When Chronic Pain Becomes Too Much, Here’s How To Manage

More people than you might imagine live in unbearable pain that interferes with living life happily. According to the CDC, 1 in 5 Americans experience chronic pain. And, for almost 1 in 10 Americans, chronic pain becomes too much.

If you live with any kind of chronic pain, information is your friend. Read on to get a better handle on your situation and find new ways to manage.

FAQs about chronic pain

You’ll find the answers to these questions in the article below, but here are some quick answers.

Is chronic pain a disability?

Long-term pain is not typically classified as a standalone disability. Rather, it is typically considered a symptom of another clearly defined, disabling condition (such as cancer, inflammatory conditions like arthritis, autoimmune conditions like lupus, and neurological conditions like MS).

However, if chronic pain keeps you from completing important tasks and you’re unable to find relief through common measures, it may be accurate to call it disability, regardless of the diagnosis or legal definition.

What causes chronic pain? What are some reasons for chronic pain?

Chronic pain can have a variety of causes. You might have long since recovered from an illness or injury that caused it, but the pain persisted. We see this in post-viral illness and other conditions affecting the immune system. Or there might be a clear, persistent reason for the chronic pain (like cancer, connective tissue disorders, or neurological conditions). 

Muscle tension associated with mind-body mechanisms causes chronic pain for many people with trauma or mental health conditions. Additionally, some people develop issues with “central sensitization,” which is when your nervous system interprets things as painful when they shouldn’t be (which is not to say it’s in your head!).

Or, some people experience chronic pain without any prior injuries or diagnosed illness. That doesn’t necessarily mean there is no cause. The cause may just not have been found yet.

Can unhealthy habits make pain worse?

Yes, but personal choices are not the be-all and end-all of chronic pain.

Uncontrolled weight gain, excessive stress, and lack of sleep are just a few lifestyle factors that rank at the top of the list of pain-aggravators. However, these factors are not always within a person’s control. It’s important to avoid the personal responsibility fallacy when talking about chronic pain.

Yes, lifestyle choices may contribute to feeling better or worse. But family situations, financial stress, developmental trauma, mental health struggles, and physical conditions are usually out of a person’s control. These may impact chronic pain more than factors related to choice.

Can chronic pain be unbearable?

Chronic pain can be unbearable in its intensity. But chronic pain also becomes unbearable when lower pain levels persist over time. Chronic pain doesn’t have to be acute to be unbearable. 

What does chronic pain do to a person?

Chronic pain patients may become fatigued, disabled, and even socially isolated by their pain. It can change the way people go about daily tasks, how they complete their work, and how they spend time with their families. People may develop feelings of inadequacy or hopelessness due to their pain and limitations associated with it.

Also, when a person experiences pain over a long period of time, it can alter the brain and nervous system. These structural and functional changes may make it easier to feel further pain.

You’re not weak or dramatic for experiencing what you do. Chronic pain is real and has real effects on many parts of life.

What is chronic pain?

Chronic pain is defined as any pain that lasts more than 12 weeks. It can be caused by a number of conditions, such as arthritis, fibromyalgia, autoimmune disorders, hormone issues, and even depression. However, it can also be caused by lifestyle factors such as the job you do, how you sleep, or the way you stand and walk.

Because it can be caused in so many ways, the prevalence of chronic pain is high (affecting about 1 in 5 Americans).

When is chronic pain considered unbearable or too much?

Chronic pain can be unbearable in its intensity. But chronic pain also becomes unbearable when lower pain levels persist over time. Chronic pain doesn’t have to be acute to be unbearable. 

Imagine you get a headache. You know you won’t die from the pain, and you can manage. But what if that headache lasts for a week, a month, a year? A “manageable” pain level becomes less manageable the longer it goes on. In this way, chronic pain often becomes unbearable.

For some people, chronic pain can become so severe that it significantly impacts their quality of life. If any of the following happen for you, it’s time to take your pain seriously:

• The pain persists
• It’s painful to move
• Pain impacts daily activities
• Medications don’t help
• Pain is affecting your sleep
• The pain is radiating

Try, try, try again is the motto of chronic pain management

If your chronic pain has become too much, you’ve probably already tried many ways to improve your pain. However, it’s worth considering that other factors may have interfered, the last time you tried a chronic pain treatment.

For example, if you tried something for your pain while experiencing insomnia, it might not have worked because insomnia is so bad for pain, that nothing could reverse its effects.

If you have chronic pain, it’s worth your time to try solutions more than once. 

Consider how to best approach your doctor about your concerns.

People with chronic pain are very familiar with doctors’ visits–and also with frustration at those visits. The frustration isn’t your fault, but there are some ways to make the most out of a doctor’s visit when you have chronic pain.

​​1. Be precise and use metaphor where helpful

Giving more precise descriptions may help doctors better understand your pain. “My knee has been hurting all the time” is less precise than “My knee feels like there’s sandpaper inside when I move it, and feels hot and achy when I don’t move it.” Your doctor may make assumptions about your experience if you don’t spell it out – that won’t help resolve your chronic pain.

2. Describe the context

Also, including context can help doctors see your situation more clearly. It can help to discuss how your pain changes throughout the course of the day. Is it frequently when you eat, walk, or engage in particular activities? Does anything make it better or worse, even if only slightly?

3. Discuss function rather than emotion

Tell your doctor exactly how your pain affects your daily life. Focus on how your function is impacted, instead of on your emotions. While your emotions are valid, impaired function may be more relevant in a medical context. 

This might mean discussing how it makes it difficult for you to get out of bed in the morning, dress, feel rested, or enjoy going out with friends. It should be a given that the pain is disruptive in your life. But as in many situations, it can help to put the “stakes” on the table.

Stay as active as you can.

