Body

In pain every day? How to cope

Chronic pain is something I have been suffering from for many years now. I used to blame my sitting job for my constant back pain. After multiple tests and doctors’ visits I was told that there are no physiological changes in my spine, and all I can do is to exercise, stretch, and get massages.  

I think I have tried everything... I do not remember the last day when I didn't have some kind of pain. It can be very demotivating. But at the same time I know, it's my body trying to tell me something. Over the years I have learnt to listen to it and to honor it, but there are days I feel like I am too tired to even try.

How common is chronic pain?

Chronic pain is not uncommon. At least 100 million adults in the United States suffer from it, according to the Institute of Medicine[1]. However many people still don't know about the connection between chronic pain and mental health.

That's why I find my passion in sharing my experience and knowledge with you. Hopefully, some of my findings can be helpful.

Top causes of chronic pain

I have compiled top possible reasons for my chronic back pain and fatigue into four groups. Of course, there can be more of them, or you might be dealing with something different. As I mentioned, I got my back checked by medical doctors before I started to look for another reasons and solutions. I think overall it's wise to pick categories that you personally would find important to focus on.

  • psychological reasons (trauma, depression, anxiety, stress etc.);
  • lack of nutrients;
  • lack of movement; 
  • chronic inflammation in the body. 

Let's talk about each one of them. 

Psychological reasons for chronic pain

According to Anxiety and Depression Association of America, pain can be a common symptom - and sometimes a good indicator of anxiety disorder, particularly generalized anxiety disorder (GAD)[1] - something I have been diagnosed with about 10 years ago. 

It is known that depression can also cause chronic pain[2]. However their association remains unclear. 

Fibromyalgia is one of the conditions that most likely relate to mental health. It's a disorder that is characterized by widespread musculoskeletal pain accompanied by fatigue, sleep, memory and mood issues. This condition is very hard to diagnose as most traditional tests don’t show any changes in the physical body, that’s why oftentimes we receive something like: “You are completely fine”, “The pain is in your head”, etc.

What is interesting, is that people with fibromyalgia have increased sensitivity to pain[3]. According to scientists, it might relate to genetics, however overall this condition is still not understood enough, therefore (sad news) the best treatment has yet to be found.

There are more chronic pain conditions, associated with mental illness[4], but there are still more questions than answers in this field, it seems like. However, knowing that there is a connection helped me to start paying more attention to my psychological well-being and to stop taking it for granted.

No matter what the name for your condition is, if you feel like it is related to your mental health, you will more likely be able to find proper tools to help you deal with it.

It is also important to mention, that when deep psychological trauma hasn’t been processed in a healthy way, it can cause chronic pain as well. I will talk about it more in the future, so stay tuned. 

Can nutrient deficiencies cause chronic pain?

I won't stop here for a long time, as I am still looking for answers. I know, though, that back pain can be a sign of some important minerals and vitamins deficiencies. To name a few: magnesium, iron, vitamins D and B.

I have been prescribed vitamins B and D for my pain condition before. However experimenting with supplements can be a waste of money, especially in today's world, where everyone plays a role of an "expert", trying to sell as many things as possible. Unnecessary supplements can have a very negative effect on the body, so make sure you ask your doctors what supplements may be helpful for your unique condition.

Lack of movement and chronic pain

Our ancestors were much stronger than us[5]. Human's level of physical activity first dropped after invention of agriculture, but now our lifestyle is even more different than that. Sedentary jobs have increased by 83% since 1950 according to American Heart Association[6]. It's bad not only for physical, but also for our mental health[7]

Recent studies show that multimodal exercise programs that include a range of activity (aerobic, resistance, and flexibility exercises) are effective at significantly reducing pain in osteoarthritis, rheumatoid arthritis and fibromyalgia[8].

But it is also important to take it easy and find exercises that work for you, as some of them can make your condition worse. 

Inflammation and chronic pain

In many instances, neuropathic pain is associated with nerve inflammation, neuritis, in the absence of nerve injury[9].

"A lot of chronic pain is the result of chronic inflammation, and the evidence is quite strong that your diet can contribute to increased systemic inflammation," says Dr. Fred Tabung, a visiting researcher with the Department of Nutrition at Harvard's T.H. Chan School of Public Health[10]

I am not going to lie, I only recently discovered, that there is a connection between what we put in our mouth and chronic pain, but it does make sense to me. Everything in our body is connected, and if we already have inflammation in our body, it's obvious, that external factors, such as food, for instance, can make it worse.

