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How to ease chronic pain

You don’t have to grin and bear it.

Woman standing on a subway platformMost twinges and pangs are helpful - whether sharp, stinging or simply uncomfortable, pain is a sign that your body is reacting to an injury exactly as it should. “It’s your body’s alarm system,” says Dr. Tania Di Renna, medical director of the Toronto Academic Pain Medicine Institute (TAPMI) at Women’s College Hospital. It alerts us when we’re hurt or something needs our attention. The physical sensations are a result of nerve stimulation. If you were to look inside your body after, say, stubbing your toe, you’d see your nervous system light up, sending SOS messages up the spine to the brain. As the body repairs itself, those signals subside – this is called acute pain, which we tend to recover from relatively quickly, depending on the injury. Chronic pain is different.

Chronic pain disease, defined as any pain lasting longer than three to six months, affects one in five Canadians. It may be brought on by an injury or an ongoing cause, such as illness. In other cases, there may be no clear cause. “Management options are aimed at teaching patients to function day by day and to focus on living a meaningful and purposeful life, rather than the pain they're experiencing,” says Dr. Di Renna. These approaches include improving coping skills and reducing stress through cognitive behavioural therapy and mindful meditation; practising healthy habits, such as exercise, and improving sleep; and teaching patients to use medications and nerve-block injections only as adjuncts to and not the mainstay of therapy.

There’s no doubt that living with chronic pain can be difficult, physically and emotionally, but there are things you can do to make life easier – in the moment and over the long run.

Start with your brain
Your brain may be your most powerful pain-management tool. Because pain, stress, fear and anxiety are closely related, how you’re feeling mentally can directly affect how you feel physically and vice versa. Stress-reducing activities like meditation and deep breathing may calm pain signals in the brain. Through practising cognitive behavioural therapy (CBT), you can even learn how to curb the negative emotions that can worsen pain. CBT is a proven effective treatment for chronic pain, which helps identify and switch off unhelpful patterns in behaviours and thinking that can impact pain and mood.

Then get moving
It may be tempting to skip exercise when your body isn’t feeling great, but research shows that most people with pain will benefit from physical activity. Movement releases endorphins that reduce pain signals, as well as improving your strength and the ability to do things you enjoy. There are no rules as to which type of exercise is the best – “choose something you like to do and will stick to,” says Dr. Di Renna.

Have a plan for dealing with flare-ups
When you have chronic pain, it’s normal to experience flare-ups, periods when your symptoms are more intense than other times. Flare-ups can be the result of a change in environment, activity, stress or overall health. It’s a good idea to have a plan in place for when a flare occurs, including a toolkit of self-management strategies that are specifically helpful to you, such as meditation, relaxing movement or distractions like books or music.

Prioritize sleep
“Developing good sleep hygiene is as important to your overall well-being as exercising and eating a healthy diet,” says Dr. Di Renna. In fact, 50 to 80 percent of people with persistent pain report trouble with sleep. Whether your pain is affecting your sleep or your poor sleep is causing flares, a consistent bedtime routine will help. Taper off any stimulating or stressful activities (like checking emails) and do things you find relaxing – reading or taking a bath, for example. In addition, limit or eliminate naps; maintain regular sleep hours; abstain from caffeine after 2 p.m.; and limit or avoid nicotine and alcohol.

Eat anti-inflammatory foods
Inflammation is one of your body’s totally normal ways of protecting itself from an irritant or injury. The downside is that it can also contribute to chronic pain. “There is evidence that following an anti-inflammatory diet can also help reduce chronic pain, specifically chronic pelvic pain,” says Dr. Di Renna. To help improve symptoms, eat an anti-inflammatory diet by choosing low-glycemic (GI) carbohydrates, cutting saturated and trans fats and eating more plant-based sources of protein or fatty fish like salmon.

THE EXPERT
Dr. Tania Di Renna, medical director of Toronto Academic Pain Medicine Institute, Women’s College Hospital

This information is provided by Women's College Hospital and is not intended to replace the medical advice of your doctor or healthcare provider. Please consult your healthcare provider for advice about a specific medical condition. This document was last reviewed on: November 1, 2019.

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