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The Psychology of Living With Chronic Pain

The Psychology of Living With Chronic Pain

A shocking 67% of people with multiple sclerosis know what it is like to live with chronic pain. There are many different causes of MS pain such as muscle spasms, MS “hugs”, migraines, and trigeminal neuralgia. Pain comes in all shapes and sizes, and is unique to each and every person. Whether pain is acute or chronic, it can have a severe impact on our physical and mental health. Over time chronic pain can lead to anxiety, depression, and social isolation.

There are medications that can help but sometimes they can only partially relieve symptoms, which is why many patients also seek out other ways to control pain. Massage, acupuncture, meditation, and psychological support have helped many patients control their pain more effectively. Studies have also shown that cognitive behavioral therapy can help control pain. Learning strategies to mentally cope with pain can help empower patients to take back their lives, and can reduce the impact that pain has on their daily activities.

Despite the many different approaches there are to pain relief many of us still have to cope with some degree of pain on a regular basis.  It is easy to be frustrated, even angry when faced with a seemingly hopeless situation. But psychologists such as Caryn Seebach are stressing the importance of taking some of the control back in order to live our lives, despite our MS. They propose that if we can become active participants in our pain relief strategies then we can become more empowered, and ultimately improve our daily lives.

Neurologists and clinicians are experts in pharmacology and in chemically managing pain, but the patient is the expert when it comes to what works for them and what doesn’t. We are learning that when we shift the focus from treating not only physical pain, but the emotional effects of pain as well, we see better results. Seebach proposes that living in the present and resisting the tendency to worry about the future or live in the past can help us reduce the impact that pain has on our quality of life. But living in the present is of course easier said then done. Like every other behavior, it has to be practiced and learned.

I would love to live more in the moment, but the truth is I’m constantly thinking of the future. This is especially true when I am worried or anxious about something. Once I start worrying I can’t turn it off, and I’ll think about it constantly until I can find a solution. Enlisting professional advice and guidance on letting go of anxieties is something that so many of us resist, but studies are showing that it can make a big difference.

A psychological concept called learned helplessness can help explain the effect that chronic pain can have on a person. There is a classic example based on an experiment that took place on three groups of dogs. The first group was kept in a harness for a period of time and then released. The second group was harnessed and given electrical shocks that could be stopped if the dogs nuzzled a button with their noses (I know, poor dogs!). The third group was harnessed and shocked with no way of stopping the shocks. Next, the three groups of dogs were put in an enclosure. Half of the enclosure was electrified, the other half was not, and the two sides were separated by a low wall. The first and second groups of dogs quickly hopped over the wall to the safe side, but the third group did not. These dogs had learned that they had no control over the painful shocks, and they did not think there was any way that they could escape so they didn’t even try to.

Similarly, people can display learned helplessness. Examples include chronic illness, depression, substance abuse, and even poor academic achievement. With multiple sclerosis there are so many things that we may feel helpless to control, which can lead to depression, anxiety, and ultimately disease progression. We may not be able to turn off our pain with a button, but psychologists say realizing that we are not helpless and being active participants in our pain management can improve our mental health.

Seebach says a key component to coping with chronic pain is to practice “mindfulness”. Mindfulness is the act of focusing on the present and not worrying about the past or the future. It is taught through cognitive behavioral therapy and it aims to help the person focus on things that can be controlled. These things may include building a good support system, seeking alternative therapies like massage or acupuncture, or using diet and exercise to improve your symptoms. The core to her theory is that we must let go of what we cannot control, and commit to finding ways to live our lives anyway.

Finding effective coping mechanisms can help reduce the impact that pain has on our daily lives, even if medications and therapies don’t allow us to live completely pain free. Seebach stresses that you and your doctor are partners in your care, and should set goals with one another. Though we may have to learn to live with our pain, we most certainly are not helpless and we do not need to resign to it.

What are your strategies for living with your MS pain?

This article represents the opinions, thoughts, and experiences of the author; none of this content has been paid for by any advertiser. The MultipleSclerosis.net team does not recommend or endorse any products or treatments discussed herein. Learn more about how we maintain editorial integrity here.

  1. http://www.hcplive.com/conferences/2014-cmsc/Empowering-Patients-with-Multiple-Sclerosis-to-Follow-Their-Own-Path-to-Pain-Relief-
  2. http://www.medscape.com/viewarticle/826015 CBT improves fatigue
  3. http://www.hcplive.com/conferences/2014-cmsc/Strategies-for-Selecting-the-Most-Effective-Treatment-for-Pain-in-Patients-with-Multiple-Sclerosis
  4. http://www.britannica.com/EBchecked/topic/1380861/learned-helplessness

Comments

  • MarcoFarber
    7 months ago

    That was indeed an amazing read.

  • MarcoFarber
    7 months ago

    Great read. Thanks for sharing.

  • Carol
    8 months ago

    Very interesting article especially the part about “learned helplessness.” Maybe that is me. I have MS which is a trial in itself, but I also have chronic back pain because of spinal scoliosis. I have had several back surgeries and with PT, walker, and practiced walking, I was able to walk after about six months (wobbly walk because of MS). I have gone through this same process three times and wobbly walked. Last December, I had cervical spinal surgery and I am unable to try to even walk. I had 7 weeks of PT, used a walker, and a cane. I can’t even walk very far with my cane without getting really scared. My husband has to help me everywhere. I had a nurse talk to me every week for a month and she thinks there is some mental block that is keeping me from even attempting to walk. I just can’t see how talking to a social worker or a counselor (even a psychiatrist) is going to help me walk. So I guess I somehow “learned helplessness.”

