a few moments noticing the pain without judgment

  Be curious: Ask the pain “What message are you trying to send me?”

• Talk to it kindly: Tell the pain voice “I know you’re trying to protect me, but we are safe now.”

Open to learning more and making a personalized pain plan? Book an intro call with me today!