Chronic Pain... get your life back.

Pain is complex, there's way smarter people than me out there debating the pathways and biological processes involved. And even they can't agree. But you don't need to know how a car works to drive one. So, this post is not going to even try attempt to simplify the mechanisms behind pain. Instead, I'm going to share a few home truths about dealing with pain that hopefully reach whoever needs to hear this. I'm not offering a magic cure, but even a 20%, 30%... increase in quality of life is surely a bonus.

Pain is our body's feedback loop to the brain. It alerts us when we hurt ourselves, giving us the chance to react, pull back, address the problem. Hopefully avoiding further damage. And when it's working perfectly, everything is hunky dory. But often it doesn't, especially in cases where someone has put up with (chronic) pain for months or years.

In some cases, the injury itself has long healed, but the signals keep coming. Over time the brain, spinal cord and the injured tissues/cells themselves become so sensitive that even just the perceived threat of harm sends a pain signal. As a result, this long-suffering person becomes over reactive to receiving these pain signals, driven by fear they avoid these movements or activities all together. They have lost confidence in their body to move.

And of course, if you don't move, you get weaker/stiffer, exacerbating the situation. Increasing your sensitivity to pain. Somehow, we have to break this vicious cycle. Now before you barrage me with hate mail, i know it's not going to be easy, but what do you have to lose? You are already missing out on the activities you wish you could do. The answer: Baby steps.

Your body is more resilient than you now think. It is incredibly adaptive if we give it time, the right stimulus and the right environment to rebuild. But you have to put the work in and be patient.

It won't be completely pain free, rehab never is. That is the key to overcoming your fear. The fear that pain always means damage. Overcome the belief it will never get better. You are injured, so there will be some pain, but that's okay. As long as the movement is controlled, the pain is manageable, ie 3-4/10 during/afterwards/next morning and isn't gradually worsening, it's ok. Again, we are trying to build confidence in your body. And desensitize those perceived pain signals.

Start small, slow, gentle, brief. Ever so gradually, expose your body to movements you wish you could do. Do isometrics, find the safe range your injured joint can tolerate.

Movement is medicine. Lotion for your joints. It gets your heart pumping, blood flowing. Blood flowing to the area, to bring in good stuff and flush out bad stuff.

The longer you have suffered, the longer you have rested/avoided that movement, the longer the rehab will take. But start today and get moving. Walk, swim, bike, gym, yoga, aqua class, whatever you can tolerate. Do ten minutes in the garden, it's a start. Even if you aren't targeting the injured area straight up, just getting moving will build momentum and improve your health whilst you introduce targeted specific exercises.

Adopt a healthy lifestyle! A good diet, quality sleep, fresh air, sunshine, social interaction, hobbies, purpose.... Patients so often declare how desperate they are to regain some quality of life, with real emotion in their voice. Yet their daily habits don't reflect this desire. Eating highly processed junk food, smoking, alcohol, stress, a sedentary lifestyle does not do you any favors, in fact it heightens your pain levels. Poor lifestyle choices create chronic inflammation and an environment not ideal for healing. You face an uphill battle, hence you need to do everything you can.

Expect the odd flare up, that's okay. Back off a touch, settle it and rebuild again. Don't entertain the thought that a slight set back equates to severe damage.

Pain is a poor measure of improvement, especially early on. Get moving with safe exercises, focusing on small improvements in distance or time or range or weight. If you can double the distance you walked with the same level of pain, surely that is a win. Over time the pain will decrease as the movement works its magic.

Try activities you enjoy, it helps motivation. The initial phase is the hardest, but seeing your quality of life improve, getting back out there in the world positively impacts your pain levels, decreasing them. Keep busy, distractions lower our pain levels. Hobbies, social activities, meaningful projects. Listen to music. Walk with a friend. Take the focus off those exaggerated pain signals.

As you improve, keep gradually increasing your exposure to these challenging activities. Introduce new desired activities. Progress via increased time or distance, greater range of motion, faster tempo, heavier weights, more complex movements, .... Or just do more of what you love.

Work on developing a morning routine that works for you. Loosens up your stiff achy body. Movement, breathing, heat, gels. Use necessary braces, splints, orthoses, footwear, whatever aids get you moving. (Ignore the theory that braces/orthoses make you weaker, if they get you moving they served their purpose. We can wean you off them later). Avoid prolonged postures throughout the day, even if you need to set an alarm every few hours to remind you to get up off the couch or office chair and move.

Patience is key, it won't happen overnight. But as everything adds up, as you move more, you create a snowball effect. Your confidence to move will improve, your self-esteem will grow. You will become more social again. All these things have a positive effect on pain. You may never get back to full function again, but any improvement is worth the effort.

Try limit the long-term reliance on ice, anti-inflamatories, pain killers, Cortisone injections, etc.... They may offer short term immediate relief but can actually hamper the body's healing process.

Note: of course, if in doubt get checked over by a proper medical professional to rule out serious damage. Confused what exercises are safe or what muscles to strengthen, I advise seeing a qualified health professional.

A note on Scans: whilst Xrays, Ultrasounds or MRI's are helpful for diagnosis, we do have to be wary of focusing on 'scary' terms. Reading terms like 'degenerative' or 'tear' or 'arthritis' can cause irreparable damage to your confidence, sometimes more detrimental than the actual injury itself. And it doesn't necessarily mean the tear is the cause of your pain. You may have had it for years. Plenty of people have degenerative discs, torn menisci, tendinopathy signs without ever being away of the structural injury.

Again, seek professional advice. Google and Instagram have their place, but they give generic advice. You need a specific plan for your individual situation (injury, circumstances). Especially be wary of anyone who puts a video on Instagram promising one stretch or one exercise will resolve all knee pain, or all back pain. It's never that simple.

Good luck, see you out there.