Understanding persistent pain For patients, families and caregivers Read this brochure to learn more about: why you feel pain how pain works in your body ways to manage it Why do I feel pain? It s normal to have pain in the first days or weeks after an injury or health change. Pain is a healthy part of how your body protects you. It is there to get you to change what you do so that you stay safe. For many people, pain goes away slowly as their body heals. But, for many other people, pain can go on even after the usual healing time. Pain that lasts a long time is called persistent pain and there are many reasons why it can happen. Changes to the nervous system (brain, spinal cord, and nerves) are always involved. Please visit the UHN Patient Education website for more health information: www.uhnpatienteducation.ca 2016 University Health Network. All rights reserved. This information is to be used for informational purposes only and is not intended as a substitute for professional medical advice, diagnosis or treatment. Please consult your health care provider for advice about a specific medical condition. A single copy of these materials may be reprinted for non-commercial personal use only. Authors: Bronwen Moore, Cara Kircher, Bonnie Cai-Duarte, Sarah Sheffe and the LEAP Service Created: 10/2017 Form: D-8652
Am I alone? No. Lots of people live with pain. For example: Out of every 100 people, about 20 live with persistent pain. Out of every 100 people who have health problems that affect the nervous system, 40 85 people live with persistent pain. Am I just imagining my pain? No. You are the expert on how you feel. You are not causing the pain yourself. But, pain can affect how you think and feel. What you think and feel can also affect pain. This happens because everything we feel, including pain, is processed in the brain. Pain signals go to many parts of the brain, including the parts that make sense of what we think and feel. How does pain work? Pain signals go to many parts of the brain. Pain signals travel through your nerves, up your spinal cord, to many parts of your brain. Your brain decides what these signals mean. When some part of your nervous system is injured, it may send confusing messages to your brain. Your brain may interpret these as pain. For example: You may continue to feel pain even when there is no real danger. A change to one area of your nervous system can cause pain in a different part of your body. For example, a neck injury can cause arm pain. 2
How long will it last? It is hard to predict how long pain will last. This can be very frustrating! For many people, pain comes and goes. There are times when the pain is well managed but also times when the pain is stronger and calls for more care. There are things you can do to manage the pain you feel. Is taking medicine my only choice? No. Taking medicine can be helpful. But finding the right medicine to control your pain can take time and patience. There are many other things you can do to manage your pain yourself. What else can I do to manage my pain? There are many coping skills and lifestyle changes that can help you manage your pain. Here are a few of the most important ideas: Find ways to escape from the pain Soothe the pain with heat or cold. Find a comfortable position, and change positions often. Gently stretch and massage a tense area. Distract yourself with a hobby, game, music or book. Picture a safe and soothing scene in your mind (for example, a beach, or getting a massage). 3
Calm your mind and body Use techniques to help you relax such as deep breathing, body scan, or meditation. Take short rest breaks often. This works better than taking long breaks. Control your breathing. Take slow breaths, and imagine breathing in and out from the painful area. Think calming thoughts (for example, say to yourself, It s okay that the pain is here for now, I don t have to like the pain, but I can handle it, This will get better, I can do this ) Talk to someone who can support you like a friend, family member, or therapist. Challenge the pain with gentle activity Be creative. Look for new ways to do things. Keep moving and stretching, but do it gently and pay attention to what you are doing. Go back to doing activities very gradually. Set small goals and plan how to get there. Track your progress. For example, write notes in a journal or calendar. Be patient with yourself. Learn about how pain works This can help you to feel less afraid of the pain and live a more active life. There are many great books, videos and websites that talk about pain. If you feel ready, consider signing up for a pain self-management course. Ask your therapist for a list of courses. 4
Here are some resources about pain to get you started: Videos on YouTube Go to www.youtube.com and search using these titles: Lorimer Moseley Why Things Hurt Hunter Medicare Local Understanding Pain: What to do about it in less than 5 minutes Cara Kircher Body scan, Breathing space Books Managing pain before it manages you by M. Caudill (2016) The Brain s Way of Healing by Norman Doidge, M.D. (2015) Websites Canadian Institute for the Relief of Pain and Disability: www.cirpd.org Pain.com : www.pain.com A good saying to remember is: Pain changes everything and everything changes pain! 5