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Chronic Pain the Vicious Cycle

AnonymousUserAAnonymousUser Posts: 49,671
edited 06/11/2012 - 8:39 AM in Chronic Pain
I have seen so many new threads lately focusing on why pain levels increase during the winter months. While I tend to agree with everyone, that temperature and barometric pressure play a large role, it seems that many overlook another and possibly more sinister factor. Focus. Here's a quote from a chronic pain health guide put together by some of the best in the field of studying and treating chronic pain.

"Looking at the list of factors that make pain worse, you can see that most of them arise as a consequence to prolonged pain. A vicious cycle may develop whereby isolation and inactivity contribute to anxiety, depression and muscle tension, which leads to increases in pain, which in turn causes more inactivity, depression, muscle tension and so on. Reactions to continuous pain can make it worse. Normally when you hurt yourself, pain causes you to stop what you are doing, leave the situation, and rest. This aids healing. With chronic pain, however, continual withdrawal from activities is boring and depressing, your fitness level decreases and you tire more easily (with one week of immobility a muscle may lose a third of its size and power). Undistracted, you focus on your pain and perceive it as more intense and your tolerance decreases. Medication you take may produce side effects, become habit forming, and not work as well (after a time they inhibit or even stop your own production of natural endorphins - morphine-like substances that help reduce your awareness of pain). Anxiety about your pain and situation may increase, muscles may become tense, and you may become depressed and less willing to become active, uncertain what to do, and, ultimately, feel helpless and defeated. "


  • That's DEPRESSING! I do know that I have depression from not being able to do the things I used to do. How do you fix this though, when you can't get out there and enjoy your life as you would wish to?


    3 level spinal fusion, L3/4, L4/5, L5/S1, November 2008. Stiff, but I can walk.
  • It is depressing. For example, one of the things I have not been able to do since my accident is go see movies. Now, obviously, I'm not going to make my entire family avoid movies- so they go without me.

    That sucks!

    And even the things I can do are always clouded by pain. Going out to dinner is especially bad, because if the chairs are not quite right it's uncomfortable.

    It is quite easy to focus on what we can't do. I think that's the point of the article.
  • I live in the great Northwest. My favorite outdoor activities were hiking and backpacking. Well - the backpacking is out. I can't carry a 60 pound pack that will largely rest on my lumbar spine and hips. I can still go hiking if the trail is relatively flat. I don't go uphill very well. It's not my legs, it's the lack of flexibility in my lower spine. Heck, I can't even ride a bike. I go over a bump and I'm in agony! I can walk, but not for a very long ways, and I'm bummed. Sure - I can go outside. I can even do a little gardening with my kneeler bench I got, but I am very limited compared to what I used to do. That's the bummer. At 55, I think I'm way too young to be in this condition.


    3 level spinal fusion, L3/4, L4/5, L5/S1, November 2008. Stiff, but I can walk.
  • Hey everyone,I hope you all are doing as well as we can.I stay at a pain level of 8 or 9 but I still work 8 to 14 hrs a day.I still enjoy my life tremendously.I can't let the pain control me or what I enjoy doing.I know I will hurt anyway no matter what.So I chug along with a smile on my face.If I let the pain control me I would not get to play with my grandkids.I never say a word about my pain to anyone,but everyone can see it.Don't let the beast get yall down!!Peace and love to you all!!Mark
  • This is an excellent thread! I work hard every day to not let my chronic pain take over my life. I try not to dwell on what I can NOT do but what I can do. I look for ways to do the things I can't do well anymore. For instance, if I have a lot of walking to do, I use my rollator walker or cane. I also make myself aware of all I am grateful for, even things that we take for granted every day such as the sun is up this morning!

    Thank you "C" for posting that quote. Shows the dangers of letting depression create more misery. Most of us are going to hurt for the rest of our life. Expect the pain, do what you can, and some day hope we can all get to a certain level of acceptance. Not saying here to give up hope of improvement, just to get on with it and live!

