Your Pain Management Hub
On this webpage you will find lots of information and support to help you to manage your pain, whatever your situation.
Why is it important to know more about how pain works?
As doctors, we know that understanding your pain can be key. Before we go any further it’s important to make it clear.
- All pain is real – no matter what causes it, or if the cause is unknown.
- We believe you and we know it hurts.
There are some other key messages we want to share with you.
Here are some short videos for you to watch:
Understanding pain (5 min video)
Understanding persistent pain (pain that doesn’t go away) (5 min video)
Why is your GP not recommending opioids for your pain? (2 min video)
The mysterious science of pain, animation explaining how pain works, and what this might mean for you (5 mins) Joshua W Pate – YouTube
Things that can help you to manage and live well with your pain
Sometimes it can be hard to know what will help you manage your pain.
Below we have made a list of some things for you to try. These things have helped many other patients. We recommend you try one idea at a time, rather than trying everything at once!
Pacing is about choosing when to take a break and building up what you do, slowly. It is a good way to avoid the ‘all or nothing’ days a lot of patients tell us about.
Patients have told us pacing can help them do more, sleep better, feel more in control, feel better in their mood, have less pain and need less medication.
There are a few key steps for making your own pacing plan
- Step 1 – Keep an activity diary, perhaps for two days. Include everything!
- Step 2 – Add an effort score for each activity (0 to 10, 0 = no effort, 10 = maximum effort). Remember this is an effort score not a “How much it hurt” score, they are different.
- Step 3 – Decide what activities you want (or need) to do. Write down your baseline for each activity. This is the amount of each activity you can do before you know you will pay for it with pain later. If that’s almost zero to start with, that’s ok. That’s your baseline.
- Step 4 – Make a pacing plan (what activities will you do each day, and for how long). This pacing plan will help you balance your activities each day, and help you not do too much or, too little.
- Step 5 – Give it a go, and try and stick to your baselines.
Keep an eye out for the days where you are tempted to push it further. You may need to break bigger jobs into smaller tasks, and also practice asking for help if it might help you manage your pain more successfully?
- Step 6 – After a few successful sessions of completing your baseline, even though you experience some pain with this, start to slowly increase what you do. If your baseline for walking is 10 steps, start taking 11 steps. Remember you are using effort to judge how and when to increase activity not how much pain you experience
It sounds simple, but it takes practice! Keep going.
Be ready to start again after set-backs. Be kind to yourself, this is difficult stuff but you can increase your activity over time.
To find out more pacing visit the Live Well website.
For many people living with pain, it can feel like it’s hard to do things that were previously enjoyed, or to get a sense of achievement. Goal setting is a great technique, for helping with this.
- Tips for goal setting
- Don’t wait for the pain to go away before you start doing things that really matter to you.
- Start small, so you get a sense of achievement. Sometimes even 1 or 2 repetitions of a movement are a good place to start?
- Make the goal something you want to do (not a job you hate!)
- Set yourself a time when you’ll do it. When will you do it, what exactly will you do.
- You may want to set yourself a long-term goal, and some short-term goals to help you get there in little steps.
- Give it a go. Notice your successes as you go.
- Remember set-backs are normal. You may have to find a new way of doing something you love. Keep going.
- Consider using how much effort you are making as your guide to how much to do rather than how painful it is
For more information about goal setting visit www.my.livewellwithpain.co.uk/goal-setting.
Movement is key
In the past the advice for those living with persistent pain was to rest for long periods of time, we now know this is not the right approach. We now know that movement is essential for all the body’s systems, and is a key part of recovery even though it may be painful and take a lot of effort.
The phrase ‘motion is lotion’ a good one to remember.
However, if we have been in pain for a long time it can be tricky to know how much to move, and where to start with things. It can feel quite scary to start moving a bit more. The longer we have been in pain the less likely doing a small amount of additional activity is going to be doing any harm even though it hurts. We can think a small amount of extra activity might be SORE BUT SAFE.
For information on taking the first steps to moving more, when you have pain visit the NHS website.
Learning to live with persistent pain
Many of our patients notice they are putting all their energy into trying to get rid of the pain completely. That is normal. However, you are probably reading this because your pain is something that’s been around for a while.
We know for people living with persistent pain it can be helpful to think about how to live with the pain. That doesn’t mean giving up, far from it. But we know it can be helpful to redirect your energy a bit towards other things that matter to you in your life, and to finding new and different ways to still do them, with the pain. In time, this can mean that you start to feel less controlled by pain, and start to feel like you are managing it.
For more about learning to live with pain you may want to visit www.my.livewellwithpain.co.uk/acceptance.