Chronic pain treatment

Based on what has been said, I chose a few things that help me to live and deal with my chronic pain. Do I hope it will ever go away? I think recovery is overall possible, but it depends on whether I am consistent with my self-care routine, how well I manage stress, and how responsive my body is to the changes that I am making. If you suffer from chronic pain, try these with me.

In no specific order.

Exercise

I don't know about you, but I feel much worse when I happen to sit all day in front of the computer. So I try to take multiple breaks, stand up and walk every 45 minutes or so (my Fitbit helps with it) and exercise on a regular basis. 

Typically, I feel my worst in the morning. Even though I usually workout in the evening, I try to do light stretching in the morning. It helps my stiff muscles. 

Sometimes I use a foam roller to release tension.

Exercise does help, but be careful with the intensity of your workouts. Usually I do a full body workout 2-3 times a week. On other days I go to the climbing gym. Climbing is definitely not the easiest physical activity, but enjoyment that I receive from it helps me forget about my pain for some time.

Usually I exercise 5 times a week. 

Pain medicines 

Pain medicines can be tricky as all of them have side effects that you would want to avoid, but I understand, it can be hard to deal with pain without any relief. 

I use OTC nonsteroidal anti-inflammatory drugs (NSAIDs) such as acetaminophen, aspirin and naproxen. 

I also find topical treatments such as arnica gel and CBD balms helpful (I apply it on my shoulders when I am not lazy).

Healthy diet

Generally speaking I follow plant-based anti-inflammatory diet. I do try to consume less sugar and avoid deep fried and processed foods. 

I feel better when I eat more vegetables and stick to "healthy" diet, but I should give it more time to see if it has any effect on my pain. Stay tuned for updates.

Self-love and self-care

In this post I don't want to talk about managing stress and getting enough sleep seperately from self-care, because to me it's all connected.

I think the more you love yourself, the more you want to take care of yourself, including your mental and physical health. Self-love also helps me to accept my pain as it is, be patient and to not give up. It is not something that goes away fast, because it can be related to some deep psychological issues that I am yet to solve. And just in general it takes time for the body to heal, physically and mentally.

So cultivating self-love, asking for help (therapy), if needed, trying to rest when my body is asking for it, is very important.

It would be silly of me to tell you to worry less, because it is one of the worst advice that I have ever been given. But I believe, the more you take care of yourself and the stronger you become physically, the easier it will become for you to deal with stress and anxiety, the stronger you will become mentally. Don't give up, we are in this together. 


References

[1] American psychological association, Managing Chronic Pain, article, December 2013, <https://www.apa.org/helpcenter/pain-management>

[2] Jiyao Sheng, Shui Liu, Yicun Wang, Ranji Cui, Xuewen Zhang, The Link between Depression and Chronic Pain: Neural Mechanisms in the Brain, article, 19 January 2017, <https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5494581/>

[3] Marta Ceko, M. Catherine Bushnell, Richard H. Gracely, Neurobiology Underlying Fibromyalgia Symptoms, article, 27 October 2011, <https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3205654/>

[4] Adela Hilda Onuțu, Dan Sebastian Dîrzu and Cristina Petrișor, Serotonin Reuptake Inhibitors and Their Role in Chronic Pain Management, article, 5 August 2018, <https://www.intechopen.com/books/serotonin/serotonin-reuptake-inhibitors-and-their-role-in-chronic-pain-management>

[5] Nina Lincoff, Why You Need to Exercise Much More Than Your Ancestors Did, article, 24 December 2014, <https://www.healthline.com/health-news/why-you-need-to-exercise-more-than-your-ancestors-122414#1>

[6] Nicole Fisher, Americans Sit More Than Anytime In History And It's Literally Killing Us, article, 6 March 2019, <https://www.forbes.com/sites/nicolefisher/2019/03/06/americans-sit-more-than-anytime-in-history-and-its-literally-killing-us/#1b320c02779d>

[7] Arlene Semeco, MS, RD, The Top 10 Benefits of Regular Exercise, article, 10 February 2017, <https://www.healthline.com/nutrition/10-benefits-of-exercise#section1>

[8] Kirsten R. Ambrose, MS, CCRC, Yvonne M. Golightly, PT, MS, PhD, Physical exercise as non-pharmacological treatment of chronic pain: Why and when, article, 23 May 2015, <https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4534717/>

[9] Tal M, A Role for Inflammation in Chronic Pain, abstract, 1999, <https://www.ncbi.nlm.nih.gov/pubmed/10998702>

[10] Harvard Health Publishing, Can diet heal chronic pain? article, July 2018, <https://www.health.harvard.edu/pain/can-diet-heal-chronic-pain>