How to Address the Barriers to Overcoming Chronic Pain

There are four main steps to overcoming chronic pain:

1. Recognize the ineffectiveness of how you are currently approaching your pain.

2. Begin to gradually move and do more than you currently are.

3. Become aware of the fact that you cannot do anything about what you are feeling at this moment. Bring acceptance to the discomfort you feel as you increase your activity level.

4. Continue to push the envelope as you move toward recovery.

Protecting a painful area and avoiding movements that aggravate pain makes sense during the early period after onset but becomes counterproductive as time moves along. The first step in overcoming chronic pain is recognizing that overprotecting and avoiding from a fear of making things worse is an ineffective strategy. It is helpful to recognize in this regard the difference between making a condition worse and experiencing a temporary increase in pain while you get used to moving and doing again. It is very important to be clear on this point.

It is essential to understand that a major part of physical rehabilitation is gradually getting the injured body part accustomed to being used again for activities that that body part is typically involved in. There is no other way to accomplish this but to do those activities. However, they must be done very deliberately and with focus so as to stress but not over stress the injured body part.

Once you start to reintroduce long avoided movements and activities, the most important factor to avoiding further injury is setting an intention beforehand to focus on and completely accept whatever discomfort is brought out. This level of focus will allow you to accurately recognize how much you can push yourself without getting into trouble.

As you begin this new approach, your confidence in the technique will grow as you progress and see that the temporary discomfort brought out by the process does not mean a worsening of the condition. It is important to focus on continually progressing toward normal function. This approach will give you the best chance at complete recovery and pain resolution.

Barriers to Overcoming Chronic Pain

There are three main reasons why people have such a difficult time overcoming pain. They are:

1. Fear of making the injury or condition worse.

2. Fear avoidance behavior that keeps us from using the injured body part or parts.

3. Many healthcare professionals are afraid to advise patients to do more because they don't want to be blamed for an increase in pain level.

I want to discuss each of these in more detail.

At first glance, it may seem reasonable to avoid pain because it can be an indication that the injury is being worsened. In the early stages after a traumatic injury, there is a period of time during which it is helpful to immobilize the injured area. But at a certain point, movement and function have to be restored and that requires us to gently challenge the injury to promote healing.

Fear avoidance behavior refers to the habit that people in pain often develop. It refers to when all movements or activities which bring out pain are strictly avoided for fear of making things worse and creating more pain. The result is a sedentary, unproductive lifestyle where muscles get tighter and more painful and then atrophy producing weakness. Joints stiffen and lose range of movement. Pain cannot be overcome without regaining flexibility, strength and joint mobility.

Finally, healthcare practitioners feed into patient fears by instructing them to avoid anything that causes pain. They may understand that the patient has to exercise to get better but because they are afraid of being blamed for a worsening of pain and possibly being sued for malpractice, they tend to baby patients more than is necessary. In the end, they create more of a problem than the one they are trying to avoid.