“Chronic pain can affect 50% of adults at some point in their lives,” cites award-winning Dr David Reilly, recognised internationally as a pioneering leader in health and wellness. “Chronic pain is pain that’s persistent or recurrent for three months or more.”
According to David, it’s extremely common with multiple causes, making it, at times, a complex problem for doctors to manage. Common causes include injury or surgery and musculoskeletal issues (back or neck most commonly - with the neck becoming more widespread with our increased use of screens). It can be inflammatory – something like arthritis, fibromyalgia or migraine. Inflamed nerves are another cause, for example, poorly controlled diabetes. Occasionally, it can signal serious disease, so if the cause is not obvious, get the help of medical professionals to make a diagnosis and advise treatment. “If the mind is troubled by not knowing the cause, that can turn up the volume of the alarm systems in the nervous system and worsen the pain. I’ve seen many patients' chronic pain settle dramatically when we have managed to air and clear fears they have been carrying about the cause and how the pain might impact their future.”
Medical investigation is at its best for ruling out serious problems that need direct treatment. However, if the diagnosis is a label of chronic pain that cannot just be treated and removed, then getting help can be more difficult, and self-care becomes far more critical. He observes that the medical journey for those with chronic pain can be tough – with stages akin to grief – as you may have to confront that there’s no ‘fix’ and face the loss of everyday ease and function, with no easy answers offered. Be careful not to take a phrase like ‘nothing can be done medically’ to mean nothing can be. If something can’t be cured, helping the body and mind to soothe, cope, rebuild, and recover offers rich hope and potential.
This is all the more important now as the NHS is not in the best state to help people with chronic pain at the moment, and you may feel stuck without help for a condition that is seriously compromising your quality of life, if not disabling you.
“There are very long waiting lists for NHS pain clinics,” states Dr David. “You can wait between 18 months or even three years in some areas of England, so self-help is now critical.”
Strong painkillers are vital in sudden acute pain, but painkillers, David warns, are not the answer to chronic pain. The body adapts to the drugs, and you may end up with the same pain level, plus side effects. “That’s a tough one to face. Opiates prescribed for chronic pain have caused very concerning problems worldwide. If you’re on them for more than a few weeks, be cautious as the body may already depend on them, and addiction often arises, too. With medical help, aim for a 5-10% reduction per month while exploring less troublesome forms of analgesics and anti-inflammatories. Critically, in parallel, explore the possibilities of non-drug methods to support your recovery and reduce your need for drugs.
Dr David has strategies for approaching the self-management and recovery pathways with chronic pain. “Realising a difference between pain and suffering is very important,” he says, “Pain is a sensation that hurts, but suffering is the emotional distress and responses triggered by the pain. You can often help the pain but maybe not completely. But you can always help suffering. As suffering is reduced, it can help reduce the pain itself.”
But if you’re stuck waiting for help from an NHS pain clinic, there are things you can do in the meantime to treat chronic pain. “Start to gather your tool kit around both the pain and the suffering,” he continues. “As far as the pain goes, useful techniques include breathwork, physical supports such as chiropractic, massage, acupuncture, and then movement is very important, especially mindful movement such as yoga and tai chi.” (And, of course, many of these are available with becoming a member of Goldster – which can help you build your toolkit in self-care for chronic pain. Click the button below to try 5 free classes.)
“For health and for pain, an anti-inflammatory diet is important. Cut down or cut out ultra-processed foods, and emphasise a wide variety of real food. Vitamin D deficiency can present as chronic pain, and supplementation is often required; increasing Omega 3 sources (foods from the sea) can also reduce inflammation and improve mood, over some weeks or months.”
According to Dr David, a central and rich area for help with chronic pain and suffering is in the realm of emotional and mental training, such as mindfulness and meditation, cognitive skills, active imagination techniques and contemplative practices. Nurturing kindness, not to the pain but to the part of your mind or body that is enduring the pain while trying to keep going for you, can be pivotal. Just because there isn’t a medical fix does not mean there isn’t a path forward for you to regain a much better quality of life.”