How to rethink your chronic pain

Do you suffer from chronic pain? If so, you’re far from alone. A third of adults in England had chronic pain in 2017, according to the charity Versus Arthritis.

The condition – classified as pain that lasts for 12 weeks or longer despite getting treatment – is often triggered by injury or illness, but it continues long after physical healing takes place. Symptoms include muscle tension, loss of energy and/or appetite, depressed mood, anger, and/or anxiety, and the pain is often severe enough to impede normal daily activities. Sadly, effective treatment is elusive – and concerns have been raised over the benefits of opioid painkillers, taken by 13 per cent of UK adults. They have strong side effects, can weaken in effect over time and may become addictive.

Psychological techniques are gaining increasing attention for their role in treating chronic pain. More recently, mindfulness-based cognitive therapy (MBT), and acceptance and commitment therapy (ACT) have shown considerable promise.

MBT encourages acceptance. Instead of fighting the pain, sufferers are encouraged to face their pain – not critically or fearfully, but with what Jon Kabat-zinn describes as a “gentle curiosity”. When tension and the desire to escape current circumstances are eased, pain is also eased.

ACT is similar to MBT, but includes a package of individualised behavioural techniques. ACT therapists help clients recognise and accept what they can’t control, and commit to actions that will improve their current situation.

But what if you can’t access therapy, or if for you the side effects of medications outweigh their benefits, or you’re too uncomfortable to do regular aerobic exercise – a recommended way to relieve pain? Here are some suggestions:

Change your self-talk. Maria Richter and colleagues at Friedrich Schiller University Medical School found pain-related words – whether in context or not – activate brain regions associated with pain. It’s best, therefore, not to constantly refer to your pain.

If you must talk about it, use another language. When Morgan Gianola at the University of Miami subjected bilingual participants to painful thermal sensations and asked them to rate their pain, they reported lower rates when they were asked to do so using their nondominant language.

Finally, if you really need to let off steam and you won’t offend others, you could always swear. Richard Stephens and Olly Robertson at Keele University asked participants to immerse their hand in an ice bath and respond with either a traditional swear word, one of two invented swear words, or a neutral word, then rate their pain. When uttering the traditional curse, participants experienced a 33 per cent increase in pain tolerance and 32 per cent increase in pain threshold compared with uttering either the neutral or invented swear words.