Gentle exercise (aerobic or resistance) can help with chronic pain–stretching, swimming, walking, yoga, etc.

Blood flow, distraction, green light, and the release of feel-good chemicals may make outdoor exercise helpful for people in pain. Even for people who don’t feel relief in response to exercise, it’s been reported that many chronic pain patients feel stronger, more capable, and more fit after moving their bodies.

Don’t shy from using pain relief medication, but not too often.

Untreated pain has a significant negative impact on quality of life and may have economic, social, psychological, and physical repercussions. If acute pain is not properly managed, immunological and neural changes may occur that contribute to chronic pain.

While there is no blanket cure for chronic pain, there are numerous efficient therapies that can help you function well and enjoy your days––depending on your pain’s cause.

Work with your doctor to identify the most straightforward long-term solution as you experiment with various medications and tools, either alone or in combination. A doctor can help reduce the risks associated with your medications to increase your chances of having many good days for many years to come.

There is no shame in using solutions available for your pain. You won’t receive a medal of honor for enduring pain without any outside help. Being willing to try available tools (medication or not) shows that you are actively trying to feel better.

That said, rebound pain is real, and it can happen with all kinds of medications such as acetaminophen, NSAIDS, products containing caffeine, and the infamous opioids. Additionally, chronic use of painkillers like ibuprofen can lead to long-term organ damage. For more on painkillers and rebound pain, see this resource from the Mayo Clinic.

As with many things in life, balance is key when using medication.

Make sure you’re using topical treatments and physical tools, like heat or ice, to help manage your pain.

Not all treatments involve medication. Topical or physical treatments like salves, capsaicin cream, heat, or ice can change how blood flows around an area (and thus change how your senses perceive pain in that area). Additionally, topical treatments can create sensory distraction to ease pain.

There are also physical tools many find relief from. Try using a foam roller, vibration pad, supportive pillows to change your sleep position, or even a self-massager depending on the type of pain you experience.

External treatments are a low-risk category of tools with many different options–so you can always try something new in case it might help.

Make sure you’re sleeping long enough and soundly enough.

Chronic pain is related to a variety of sleep disturbances. Difficulty falling asleep, nighttime awakenings, waking up very early, and feeling exhausted after a night’s sleep can all be either causes or effects of chronic pain. 

You may not be able to change the pain that interferes with your sleep. But you can take measures to make sure the sleep you DO get is restful. Here are two tips that anyone can try to fall asleep more easily despite chronic pain:

1. Use your breath as a tool for falling asleep

Breathing slowly and rhythmically can assist promote sleep by soothing the mind and body and possibly reducing discomfort and stress. According to research, taking calm, deep breaths before bed can help you fall asleep more quickly and stay asleep if you wake up during the night.

The most important tip here? Make your breath out longer than your breath in. This sends a message to your nervous system, activating parasympathetic action (also known as a “rest and digest” body state).

2. Take a hot shower or bath to fall asleep quicker

In order for a person to fall asleep, the brain has to experience a temperature drop. This can happen naturally as your body realizes it’s time for bed. However, if you’d like to speed this process, you can do something counterintuitive: taking a hot shower or bath. According to sleep expert Dr. Matthew Walker, once you exit the hot water, your brain will experience a clear temperature drop, and this can speed the process of falling asleep.

Try yoga or another mind-body practice for chronic pain

Yoga is a mind-body therapy that may aid with chronic pain relief and sleep improvement through physical positions, rhythmic breathing, and meditation.

One way yoga can help chronic pain is by training your muscles to hold your joints in “correct alignment.” Your muscles hold your joints in place as they move, but if you’re holding your muscles in an unhelpful way, movement may cause pain in tendons, muscles, or joints. Yoga builds muscle strength in a way that keeps you in better alignment, even when you’re not actively practicing.

It can be helpful to take yoga lessons from a certified instructor who can check alignment, modify the poses based on your pain tolerance, and help keep you on-track.

Understand how your nervous system affects pain management

If you never (or rarely) exit fight or flight mode, that sends a signal to your body that you are unsafe. When your body feels unsafe, it may be more likely to signal pain–letting you know that it needs help, quickly.

In chronic pain states, the autonomic nervous system may be dysregulated, often leading to heightened reactivity to sensation or stressful stimuli. Your vagus nerve may become under-active, keeping you in fight or flight.

If you don’t heed your body’s requests to rest and recharge, it’s hard to get rid of chronic pain no matter how many other solutions you try. Your nervous system won’t let you ignore your need for rest. If you ignore that need, your pain is bound to continue.

Signs of being in fight or flight mode (aka: signs that rest may help your chronic pain)

• Stress eating (fight)
• Stress nausea or loss of appetite (flight)
• Clenched muscles
• Night sweats

Takeaways for chronic pain management

⚫ There’s no award for suffering. You can and should keep trying as many therapies and tools as possible. It’s important to maintain hope that something will eventually work. Circumstances, current understanding, and available therapies can always change.

⚫ How you communicate about your pain matters. Even though it sucks, sometimes the “package” or words you use make a difference in how providers respond to your pain.

⚫ Sleep can impact chronic pain, but can be improved through non-medical means.

⚫ Exercise and practices like yoga have concrete physical effects that can alter pain mechanisms. It’s not all hand-waving mumbo jumbo. Movement is worth your time even when you’re actively in pain.

⚫ Your biomechanics and posture can actually make or break your chronic pain management strategy.

⚫ If you can’t change your chronic pain, it might help just to talk about it.

Breaking a subject down into smaller pieces by talking about it can help you stop feeling so overwhelmed. You can feel less isolated and like you’re not experiencing things alone by talking to someone.

Chronic pain may be difficult and intolerable, but if we fully understand it, its causes, and some techniques to manage it, the experience can get easier over time.