Self-care

Heat and cold treatments

Heat or cold on affected areas can be effective in relieving pain; sometimes alternating between the two can be helpful. You can use hot water bottles or microwaveable rice bags and heating pads. If you want a bit of extra comfort you can get teddies that go in the microwave which also smell like lavender; this can be very calming.

Ice packs or cloths dipped in ice water can be used as cooling options. You can also buy heat or cool pads which can either be applied to clothes or directly to skin; effects typically last for a few hours.

Splints and supports

Transcutaneous Electrical Nerve Stimulation (TENS)

TENS machines can sound scary but really it’s just a small machine with sticky pads which you are instructed to put on various areas of your body. The machine sends small electrical signals which interrupt the pain signals in your nerves to bring some relief from pain. 

This type of treatment isn’t painful, but you may feel a small sensation which you soon become accustomed to. Usually your doctor or specialist will show you how to use a TENS machine, and you will usually be permitted to take it home with you to integrate into your daily pain management.

Educating yourself on pain science

The more you learn about chronic pain, the more prepared you will be to tackle it. Understanding the science behind how the body processes pain, can give you the ability to see why and how various self-help techniques and professional treatments work. This knowledge can give you the confidence to tackle your pain in new ways.

Finding purpose

In some cases, chronic pain can make you feel worthless. It can reduce your level of functioning until you feel that you are just surviving rather than thriving. Finding a purpose in your life is so important, especially if you aren’t working. This could be things as simple as hobbies that you enjoy or adopting a pet, or more complex purposes such as getting back to work.

Maintaining a healthy diet

Giving your body the fuel it needs to function optimally becomes even more important when you have extra health challenges like chronic pain. Ensuring that you are limiting junk food and focusing on eating in a healthy way can provide your body with the right nutrients to function optimally.

A good sleep routine

Reducing stress

Stress feeds into the stress and pain cycle, increasing pain and worsening accompanying symptoms as this study explains: “Pain and stress are two distinguished yet overlapping processes presenting multiple conceptual and physiological overlaps”

Reducing stress in your life as much as possible can help to reduce your chronic pain. Try to talk about things that are on your mind with someone you trust; sometimes sharing your worries can help you to see the way forward and lighten your load. Surround yourself with people who will encourage you and add to your life in positive ways. Practicing self-care can help you to lower stress levels.

Setting boundaries with others

When you live with chronic pain, you often cancel plans at the last moment because of a flare up in symptoms. Sometimes you can harbour a sense of guilt when you are not able to keep up with things around the house, daily chores or a regular social life with your friends. While it’s important that we do maintain social connections, it’s also vital that you do not push yourself too much, subsequently causing a flare through a sense of obligation or a need to please others.

Setting clear boundaries with loved ones and being assertive with saying ‘no’ if you feel that something is too much can be tough emotionally but is so beneficial. You have a right to put your own health first. Remember that the word ‘no’ is a sentence within itself; you do not have to explain yourself unless you feel comfortable doing so.

Encourage loved ones to educate themselves; send them links to articles that give them a deeper insight into your condition or have open conversations with them so that they understand that when you say no, it’s not because you don’t love them, it’s because you love yourself.

Monitoring your symptoms

Keep track of your symptoms, whether it be writing them down, keeping notes on your phone or using a monitoring app, can allow you to see useful patterns. This helps you to keep medical professionals up-to-date, allowing them to see your condition in a clearer light.

Knowledge is power, and the more you learn about the ebbs and flows of your illness, the more you can counteract it and adapt your life to work around it.

Keeping a journal

Journaling can help you with monitoring your symptoms, but it can also be an emotional outlet. Sometimes it can be tough to talk to others about what we are going through, especially because we may not want to upset loved ones. Having a place that you can vent without feeling the need to filter your feelings can be freeing and cathartic.

Writing notes and reminders

Often with chronic pain comes issues with cognition and memory; for me ‘fibro fog’ can make it tough to remember little things. One of the ways I tackle this is to set alarms and reminders on my phone. You could also leave post it notes around the house or make lists of anything that you need to remember.

Adjusting your environment to set you up for success

It’s important that your environment is conducive to keeping your pain levels as low and managed as possible. You can adjust things to make life easier for you, like adding support bars to help you get in and out of the shower like me for example.

