John Scott asked:


Almost everyone will have experienced acute, short-term pain at some point in their lives. You fall, have the misfortune to be involved in an accident, or have surgery. In most cases, you know you will get better – cuts, bruises, strains and fractures heal and you can resume life as though nothing had happened. The confidence that the pain will soon be gone makes it easier to bear. If you do find it too much, almost all the drugs on the market will give you relief while your body mends. But things are very different if the pain is chronic. Once you know that the pain will be with you over time, your mental approach changes. Patience is replaced with resentment or anger that you have been unlucky, that your body has let you down. This darker mood often translates into damage to your personal relationships. Your work suffers. Your marriage comes under pressure. Depression is lurking in the wings as stress builds, making it more difficult for you to sleep. Because you grow afraid of the pain, you stop doing all the things you used to enjoy. A vicious cycle emerges where your depression becomes more dominant as your inactivity increases. This list guarantees long-term suffering: stress, insomnia, inactivity and depression. The inactivity often leads to an increase in weight which reinforces the lack of mobility. You nap and find sleep difficult at night. You take increasing quantities of painkillers but find them increasingly less effective. To allow this to develop unchecked is to give up hope. You need to manage the pain which is the original source of this more general decline and take better control over your life. The first step is to understand that you can regain a better quality of life. Remaining positive in the face of your difficulties will give you the motivation to reclaim what has been lost. The second step is to find a physician or therapist prepared to give you real help. No matter how good a drug like tramadol or the more powerful opioids, reliance on drug therapy is not enough. Do not accept the lazy physician’s prescriptions and rapid dismissal. If he or she will not guide your pain management, ask for a reference to a doctor who will give you the help you need. The next step is to accept that, as part of the pain management regime, you may need to take antidepressants or drugs to help you sleep properly. So much of the problem you face is emotional. The less sleep you have, the more stressed you will feel. The less positive you feel about yourself, the less you will feel like changing yourself. Also recognize it may be necessary to change the range and dosages of the drugs you take until you start to see an improvement. Be patient and consult with your physician on a regular basis. To help the physician or therapist to help you, start observing yourself carefully. You should be able to describe exactly what triggers pain and how you change your movements to relieve it. A therapist will help you learn how to work through the emotional and fear barriers to movement. It is possible to move. You just have to accept limitations and rebuild your mobility within those limitations. Start by walking a few minutes everyday and slowly build up distance and speed. Some find swimming or water aerobics a better way of restarting mobility because the water supports body weight. And finally, you need to reduce that weight. Dieting and eating healthier food helps restore physical health. Put it all together and stress levels should fall and life should grow more normal. It is not easy, but it can be done if you want it.



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