This page aims to provide a reflective space for people who live with pain and healthcare professionals. All experiences discussed throughout the case studies shall remain anonymous unless otherwise stated.
If you would like to add your own accounts of either living with pain or working to help others make sense of painful experiences
please contact me at firstname.lastname@example.org
Case Study 1
A Personal Journey With Pain
Case Study 2
A Vet’s Approach to Fear, Pain & Mobility
by Dr Marianne Dorn
Case Study 3
A Physiotherapist’s account of caring for 4 people with pain
by Robin Higginson
Case Study 4
How the words we use can limit our ability to heal
by Joletta Belton
Case Study 5
Pain has to live with me, I haven’t got to live with it!
by Ann Parkinson
I have a professional and personal understanding of persistent pain. Personal experience of persistent pain is one of the reasons I am so passionate about helping those with persistent pain find themselves again, enjoy life and do what they want to be able to do.
This post is dedicated to pacing and managing pain. To help explain this I am going to use the spoon theory by Christine Miserandino and the blog by two Occupational Therapists about this. Please read the blog before reading the rest of this post. This is the great blog by @LifeReclaiming http://reclaiminglifefrompain.blogspot.ca
So many patients come to me and say they have lost who they are, have lost hope, and have stopped doing many of the things they used to enjoy. I am grateful to be able to give that hope back, help them find new things that are enjoyable and return to the things they used to love (if they choose to), and help them find who they are again.
There are many things that are important in persistent pain, some of the main keys to unlocking life again are understanding pain, hope, pacing, exercise, relaxation, social support and fun.
When pain persists the nervous system (brain and spinal cord) and the body become sensitive and react to things they wouldn’t normally. If we ignore pain and push on through it our brain thinks it needs to shout louder to get us to stop and the pain becomes worse and takes longer to settle down. People sometimes avoid doing a particular task or going out because of fear of pain. When we avoid doing something this increases the sensitivity. So what do we do?
We need to know what helps us emotionally, physically & mentally, and what doesn’t. Some things are a trade off, for example it may be going out to an event with friends is really helpful emotionally and mentally but physically it causes fatigue and an increase in pain. If the benefits outweigh the costs of going and you know it will cause an increase in physical symptoms, planning and consideration of what is helpful for before and after the event is needed. Consider the spoon theory, how many spoons is it likely to take away? Do some spoons need borrowing from the day/few days before and how can they be replenished afterwards?
It is important to desensitise the nervous system and body. If we are in trade off all the time we are winding things up and calming back down to a similar level. It is important to use things like relaxation, breath and body awareness, and gentle exercise to help calm things down and re-educate mind and body.
One patient once said to me ‘I have decided pain has to live with me I haven’t got to live with it.’ This was a turnaround point from the pain being a focus to life being a focus and pain tagging along in the background. Pacing, fun, exercise, relaxation, socialising, and hope, all help keep pain in the background. Sometimes pain goes away eventually, others it keeps fading with occasional brightening to varying degrees before it fades again. It is important to remember pain can change, we are the ones in the driving seat and can make conscious choices which help pain to fade.
On a personal note I do not hate the pain I have had or have, I do not resent it or wish I had never had it. I am grateful: for all it has taught me; all the things I would never have seen without it especially as at one point in time I had to take some time out and slow right down, in fact it was so slow I had nearly stopped, this was because I had sensitised my nervous system really well by carrying on through the pain using will power and determination (not recommended and I knew better really, there is a story there); and I have also been able to help many people with persistent pain learn how to help themselves.
I would like to leave you with an analogy I use often with my patients and used with myself when I needed it. Think of the hare and the tortoise, who won the race and which one benefited the most? When we slow down, take rests when needed, and keep moving steadily, we can see all life has to offer, we can observe all the colours and feel the earth beneath our feet, have fun, and choices are usually easier. It’s ok to be the hare when needed and then use the tortoise ways again. Notice when you learn most and which is more enjoyable.
Case Study 6
Today, I am angry
by Marie Bourgeois