  • sevensix
    1 year ago

    Surgery. Lots of surgery. Conditions like sciatica and cervical rediculopathy will get your attention!
    It is the worst possible pain anyone will experience.
    Was it MS? Doc declined to answer. Almost all my physical ailments occurred after MS diagnosis. Go figure.
    -sevensix

  • dscott506
    1 year ago

    Three years ago at the age of 51 years old I was diagnosed with MS. I have pain every day some days worst then others. I don’t take many of the pain medication that is available because am a nurse and do not need anything to fog my mind when taking care of patients. I usually will take motion 600mg every night even if the pain is a 3 on the pain scale. My regimen is motoring 600mg or Tylenol. Sometimes it don’t work so I try to meditate or cry.the pain can sometimes take a toll on me.

  • sunEz
    2 years ago

    My daughter is 25 and was diagnosed with MS in 2013. She has had chronic pain all over her body 24/7 for almost 2 years. We have tried almost everything and nothing helps. She gets a massage weekly and that does help relieve her headaches a little but only lasts a day. Going try Charlotte’s Web, waiting for it to arrive. When she exercises even a little bit, she is in pain for days. On a 1-10 pain scale, a good day is about a 6. Most days are a 7 or 8. She won’t join a support group and her friends don’t understand because she looks so “normal” when they see her. I am at a loss as to how to help her.

  • Annie1
    2 years ago

    I have a P.S.- also I’ve done acupuncture about 7 times now and do feel relief from it. It works better than lumbar epidurals! Although we just changed our insurance from them, Kaiser Permanente does offer acupuncture for pain patients and it’s virtually free.

  • Annie1
    2 years ago

    Thanks for this article, Stephanie-just knowing I have substantial company in this MS/chronic pain journey helps. I’ve been diagnosed for 16 years, I just turned 54. Getting out of bed repeatedly during the night and in the morning is very difficult every day. I still have my third child, a Senior, at home so I am motivated for her and my husband…However I do stretch and do a couple reclined yoga poses first (almost always have moderate to severe right sided head and neck pain, also upper back and shoulders, sometimes the entire rib cage, shooting pains have been stabbing through my eyes lately), I do have a medical marijuana card that my neurologist endorses, I do yoga 3-4 times a week off of YouTube-I like Yoga With Adrienne as she shows modifications for every level, and go on my elliptical machine (the one gym machine I love to rock and asked for for Christmas some years back) for a half an hour to 45 minutes almost every day. I wear a FitBit to keep track of my stair flights, steps, diet, sleep (insomnia has been plaguing me for about 4 years but doctors like to blame that on menopause). I’ve been meditating for almost 2 years now and I believe that is helping with the insomnia. I recommend the apps-HeadSpace and especially Insight Timer as it is free and more free form for many types of guided meditations. I’ve always exercised and I believe it truly is key for me and is MSers – my husband gets me out on hikes and bike rides that we’ve always enjoyed together in our 31 years of marriage. Although exercising vigorously or even moderately is painful at first, after about 15-20 minutes I do tend to get into a better zone, and I figure I could sit and be in pain and get into worse pain as usually happens or I can bite the bullet, put on some (quiet) peppy music and go for it. As far as the Cannibas-the strain one should try first as I’ve learned is CBD, a pain relieving component of the plant which has been and is legal that you can get online. It is non psychoactive with little THC. Icy Hot is also great to rub on places that are acting up for temporary relief; I use it several times a day and night. I have many “weapons” and I use them daily. It’s never easy, always a challenge but worth it for me and those I love.

  • joannmaxwell
    2 years ago

    Thank you so much for your article! I deal with pain on a 24/7 basis. What works for me is to focus on the love of God for me. My “mindfulness” is centered on God and his word, the Bible. If I didn’t have my faith, I’m pretty sure that the pain that I feel would be more of a problem.

  • Diane
    5 years ago

    Mindfulness didn’t work for me. I can’t afford massage, acupuncture or gym fees. My exercise is in the form of stretching. I have four bulging lumbar discs & neuropathy. I’m in pain always….NO relief. I fell several times & injured my back before I was diagnosed with MS. Now I still continue to fall…..I use a cane, walker & even a wheelchair, my balance is so poor. Ten years like this is ten years too long. This is not living but just existing.

  • Diane
    5 years ago

    Thanks Stephanie for responding to my comment. It meant a lot to me. I have checked and triple checked with my insurance and isn’t covered. No one ever said life is FAIR!!!

  • Stephanie Buxhoeveden, RN, MSCN author
    5 years ago

    Hello Diane,

    I’m sorry for everything that you are going through. This may or may not be helpful, but if you have insurance there may be a way for you to try acupuncture and massage. Some pain management specialists/centers offer massage, and a lot of integrative medicine doctors perform acupuncture and are covered by insurance. Of course there’s no telling if these therapies will make a difference for you, but in a perfect world everyone would have the right to try.

    All the best,
    Stephanie

  • Bill B.
    5 years ago

    Stephanie, Thank you for a great article! Keeping a positive attitude has probably helped me more than many of the MS medications I’ve taken over the years. Strange as it may sound coming from someone with a chronic disease for which there is no cure, I often think how blessed I am for the health I do have, for my wife and for the support groups I belong to. Of course I know things could change tomorrow, but I’m exceedingly grateful for my life.

  • theMSinME
    5 years ago

    Amazingly good article, thank you… Mindfulness is a diamond in the rough and does take determination and effort, when comfortable with it, the power of letting go is hugely beneficial.

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