Chronic Pain Guide
Chronic pain is a frustrating, often lonely condition that can leave people with little to no hope of having a ‘normal’ life again.
Often, people with chronic pain are told that their treatment options are limited, and that they may never live pain free again. It can be hard to stay positive when no hope is given.
As a naturopathic doctor with a focus on chronic pain, I’m here to tell you there is hope and I’m going to share the same tips I give my patients.
Tips you can do at home, without making massive changes to your lifestyle.
These tips are focused on helping to reduce pain, making the unbearable, bearable again, so you can do things like your shopping, go for a walk, even sit without being constantly reminded of the pain.
My goal is to share these with the hope it can offer relief from the pain and frustration and improve your quality of life.
In this article I’m going to share:
How chronic pain is defined
What causes chronic pain
Treatment goals for chronic pain
Natural treatments that have shown to reduce pain
The top 5 things you can do now to help with chronic pain
Chronic pain is caused by a variety of reasons and health conditions, so it is important that you seek medical care prior to implementing any recommendations. Some of these treatments may or may not be suitable for you, which is why we must individualize your treatment plan and ensure it is safe and effective for you.
How is chronic pain defined?
Chronic pain is defined as pain that remains constant or comes and goes for a time period of 3 months or greater. This can be experienced anywhere in the body, and often interferes with activities of daily living. Pain is subjective, meaning only the individual experiencing it can describe what it feels like.
Chronic pain is often difficult to diagnose, and typically requires a team of healthcare providers for both diagnosis and appropriate treatment.
When we ask patients to describe what their pain feels like, common words we hear are: aching, shooting, burning, stiff, throbbing, squeezing, and more.
What causes chronic pain?
A variety of conditions can cause chronic pain. Some examples include:
• Rheumatoid Arthritis
• Osteoarthritis
• Fibromyalgia and Chronic Fatigue Syndrome
• Headaches/Migraines
• Post-Traumatic Pain (due to physical, mental, emotional trauma)
• Cancer
• Inflammatory Bowel Disease
• Endometriosis
• Interstitial Cystitis
• Vulvodynia
• Lupus
• Multiple Sclerosis
*Note: This is not an exhaustive list of conditions that can cause chronic pain.
Goals of treatment for chronic pain:
• Improvement of symptoms, daily functioning, and quality of life
• Working proactively to prevent any worsening of symptoms
• Providing emotional support throughout the journey
• Prevention of new associated symptoms that can arise
The Top 5 Things You Can Do Now To Help Relieve Pain!
1. Increase anti-inflammatory foods in your diet.
In many cases, chronic pain can be caused by high levels of systemic inflammation. This means that trying your best to increase anti-inflammatory foods and decrease inflammatory foods in your diet is very important.
Anti-inflammatory foods to INCREASE:
• Fatty fish (meaning high in omega-3s) including salmon, sardines, mackerel, herring, trout
• Raw olive oil
• Nuts/seeds (walnuts, ground flaxseeds, chia seeds, hemp seeds)
• Leafy green vegetables (spinach, Swiss chard, bok choy, broccoli, collard greens)
• Berries (blueberries, blackberries, strawberries)
• Spices and herbs (turmeric, ginger, cinnamon, garlic)
Inflammatory foods to AVOID:
• Artificial sugars (soft drinks, fruit juices with added sugars)
• Refined grains (white bread, pasta, cereals, pastries)
• Fried foods
• Processed meats (bacon, lunch meats, cured meats)
• Alcohol
It can be hard to know what to cook or eat when dealing with chronic pain. Cooking can take a lot of time and exhaust you even further.
When working with Dr. Madeleine, she will create a customized nutrition plan for you, that is both manageable and sustainable for you and your needs.
2. Optimize your sleep by practicing sleep hygiene techniques.
The relationship between sleep and chronic pain is a complicated one. This is because chronic pain often causes sleep issues, while a lack of sleep leads to worsening of pain.
Studies have shown that a lack of sufficient sleep and poor sleep quality are risk factors for developing chronic pain. Why? Several mechanisms have been considered, one being the effects of sleep deprivation on the opioid system (our pain regulation system). It has been shown that sleep disruption impairs our body’s ability to turn off pain signals.
Where can we get started?
Sleep hygiene, a fancy way of saying healthy sleep habits, is very important to ensure our bodies are resting and recovering over night. Research has shown that daily pain intensity is correlated to the quality and duration of sleep from the night before.
