Wednesday, November 04, 2009

Pain Tolerance: How Your Behavior Decreases or Increases It


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At the behavioral pain management program I'm participating in we spend an hour in a classroom setting in addition to an hour of group therapy / relaxation training and two hours of physical therapy. In class we've spent time learning about the differences between acute pain and chronic pain and have learned how to rate our pain, stress, fatigue and depression levels on a scale of 1-10 in order to determine how to approach our activity levels and decide whether we need to stop and use our tools based on our data. Last week we started to learn about the differences between pain level, pain tolerance and pain threshold. Just as there are factors that can decrease our tolerance to pain, there are also things that can increase our tolerance to pain. We often cannot control whether we have pain, but we can control how we react to our pain. If we're familiar with both sides of the tolerance coin we can better help ourselves cope with whatever our bodies throw at us.

These factors decrease pain tolerance:

1. fatigue
2. physical weakness
3. negative thoughts - I'm lazy, I'm a failure, I'm a bad wife/mother/daughter, etc.
4. negative emotions - angry, mad, sad, scared
5. long-term stress
6. pain medication

These factors increase pain tolerance:

1. rest
2. physical strength & conditioning
3. positive thoughts
4. positive emotions
5. minimizing stress
6. avoiding pain medication

Some of these ideas are incredibly controversial because they scare patients and challenge the typical medical model of how to treat pain. I didn't buy into some of them when I first started the program at The Lemons Center, especially the idea about reducing my pain medication consumption. I thought it was all about the judgment so many of us face as a result of our long-term use of narcotics. It's not.

The How to Cope with Pain Blog recently published an excellent piece on the use of opioid medications for pain. I highly recommend each of you read it to gain a greater understanding of the challenges associated with the long-term use of these medications for treatment of chronic pain. One issue is something called opioid-induced hyperalgesia, which means that opioid consumption increases your pain.

Medication for Pain Series: Opiates

I also challenge you to spend some time considering each of these points and taking an honest look at how you can improve each one in your own life. Are you playing a tape of negative thoughts in your mind? How can you challenge those thoughts? Are you depressed about your pain? How can you start to work through the negative emotions that depression brings with it? Are you moving your body or are you under the mistaken impression, as I was, that you cannot handle exercise because of your migraines and pain? I've had to start out very, very slowly, but I'm learning that I can do two hours of stretching and conditioning exercises a day. I have to pace myself and respect my limits, but I really can do it! I'll bet you can, too.

As always, please do not make changes to your medication without discussing it with your doctors first.

Sources:
Medication for Pain Series: Opiates
Opioid-Induced Hyperalgesia

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DISCLAIMER: Nothing on this site constitutes medical or legal advice. I am a patient who is engaged and educated and enjoys sharing my experiences and news about migraines, pain and depression. Please consult your own health care providers for advice on your unique situation.