People who experience chronic pain know that it is very real. They experience it in their body, it affects their actions, emotions and everyday function. It impacts on every aspect of their life. In the past there was a general belief that the pain is an indication of something wrong with our body and therefore, a rest and various types of medication (including opioid medication was commonly recommended as a recovery. This often included opioid medication such as MS Contin, Oramorph, Avinza, Kadian, Roxanol (chemical name: morphine); Codeine; Dolophine (chemical name: methadone); Opana, Opana ER, Numorpahn HCI (chemical name: oxymorphone); Dilaudid (chemical name: hydromorphone) etc.
Whilst this approach may still be applicable during the initial weeks following the injury, the prescription of opioid medication is no longer recommended for extended uses due to associated risks (addictions and overdoses), and its verified ineffectiveness in the management of chronic pain. Instead, currently commonly prescribed advice is that of a more active lifestyle. The new body of evidence indicates that activity* along with positive outlook and refined understanding of pain experience works wonders in recovering from chronic pain (Mosley & Butler, 2015)
The nationally renown work on management of chronic pain by Dr. Lorimer Mosley & David Butler discusses recent discoveries in the biology of nociception and pain. Their work explores the complex interaction between the neural and immune system in pain and protection, and the identification of altered sensory and spatial processing in people with pain. Mosley’s and Buttler work “Explain Pain and The Explain Pain Handbook: “Protectometer” clearly demonstrates the need for a shift from our perception of pain as the indicator of something being wrong with our body to simply perceiving the pain as a signal of danger. (Mosley & Butler, 2015)
Every part of the body has pain receptors that send information to the brain to let us know when we experience pain in this area. In acute pain when there is a new injury, the pain signals are very useful, telling us there is a danger to our body which needs to be addressed in order to ensure our recovery. In chronic pain the pain signal patterns become so well established that sometimes our brain continues to send them out for months and years after the injury, even when there is no longer any real danger and even in situations when everything is already healed (I.e no sign of damage can be detected).
What does all this mean? This new body of evidence brings a new hope by providing a wide range of new strategies to assist in living life pain free. It reassures us that there are ways of self-regulating pain signals, the way we can regulate any other danger signals (i.e. either paying attention and acting on them or not).
For example, let us consider a green python snake. Let’s imagine that we spotted the snake on the ground a few metres from us. And our eyes send the message of danger to our brain. We have about 2-3 seconds to evaluate the signal and all the relevant information we know – to decide if we should act on this danger signal or not. If we believe that all snakes are dangerous and know that our friend almost lost his life after being bitten by a snake, we would definitely pay the full attention to the snake and act on the danger signal (i.e common fight or flight defence mechanism, including running, hiding, trying to kill the snake or becoming petrified or freezing) . If on the other hand we had a green python snake as a pet in childhood and know that green pythons don’t pose any danger to humans, we would most likely ignore this particular danger signal and continue feeling safe, carrying on with our previous activities.
The same self-regulatory function is available in relation to chronic pain. If we feel pain, we have the choice to decide if this danger signal is indicative or real danger like for example, at the time of injury, where we be best to address our wounds or else our blood loss could be fatal. Or else we could decide that the pain is just a false alarm signal and decide that we are safe regardless despite the pain (like in situations of chronic pain).
What are the other options for self-regulating in this area? Self-regulating of our pain experience can be achieved by identifying and redefining our danger versus safety messages that we use in daily self-talk, Danger and safety messages could include messages about situations, events, places, memories, people that matter, personal beliefs, sensations, things that we do, say and think. The examples of danger messages include messages about divorce, stress at work, swelling legs, feeling tired and needing rest, being diagnosed with chronic condition, memories about a friend who had similar condition and is now dead, thoughts, such as “doctor told me I would never recover”, or “yesterday I looked over my shoulder and heart a crackling noise in my back’,
The examples of safety messages, include: your belief that pain is a danger signal that can be self-regulated, daily exercise to assist your body natural healing properties, thoughts about people supporting and reassuring you, spending time with supportive family and friends, positive self-talk about recovery and living pain free, belief in your strengths and abilities, reconnecting to hobbies and interests, and so forth.
The process of self-managing chronic pain involves identifying your danger messages and replacing them with safety messages. You may also consider supporting your recovery from chronic pain by applying the following self -management strategies:
- Regular, exercise of your choice (as recommended by Physiotherapist or specialist)
- Quality time with nature
- Connecting with your creativity (according to your interest, i.e. craft, paining, woodwork, poetry, writing, dancing, singing etc)
- Reconnecting with old friends and interests
- Engaging in fun activities i.e. watching happy movies, having a massage
- Engaging in revitalising activities such as mindfulness and / or meditation
- Keeping a journal with wonderful, happy thoughts, memories, activities in your life
- Healthy eating / enjoyment of good food
- Engaging in hobbies, social groups or activities
Hypno-Link Chronic Condition Management Program applies Mosley and Buttler’s ‘Explain Pain principles’ in a series of effective counselling and clinical hypnotherapy sessions (and in consultation with your doctor).
The Hypno-Link Chronic Conditions Management Program not only explains recent findings in relation to pain processes but also effectively rehearses self -regulatory process of replacement of danger messages with positive safety messages. To organise an appointment please contact Alicja / Therapist from Hypno-Link on 0490 463 042 or [email protected]
Explain Pain and The Explain Pain Handbook: Protectometer. (2015) Moseley and Butler, Noigroup Publications.
Also see: www.noigroup.com or www.protectometer.com
(^ as recommended for each individual situation by the Physiotherapist or medical specialist)