Having a mattress topper or a new mattress that is specifically designed for support, depending on your resources, can ensure that you are optimizing your comfort and increasing your chances for a restful night’s sleep. 

Adding things like stools to your living room so that you can raise your feet up can be helpful to reduce swelling and provide extra comfort. Keeping things that you use regularly within your reach can be helpful.

It’s about what works for you and your routine. Take a look at your living environment and think about what would make things easier for you in your daily routine. While it’s important to keep active to tackle chronic pain and prevent deconditioning, it's also about increasing your level of functioning. If you can make some actions easier for yourself, then it saves your energy for other activities, increasing your functioning rather than reducing it.

Being open and clear at work

If you work, it’s important that you are open and honest with your employers and colleagues about your condition and be assertive yet professional about what you might need. If you need guidance you may be able to arrange an occupational therapist to come to the workplace; they can advise and advocate for adaptations or accommodations that could make things easier for you. Just as with daily tasks at home, it’s about optimizing your level of functioning without causing a flare in your symptoms.

Support from others

Seeking support from others with chronic pain

There’s nothing quite like the support you can get from someone who truly understands what you are going through, because they have been through it themselves. You could join a local support group, or you can find communities of people on social media who share your diagnosis and can empathise with your experience. 

Search for hashtags and keywords that relate to your diagnosis in order to find people who are talking about topics of interest. I have found a group of people on Twitter who mean the absolute world to me. We support one another through tough times, provide guidance to each other and encourage one another to keep going. This sort of support is invaluable!

Being social

Fear avoidance often means that people withdraw from their social life, avoiding getting out to see family and friends because they fear the activity may make their pain flare, or because they feel that their loved ones won’t understand what they are going through. This can lead to isolation, which has a significant impact on both mental health and worsens symptoms. 

Ensuring that you are maintaining social connections can make a big positive difference in your life. Having that support from those who care about you the most reduces loneliness, depression and anxiety, and provides you with a strong emotional basis to tackle your pain.

Asking loved ones for help

Whether it’s talking through your feelings or more practical support like asking for help with household tasks or accompaniment to medical appointments, help from those in your life can make a big difference. Often we can feel like we don’t want to be a ‘burden’, but if you can realise that guilt and realise that those in your life want to be there for you, just as you would be there for them, you can learn to reach out for help.

Psychological treatments

These therapies can help to equip you with the skills you need to self-manage your pain. This study concluded that learning pain management skills from psychological therapies and then applying them in your day to day life, “increased self-management of pain, improved pain-coping resources, reduced pain-related disability, and reduced emotional distress”.

Some of these treatments you can actively seek from your doctor or specialist while others you may need to find privately. With psychological therapies you could also find them online, or through our pain therapy web app (like ours). This study concluded that, “existing evidence suggests that technology-assisted psychological interventions are efficacious for improving self-management of chronic pain in adults.”

Mindfulness

Mindfulness allows you to calm your emotions and parasympathetic nervous system, so you can reduce pain and feel more in control of your life. Mindfulness involves being present in the moment without judging the situation as good or bad.

Guided mindfulness meditations typically involve using imagery, breathing techniques or Progressive Muscle Relaxation (PMR). PMR focuses on each individual area of your body, instructing you to tense then relax each muscle to achieve complete relaxation.

Movement can be incorporated into mindfulness, which can often be useful for those who struggle to calm their mind when sitting still. Often mindfulness techniques are incorporated into other therapies, such as ACT, CBT and graded therapies in order to achieve the best results. This study explains that, “Mind and body practices such as yoga, meditation, progressive relaxation, or guided imagery use mental and physical abilities to improve health and well-being.”

Mindfulness can be integrated into your daily life, with proven results to help you relax and lower stress levels, in turn reducing pain. You could begin mindfulness meditations at home in your own time; the more you practice the more you can start to incorporate mindfulness into everyday tasks like washing the dishes or taking a shower. You can use mindfulness at night to improve sleep, in the morning to set your intentions for the day. 

Breathing exercises can help you to slow down and consider your options when you face a difficult situation, allowing you to figure out the best route forward. Mindfulness allows you to have a greater control over your emotions, to fear your pain less and to feel empowered to increase your functioning. This study explains that, “Meditation practice has been found to promote well-being by fostering cognitive and emotional processes”

Cognitive Behavioural Therapy (CBT)

CBT is a talking therapy based on how our thought processes link to our actions. CBT helps you to see how your thoughts are influencing your behaviours. By addressing unhelpful or negative thoughts and behaviours head on, CBT helps you to replace them with more positive, helpful thoughts and behaviours. 

