Dealing with pain takes more than endurance; for chronic pain, it requires strategy and persistence. Pain relief is a long-term project, but with an understanding of the nature of pain and new tools, managing pain can actually be easier at home than in a health care setting.

UNFAIR WARNING

Pain is a complex array of causes and consequences. It acts as an alarm system, notifying the brain of danger, much like a motion detector around a vulnerable window. With persistent threats, more and more alarms are installed in an attempt to keep the location safe. But alarms may become so sensitive that they still go off even after the cause of the danger is gone. While physical alarms can be uninstalled, dismantling the warning signals created by chronic pain is less straightforward.

Chronic pain physically changes the brain. For example, before knee replacement, the thalamus enlarges from processing large amounts of pain. Within six months of a bad knee—and the pain—being removed, the thalamus returns to normal size. For pain without that kind of quick fix, treatment must include retraining the brain to cope with sensations that aren’t actually threats.

Distraction Helps

Pain scales are great for rating pain in acute or emergency situations where a treatment and change are eminent. In that case, knowing that a dose of medicine lowers a patient’s pain from an “8” to a “3” is useful. At home, however, constantly rating pain draws focus to it, magnifying the brain’s perception. Pain eases when focus is placed on something else.

In order to manage pain at home, it’s also important to make a plan. Pain without a way to treat it leads to fear and vulnerability. Fear increases the perception of pain and makes it hard to focus on anything else.

In a more intense form, fear of pain is sometimes called “catastrophizing.” All the possible ramifications of untreated pain run through the mind, leading to depression, fear of attempting activities and lack of movement. Studies show that people who tend to catastrophize require more pain medications, are more likely to become addicted to medication and take longer to heal.