Chronic Pain
Chronic pain can be awful. You might experience persistent pain that doesn’t go away after an injury has healed, or suffer from conditions like arthritis or fibromyalgia that bring constant discomfort. This pain can make it challenging to engage in daily activities and enjoy life. Often, chronic pain not only affects your physical health but also your mental well-being, making it hard to maintain a positive outlook.
Dealing with chronic pain is something I have a lot of experience with (I suffer from chronic pain and spent two years working in a public health chronic pain team), so if you are suffering, don’t hesitate to book an appointment to speak to me. If you do want to speak to me about chronic pain I strongly encourage you to read the rest of this page before booking in.
Chronic Pain Symptoms
Living with chronic pain means more than just dealing with the physical discomfort. The emotional toll it takes can be just as significant, impacting your mood, sleep, and overall quality of life. Chronic pain can involve:
- Persistent physical pain that is either sharp or dull
- Inflammation or stiffness in the affected areas
- Reduced mobility or flexibility
- Sleep disturbances or fatigue due to pain
- Mood swings or increased irritability
- Anxiety or depression linked to ongoing discomfort
Getting Help with Chronic Pain
Getting effective help with chronic pain can be difficult for a few reasons.
First, a lot of people do not know that while pain is 100% real, it is created in your brain. Pain is similar to any other sensory experience like vision, taste, touch and smell. For example, the experience of vision follows light hitting your eye, information being transferred to the brain and your brain creating the experience of vision. If goes wrong in the pain processing system you can experience pain. For example, you might have cut on your leg that signals leg pain, you might have nerve damage in your spine that signals leg pain, you might have a physical brain disorder that signals leg pain, or you might experience a lot of anxiety that is upregulating the pain processing parts of the brain, resulting in leg pain. Not knowing that pain is not just about tissue damage can lead people to not seeking help.
Second, chronic pain is usually the result of multiple inputs. There might be an ongoing disease process, and some unhelpful behaviours, and stress/anxiety (and many other factors) all contributing to your overall experience of pain.
Third, sometimes chronic pain won’t resolve until you do a good enough job addressing as many of the inputs as possible. This can be: time consuming; expensive; involve getting second, third or fourth opinions from health professionals; and, overall can be a stressful experience.
Fourth, there are a lot of health professionals who say they help people with chronic pain but either don’t actually know a lot about it.
Given these difficulties it can be hard to know where to start. Luckily in Melbourne there are quite a few health professionals who are experts in Chronic Pain.
I think it is vitally important to know that getting improvement is not only possible but that many people do get significant reductions in pain or even complete resolution after putting a chunk of work into it. However, this can be a long process and you need to take control of it. You may need to see a number of health professionals, spend quite a bit of time educating yourself about chronic pain, and if relevant, you might have to put time and effort into changing your lifestyle, habits and psychology.
Where to Start
Given I don’t know why you have chronic pain I can’t be 100% sure of the best place to start but the following are places to start. You do not need to do these in the order listed:
See your GP and determine if you have any active disease processes that may be contributing to chronic pain and come up with a plan to treat or manage them as best you can.
See a physiotherapist who specialises in Chronic Pain. I would start with this directory from the NOI Group. I don’t want to recommend anyone specifically (as experiences may vary) but I found both of the excellent pain physios I have seen on this list. Personally I went with the people who have a lot of experience (i.e., they only do chronic pain in their work) and who have the most education, or are in fact educators.
See a psychologist. If you think that there are any psychological factors contributing to or directly causing your chronic pain I would book into see a psychologist. To be honest, this is going to be almost everyone because:
- If you have difficulties with perfectionism, self-sacrifice or assertiveness this is typically correlated with doing too much or too little rehab/healthy behaviours.
- If you have any sort of mental health related difficulty (anxiety, low mood, stress etc.) this will upregulate the emotion centres of your brain and this typically exacerbates chronic pain.
- Dealing with health professionals, friends and family is often stressful and this can contribute to pain. Many times people I work with have been told things like “there is nothing you can do” by health professionals (which is almost always incorrect), or “it’s all in your head” (shockingly it’s not just lay people but also health professionals who can say things like this)
Download the Curable App (you could do this right now in fact, I have no relationship with them and get nothing if you do sign up with them). Curable is a fairly eclectic/grab-back mix of a lot of the evidence based techniques to help with chronic pain (although the evidence for techniques varies a lot), they also have interviews with people who have recovered from chronic pain and with experts. Some people love this App and some people do not. I think there is a free trial so it doesn’t hurt to give it a try.
What’s Next
If you have tried the above or just need more information here are the resources that I would look at next. Again these are not in any particular order:
See a pain specialist. A pain specialist (medical doctors specialising in the treatment of chronic pain) can help you with medications, surgeries and other medical procedures/interventions that can help with chronic pain.
Get a referral from your GP or Pain specialist to a public health pain program. There are a number of Pain Clinics run by public hospitals in Melbourne. Unfortunately, waitlists can be long (that is, one to two years), the clinics can be limited in what they offer, and the quality varies. On the other hand it is free so it doesn’t hurt to get that referral in.
Get a referral from your GP or Pain specialist to a private health pain program. Quite a few private hospitals run pain programs and unlike the public programs the waitlists are much shorter. On the other hand they can also cost quite a bit of money and the quality varies.
Mindfulness-Based Stress Reduction (MBSR). This is one of the most researched interventions for Chronic Pain and well worth a try if you have the time and stamina for it (it is quite the time commitment). Essentially it involves doing mindfulness for your painful sensations. Counter-intuitively, if you can pay attention to bodily sensations with a neutral or positive attitude the ‘pain’ aspect of the sensations can diminish over time. I’ve linked to a free version of the entire program that has been helpfully added to the internet.
Read books about Chronic Pain. There are a lot of books out there on Chronic Pain. I would suggest start with the books put out by the NOI Group and then branch out from there.
NOI Group: Explain Pain and Protectometer are the two books to start with and I have linked the discounted bundle.
The Way Out. This books describes a mindfulness exercise that can be incredibly helpful for chronic pain called Somatic Tracking. You can get instructions on somatic tracking from the Curable App or just look some up on YouTube. Somatic Tracking is basically an updated (or version 2.0) of Mindfulness-Based Stress Reduction (although it wouldn’t hurt to combine MBSR and Somatic Tracking either).
Chronic Pain Australia: Runs in-person support groups in Melbourne focusing on education and peer support.
Community Health Services: Not many community health services offer chronic main services but some like Merri Health do so it is worth checking. The Merri Health program has gotten some great outcomes so if you can get a referral to their program.
I hope this information helps you find the support you need. If you are struggling with chronic pain and its impacts on your life, please consider reaching out to me.