Once you have gotten the hang of these techniques you can then use them in your daily life to stop negative thoughts in their tracks, and to adopt much healthier coping strategies.

CBT can help to tackle fear avoidance, hyervilegence and catastrophizing. This allows patients to be more in control of their emotions and cope both emotionally and practically with their chronic pain in the future. This study concluded that CBT lead to, “Decreased negative emotional responses to pain, decreased perceptions of disability, and increased orientation toward self-management”

Acceptance and Commitment Therapy (ACT)

Rather than trying to change negative thoughts as in CBT, ACT focuses on understanding that a thought is just a thought and that it doesn’t have any power unless you allow behaviours to be formed around it. ACT gives you the skills to let negative thoughts pass without worrying about them or letting them influence your behaviour. 

ACT is about accepting your current situation, accepting that you are in chronic pain but at the same time, understanding that it does not have to control your life, and is not causing you damage. As well as this acceptance, ACT teaches you to commit to actions which will allow you to live the life you truly want. It’s about you taking the lead and being determined to put healthy coping behaviours in place, to live well despite your chronic pain. 

In essence, ACT focuses on changing behaviours rather than thoughts. This study concluded that ACT strategies can be integrated at home stating “the benefits of therapy are durable or may further integrate into people's lives after treatment is complete”

Graded Exposure Therapy

Often patients can become fearful of situations they feel may increase their pain. This leads them to avoiding these activities (fear avoidance). This can lead to deconditioning, an increase in stress levels, emotional distress and fundamentally, actually perpetuate chronic pain!

Pain Neuroscience Education (learning the science behind pain) is a vital starting point of graded exposure therapy. This knowledge allows patients to understand what is going on in their bodies and how the therapy will work. 

Graded exposure therapy then tackles the fear of movement and unhealthy avoidance behaviours by facing each feared situation head on, but in a gradual way. This can sound scary but patient’s are guided by a therapist. Far from jumping in at the deep end, each situation is broken down into small, manageable parts and dealt with one at a time. 

A graded approach allows the brain to learn that each action does not need to cause pain and allowing the patient to understand fundamentally that the action does not need to be feared. This study explains that during graded exposure therapy, “Patients are instructed to safely break the cycle of inactivity and deconditioning by engaging in activity in a controlled and time-limited fashion”

Graded Motor Imagery (GMI)

Our brains are neuroplastic, meaning that they are changeable; they learn and develop based on our experiences. Graded Motor Imagery (GMI) uses this neuroplasticity to the patient’s advantage. Our quarter of our brain is made up of mirror neurons. This simply means that these neurons start sending out messages even when you’re just watching other people doing certain actions, or when you’re imagining them! 

GMI reduces pain and retrains the brain away from pain by using imagined movements to gradually build up to performing a full movement. Any movement that the patient finds painful can be focused on. Essentially, your brain is learning that it doesn’t need to send out pain messages in response to these movements. The results of GMI are long lasting as explained in this study.

Biofeedback

During biofeedback a therapist will teach you how to be aware of your bodily processes (such as heart rate and respiratory rate) through the use of monitors. They will introduce the association between these biological processes and your levels of stress and chronic pain. The therapist will then teach you how to calm these biological processes to reach a state of relaxation. 

Biofeedback can also be used to become aware of tension within your muscles which may be contributing to pain and in turn help you gain the tools to relax those muscles. These tools can then be used in your day to day life to reduce stress and lessen your pain levels as this National Institutes of Health report explains.

Art and Music Therapy

Art and music therapies provide relaxation and stress relief. Having a form of creative expression allows patients to get their feelings out in a new and often very cathartic way.

Music therapy can involve listening to music, writing songs, playing instruments or singing. Art therapy often involves painting, drawing or other artistic crafts. 

This study explains that, “The idea behind this type of therapy is that the stimulation of creative activities promotes the healing process and rehabilitation.” Art or music therapy can be done in classes or one to one sessions with a therapist. It can also be done in your own home.

Weighing up the pros and cons of each type of available management technique and medical treatment can help you to figure out what is best for you. Remember that even though it’s difficult, there are options out there; your situation is not hopeless.