Coping Strategies for Managing Chronic Pain and Mental Health
November 19, 2023
Chronic pain as a concept is very broad and contains multitudes. A person who breaks their arm and has prolonged pain post-injury is considered to suffer from chronic pain, just the same as a person living with a neuropathic pain condition, such as Fibromyalgia. There are multiple modalities and presentations of pain, which means that coping mechanisms need to be adapted and depend on these differences.
Chronic Pain vs. Neuropathic Pain
First, it is important to distinguish chronic pain from neuropathic pain. Chronic pain can be prolonged pain after trauma, a health condition or injury, but it improves and may go away with time and treatment. Neuropathic pain arises specifically from damage to the nerves by a health condition. The pain can feel different to the pain that we are used to, such as headaches, bellyaches or injuries. Neuropathic pain could present as:
- Freezing,
- Burning,
- Tingling,
- Electricity,
- Numbness,
- Other modalities.
Both neuropathic and chronic pain can be continuous, “on” and “off”, or tender to touch, but neuropathic pain is more persistent and can be affected by weather changes. Neuropathic pain is also more difficult to treat and oftentimes can be life-long with some conditions also being drug-resistant.
Significant health events and conditions can lead to the development of a long-term neuropathic pain condition, such as Fibromyalgia (FM), Painful Diabetic Neuropathy (PDN), and Central Post Stroke Pain (CPSP). While PDN and CPSP are caused by a very specific health condition, FM is more varied and can arise from different chronic pain issues, such as lower back pain, injury, infection, physical stress, or even psychological stress. However, not all neuropathic pain is attributed to neuropathic pain conditions. Neuropathic pain can also arise from causes such as:
- Shingles,
- Alcoholism,
- Viral and sexually transmitted infections,
- Multiple Sclerosis,
- Others.
There is medication to address most chronic pain issues, such as paracetamol, ibuprofen, and opioids. Neuropathic pain tends to be treated by repurposed medication, such as antidepressants or anticonvulsants. Refractory persistent neuropathic pain may be treated by neuromodulating treatments, such as repetitive transcranial magnetic stimulation or deep brain stimulation. The common treatments that are the same across both chronic and neuropathic pain groups are physiotherapy, occupational therapy and psychotherapy. Physiotherapy and occupational therapy, in particular, are more often used for neuropathic pain than chronic pain, as neuropathic pain tends to lead to more significant disabilities and persist for longer periods of time.
Chronic Pain and Mental Health
Psychotherapy, on the other hand, is effective and useful for both groups as it is easily adaptable to the circumstances. While chronic pain patients may need to address chronic pain alongside their underlying mental health conditions or injuries or medical conditions that led to their pain, people with neuropathic pain may need support to deal with accepting and living with their pain. Mindfulness has been proven to provide partial alleviation of pain by itself or when combined with standard treatment. Psychotherapy can also address issues that are common among people who suffer from neuropathic pain:
- Negative work-related outcomes,
- Cycle of unsuccessful help seeking,
- Ineffective therapy with multiple side effects,
- Isolation from the community due to general lack of knowledge of neuropathic pain conditions
Psychological Therapies for Chronic Pain
Mindfulness and Psychotherapy can also help ease the worry and stress of people who have family or are carers of people struggling with neuropathic pain. Mindfulness provides a way to reduce underlying stress and learn coping skills that can be easily utilised at any point of the day. Additionally, psychotherapy may be able to address frustrations and worries that come with neuropathic pain. Talk therapy is incredibly important and provides improvement in two ways: talking about pain can lead to de-stressing and consequently feeling reduced pain, and releasing frustrations that may arise from the patient journey, which then leads to better engagement with treatment. There are also some psychology-based coping strategies that can help alleviate or distract from pain:
- Ice packs and cubes on the tender/warm area,
- Relaxation – finding a way to unwind with your favourite activity,
- Distraction – listening to louder music, or focusing intently on a hobby could provide a temporary distraction from pain,
- Biofeedback – learning from mindfulness to control your breath can lead to better control of your muscles and learning to relax them
If you struggle with adapting these strategies or if you would prefer to have additional support in dealing with your pain, Mindsum has dedicated therapists who will work with you to provide emotional support, find inner strength, and provide assurance in your treatment journey.