3 Strategies to Manage Chronic Pain Flares
Learn 3 steps to keeping chronic pain flares away
Managing a chronic pain condition can feel like a full time job. You have the medical appointments, the exercises, the medications, the tips, tools and tricks from every health care provider, coach, counselor and influencer in the area. And you might feel like you have to do it all to keep your body and mind working! But does trying to do it all actually help us? Nope. And while it may feel like a full time job, it doesn’t have to.
For the sake of this article, chronic pain will be used synonymously with any chronic symptoms, including chronic urinary urgency, chronic constipation, chronic stress and anxiety, chronic low back pain, etc.
We will also be assuming that symptoms have been relatively well managed and you are not in a current flare. If you are struggling with a flare, check out how to develop your own Emergency Action Plan to bring you out of the flare.
How Stress Triggers Chronic Pain Flares: The Stress Bucket Analogy
How do chronic pain flares start?
Short answer, stress. This can be physical stress, mental stress or emotional stress. If you are not yet well versed on how stress physically affects the body, check this out to learn more.
An analogy that can help with managing life so that stress doesn’t spiral you into a flare is to think about an empty bucket. Every day you have stressors and the level of intensity of the stressor determines how heavy the object is that goes into the bucket. Little annoyances are drops of water while big arguments are heavy rocks. When the bucket is filled you have to dump it over or take out each thing, item by item. If the bucket overflows, here comes the pain flare.
If you wait until the stress bucket is totally full then it’s going to be incredibly heavy to tip and it will take us a long time to unpack each item.
But what if you spent time on a regular basis to check in with your bucket and take out items you no longer needed. That is emotional processing and that is what keeps your stress levels, and therefore, your symptoms, under control.
The Mind-Body Connection: How Mental and Physical Stress Interact in Chronic Pain Management
When we are dealing with chronic pain it makes sense to us to keep our bodies moving. We stretch, we strengthen, we do our yoga, we go for walks, all the good stuff. But what are we mentally doing during that time? For many years we tried to separate the mind from the body but it’s clear to see now that what affects one will affect the other.
For example, you can probably think of a time when you were in pain (physical stress) and felt irritable and less patient with those around you, which probably made you feel badly (emotional stress) later for your interactions.
In the opposite direction, you can probably think of a time that you had been so worried (emotional stress) about an upcoming interaction that you spent the rest of the day clenching your jaw and neck (physical stress) only to end up with a headache at the end of the day.
Our thoughts and feelings affect our body and our body affects our thoughts and feelings. So what do we do about this and how do we take stress items out of our buckets on a regular basis so that we don’t push ourselves into a flare? To learn more about the intricacies of this system, check out Dr. Bessel van der Kolks book The Body Keeps the Score.
Here are my favorite 3 ways to bring the mind and body together to manage stressors so that chronic symptoms stay away.
Physically Processing Emotions During a Walk: A Step-by-Step Guide
I love this technique! First, go for a leisurely walk. During this time, let yourself vent. Say all of the mean, terrible things you are feeling and thinking (even the things you feel like you shouldn’t say or think). This is a filter free zone. You’re the only one hearing it so have at it! Give yourself the gift of venting.
Then, come in with compassion. This can be hard for many people and it’s understandable. We are often so readily able to give compassion to others but rarely able to give it to ourselves. Say things to yourself as if you are your own best friend. What would you say to your best friend in this situation?
“This really stinks, I am so sorry this happened to you”
“That does seem really unfair, I can’t believe they got away with this”
“I was shocked too, I really didn’t think they would ever do something like that”
“This absolutely feels hard. I’m here with you”
After you vent and then give yourself compassion, think about what is still lingering. There may be a few things and the longer the walk, the more stuff you get to work through. Start with the heaviest emotion or thought and put it into this pattern:
I am experiencing the emotion of __________
Because of the thought that _____________
And it feels like ___________ in my body
Emotions can feel so real, heavy and intense. But they are only a chemical recipe of hormones and neurotransmitters. It is just a feeling, it is not real. You are not angry, you are experiencing the emotion of anger. There is a difference. You are not your emotions.