It is so important to ensure you are getting a good night’s rest, and as Naturopathic Doctors, there is a lot we can do to help you optimize sleep. Try starting with this.
Sleep hygiene techniques:
• Set up a sleep routine: consistent bedtime and wake time every day of the week, consistent length of naps if needed
• Create a comfortable sleep environment: a dark and quiet room with a pleasant temperature, mattress and pillow that are comfortable for you
• Calming habits before bed: reading a book, listening to relaxing music, practicing yoga/meditation, taking a warm bath, journaling, etc.
• Use bedroom for sleep and intimacy only. Ideally, your office and social spaces should be separate from your bedroom.
• Avoid before bed: caffeine, alcohol, large meals, simulating activities (watching TV, using your phone/computer, all of which use blue-light which negatively impacts our sleep)
3. Manage your stress levels as best as you can.
Stress has a profound effect on chronic pain, and high levels of persistent stress have been associated with worsening of pain levels. This is in part due to our stress hormone, cortisol, that when released for prolonged periods causes inflammation and heightens our stress response – the opposite of what we want it to do. We want it to regulate our stress response in a balanced way. When our bodies go through this chronic stress response, the pain we experience is significantly worsened.
Managing your stress can be tricky, as experiencing chronic pain often significantly adds to stress levels. It makes sense. When we’re not feeling great, we typically experience some worry and stress around it. On top of that, things that we can’t control come our way and can add an extra layer of overwhelm.
Be patient with yourself and try to start somewhere.
The best place to start is with your BREATH. Here is a simple breathing technique that can help calm your nervous system and allow you to reset your thought patterns.
4-7-8 Breathing:
Breathe in for 4 counts, hold the breath in for 7 counts, and exhale the breath for 8 counts. Do this around 3-5 times.
This technique can significantly reduce symptoms of acute stress and anxiety.
4. Try to get your body moving every day.
Physical movement with chronic pain is so important, as it maintains the body’s mobility and range of motion, and can help to prevent worsening of symptoms.
With chronic pain, there is a tendency to avoid and be skeptical of physical movement. However, keeping the body moving helps to prevent pain levels being worsened by immobility and stiffness.
It can be challenging to get up and moving depending on the severity of your pain. If you need some relief prior to getting moving, using a heat application can really help. Applying heat to the locations of chronic pain increases blood flow to those areas and relaxes the musculature. This can help reduce pain and stiffness acutely to help you get up and moving.
When we say physical movement, we don’t necessarily mean vigorous exercise. We mean generally getting your body moving, if possible. That being said, if it hurts too much to move right now, don’t worry about this tip. We can work together to get you there.
It is important that your physical activity needs are properly assessed prior to implementing any major changes. As Naturopathic Doctors, we can help determine what type of physical movement is best for you and your needs.
Examples of physical movement for chronic pain:
• Short, regular walks
• Avoid sitting for extended periods of time and try to move every 30-60 minutes
• Gentle stretching, yoga, and/or Pilates
• Swimming or water aerobics, to allow for movement that doesn’t impact joints
• Light weight lifting
5. Anti-inflammatory supplementation, nutrients and/or herbs.
Supplements, nutrients, and herbs that have shown effectiveness for chronic pain include omega-3 fish oil, natural eggshell membrane (NEM), palmitoylethanolamide (PEA), magnesium, vitamin C, curcumin, boswellia… and the list goes on!
There are a couple of basic mechanisms that can explain how these products help with chronic pain. In many cases, pain is caused by systemic inflammation, and some of these supplements and/or herbs are known to be strong natural anti-inflammatories. Additionally, a couple of these supplements relieve joint pain and stiffness by adding lubrication to the joint capsule… kind of like adding oil to a stiff door hinge!
We recommend that you work with a Naturopathic Doctor to determine which products are best suited for you, in terms of safety and effectiveness. Depending on your case, some supplements and/or herbs may be better suited for you than others. That’s where we come in with our clinical experience and decide what will help you the most.
Chronic pain can be a challenging thing to live with. Thankfully, there are ways we can help you manage the severity, and our hope is to help improve your quality of life.
The 5 tips above are ways you can get started today. If you are looking for more individualized care with a treatment plan that is customized to your specific needs, book a free 15-minute consultation with Dr. Madeleine, one of our Naturopathic Doctors. She is passionate about helping individuals with chronic pain feel relief and hope for their futures.