Sounds easy, but as you probably know it can be quite a challenge . Learning how to relax your body can be a big help for managing pain. It is a skill that takes practice, like many skills you may have learnt over the years.
For some here is a short (2 min) relaxation practice from Coventry and Warwickshire NHS Partnership Trust:
Mindfulness is a type of meditation. It is a mental exercise that can bring about a soothed state that helps many of our patients to manage their pain. It’s a skill that takes time to learn!
To find out more and to have a go watch or listen to this 20 minute meditation for pain management. Sit back and enjoy.
Be kind to yourself
Pain impacts us emotionally, and can send our emotions out of balance. It’s understandable that this happens, and it’s not our fault. It can help to be kind to ourselves. For example, notice how you speak to yourself. Do you beat yourself up? (many of us do).
If this is sounding familiar, here’s a short exercise from one of our Clinical Psychologists that you might like to try.
- 1) Notice how this pain is affecting you.
- 2) Understand your response, and try not to judge yourself. You did not cause this pain and your suffering is not your fault.
- 3) Try changing your inner voice…slow it right down, warm up the tone and speak to yourself with warmth and smile as you do this. Take a few moments and try breathing a little slower and a little deeper than you normally would.
- 4) From the part of yourself that understands that life can be difficult, recognise we can all just find ourselves here, doing our best, and give yourself a kind message. Make it specific to you, and make it kind. It might be something like…
“It’s understandable that I feel guilty when I can’t do the things I used to do…..Most people would find that upsetting. I’m not perfect, no one is. This pain is real and it’s not my fault. All I can do is to do my best, and do what I can.”
- 5) Don’t worry if this feels too difficult first time. Keep going, it takes time.
To find out more about how to be kind to yourself you might want to listen to this podcast by Dr Kristin Neff.
Getting better sleep can help with managing pain. However, we know pain can really get in the way of sleep. There are things that can help.
Top tips for sleeping well include:
- Keeping your bedroom as a place to sleep.
- Sticking to a routine (no matter the day, or how much sleep you got).
- Doing physical activities you enjoy (ideally late afternoon or early evening).
- Trying to cut down on caffeine and alcohol.
For more information about sleep and things that can help you sleep better have a look at the Live Well webpages on sleeping well with pain.
You might also want to visit the Sleep Council website
Pain management apps
Apps really help some people manage their pain or boost their mood. There are plenty of good ones for pain management, and many of them are free.
To find an app that’s right for you visit www.derbyshire.orcha.co.uk.
Can these ideas really help someone like me?
Yes. For a range of videos from people who really know what it’s like to find ways to live with persistent pain, visit the website below. Videos include, ‘My life without opioids’ and ‘Breaking through the pain cycle’
We know living with persistent pain can be really tough. You’re not alone.
More reading on managing persistent pain
If you want more detail on understanding and managing persistent pain we recommend you have a look at Dr Lehman’s recovery guidebook. You can read it for free by visiting www.static1.squarespace.com/recovery+strategies+pain+guidebook+2017.pdf
A useful summary of pain management techniques is the 10-step plan for managing your pain which you can find here – www.resources.livewellwithpain.co.uk/cover
Support groups and online support
We know that many of our patients find it really helpful to speak with others living with persistent pain. There are lots of options for you. We have listed some groups below that you may want to look into.
- Derbyshire Persistent Pain Support Group (COPING) – Befriending and mentoring, group support meetings and activities.
- A Way With Pain – Information and forum via Facebook
- Pain Support – Information, forum, contact club and newsletter
CBT or other talking therapies for persistent pain
Some people find talking therapies like Cognitive Behavioural Therapies and Acceptance and Commitment Therapy help with managing their pain. Both are now recommended in the recent NICE guidance for managing of persistent primary pain. You can refer yourself for talking therapy for free.
Go to this website to find out more – www.derbyandderbyshireccg.nhs.uk/improving-access-to-psychological-therapies-iapt
If you need more support to help you to manage your pain
We know that it can take time to find the pain management plan that is right for each person.
If you need a bit more support to help manage your pain you can speak to your GP for more information on support available to help you manage your pain. We are here to support you to find ways to manage your pain, and to get to do the things that are important to you in your life.
We can tell you about other things that can help you manage your pain, and that you can access for free. These include pain management groups, physiotherapy, and 1:1 psychological therapy.
What will your next step be?
Be kind to yourself. These ideas may sound simple but they take time to practice. Setting small little targets can be very helpful. What will your first mini goal be? For example, maybe your first goal could be to read about pacing this afternoon?