Next is the thought. The thought is just a thought, it does not necessarily mean it's true. I used to have a thought that there was a monster living in my closet when I was a kid. Was it true? No. Did I still believe it? You betcha! And did I let that simple thought terrify me every night. Absolutely.
If we believe all of our negative thoughts, we get stuck in states of chronic fear or anxiety which will oftentimes lead to the same physical response of a pain flare that we are trying to avoid.
Lastly is assessing what it feels like and where you feel it in your body.
Focus on this physical feeling, follow it through your body, notice what it does, give it space to exist. We can only physiologically hold onto an emotion for 1-2 minutes when we give it our full attention. The reason things stay with us is because we bounce from thought to thought and emotion to emotion. When you feel your brain wanting to pull you into a new thought or emotion, refer to the above pattern and stay with it.
Once this particular emotion and thought are processed then move to the next one. We can have many thoughts associated with a single emotion and many emotions tied to a single thought. That’s the beauty of a long walk.
If you’re new to this, you may need to sit or lay down to be tuned in enough with your body to feel where the emotion lives. If this is the case for you, consider venting and compassionate talk during a walk and physically process the remaining pieces when you get to a safe place where you can be still.
Big, Powerful Movements: The Benefits of Sweating Out Emotions
Did you know that stress hormones are found in your sweat? Crazy, right?! Big, heavy movements that require a singular focus can be fantastic for helping you get your sweat on while not letting your mind wander. Some great options would include moderate to heavy weightlifting (if you’re trained in this), hitting a punching bag, jumping rope, or jogging/sprinting.
Getting in some big and powerful movements to get out some of those pent up emotions and get some sweat rolling down your face every couple of days can be fantastic at taking some of those items out of the stress bucket and helping life's stressors feel much more manageable.
Deep Breathing, Music, and the Physiologic Sigh: A Powerful Stress Relief Combo
Deep breathing has been an age old technique at managing stress. I like to add in a little flavor with some gentle music. I’m a big fan of Beautiful Chorus, specifically their Mantras in Love album. The rhythmic positive affirmations can really help calm that mind and give you a message you desperately need to hear.
Another favorite of mine is music set at a hertz level for alpha or theta brain waves. These brain waves are calmer and more relaxed than our beta waves, which is where we spend a lot of our waking time with information absorption, recall and waking stressors. Steven Halpern has some great albums that I like to use, specifically when working with my patients with chronic pain just to help with a little more nervous system relaxation.
You can add into this a physiologic sigh which is an immediate stress reliever! To do this, take a look at the following steps:
Take a deep breath in
At the top of the inhale, force inhale slightly more air
Breathe out slowly, slower than your inhale time
Do this 1-3 times
If you want more details on this, Andrew Huberman has a great and quick video you can watch.
If you are really looking to beef up your emotional processing game, consider combining deep breathing, music and the steps for physically processing emotions. You may just feel like a new person when you’re done.
How Mind-Body Awareness and Stress Management Build Resilience Against Chronic Pain Flares
Does all of this really help?
Yes! If you take time to get to know your own mind and emotions, you’ll notice certain emotions are felt in certain parts of your body. You may notice you feel anger in your throat or sadness in your chest or fear in your gut.
As you notice trends, you can start to notice how this ties to your symptoms. If you notice you feel anger in your throat and you’re prone to chronic migraines, which are affected by the muscles in and around your neck and head, then you may want to pay more attention to when your body is feeling anger, as this may push you into a flare.
Sometimes we have emotions that are not so obvious and simply moving our bodies in hard ways that are not too physically stressful as to cause injury can help push any of those latent neurotransmitters and hormones that haven’t been used up yet right out of our body through our sweat.
Doing these things on a regular basis helps keep our stress bucket relatively empty and helps our body resilience. It allows us to prepare for that big presentation without being knocked out by a flare afterwards. It helps us prepare for and have that awkward conversation with our mother-in-law without getting sick. It gives us more leeway to live our lives without fear of the flare!
If you're struggling with how you can build resilience in your system to avoid chronic pain flares, reach out and we’d be happy to help support you in this journey!