    Best wishes,


  • My personal experience has shown me that I can "change my focus" and thereby still function despite my discomfort and limitations. When I started to slide into the "pit of despair" that chronic pain can dig, I got desperate and angry because I was not willing to give up on living and enjoying life. I was unable to accomplish anything until I changed my focus and stopped focusing on what I could no longer do. Instead I focused on finding ways to either still do the things I enjoy and that define me, or find other new things I can do.

    There's nothing I can do that does not elicit pain. I choose to refer to it as discomfort, in my own mind game to keep pain from being in command of my life.

    For instance, I too live in the North West now (moved back from Japan this summer) and I love to hike and backpack. I can no longer wear a pack on my shoulders. So I found a waist pack that has a cumber bun and harness system that allows me to carry the same amount as a day pack without stressing my lower back and shoulders. Actually quite remarkable if you take into account my lumbar issues and my SCS generator being in my hip/upper buttock area.

    In the military we always lived by the mentality of "innovate, adapt and over come". I choose to carry that through into my life of chronic pain.

    So my focus has been shifted from "what I can no longer do" to "How can I manage to do XYZ today". By doing that, I avoid the depression pit, I motivate myself and I find I enjoy life despite my constant discomfort. I am always finding new ways to do old things.

    So despite the cold, clammy, overcast weather, I will find things to do today that I can enjoy and therefore shift the focus off my discomfort and back onto living.

  • RangerRRanger on da rangePosts: 805
    Hey C and all others here,
    Lets face it, we all have our down time and how we deal with it may vary. But in a nutshell I think the keyword here is "diversion". We need to divert our attention away from the issue of chronic pain as for many of us will not get better and most likely will get worse. We can accept the fact that we will not improve but we must not dwell on that reality and do something that we really enjoy and gives us personal satisfaction. Yes, depression will return to visit now and then but the key is to not let it lock down and take hold of our lives. Life is indeed short and we need to make every single day count.
    Take care friends,
  • Diversion is needed to maintain our sanity. Going out to dinner is what my family likes to do, and I admit sometimes I'd rather stay in than to deal with all the hassle. So I started taking a pillow to sit on. We go to places that are NOT jammed packed so we are seated right away. I take my meds before leaving the house. If I can't sit through dinner on my pillow in our booth then I eat fast or take it to go. I'll go wait in the car until everybody's done eating, and I'll listen to the radio to distract from the pain. This has been my game plan for a long time.

    I'd like to go to the movies more often but since we have such a cool set up at home with powerful surround sound, we end up watching a lot of movies on DVD or On Demand. Sometimes I'll knock out during the movies-it's probably the meds I guess.

    I like going to stores and I definately need a scooter or wheelchair. If the store is too big and they don't have anything for me to use, then I just won't go there.

    I enjoyed getting in the pool with my family last summer, and it was at a senior living apartment place so it came in really handy for me. I plan on doing it next summer since we had a lot of fun.

    See, I have tried to work around my limitations and it feels great when you can overcome obstacles you thought were too lofty. If I have a real bad pain day, I'll stay in bed and watch tv, a movie, talk on the phone, or just hang out with my family. Whatever we do is ALL good. :H
  • dilaurodilauro ConnecticutPosts: 9,865
    Anyone dealing with pain levels of 8 or higher should be seeing a doctor or going to an ER.
    We can not function correctly with pain levels that high. We can no longer drive, we can no longer really take care of ourselves.
    Studies have been done to demonstrate that people dealing with pain levels of 8 can not think straight nor be counted on to do any real tasks.
    I would strongly suggest that while you live with pain levels 8 and 9, you should be under a doctors care around the clock
    Ron DiLauro Spine-Health System Administrator
    I am not a medical professional. I comment on personal experiences
    You can email me at: rdilauro@veritashealth.com
  • Yes...It is a vicious cycle. It's like a washing machine and right now Im on the spin cycle....Thanks for the insight!!

    Also...I find the pressurized cabin of an airplane...a very uncomfortable place to be. It makes me hurt real bad and I hate it....
  • C,
    We to some aspects are the determinants of our own alternative flight plan and in the notion that knowledge is power we can lean where not to go or at least try, with experience and tenacity. Pain will change us, with or without our understanding or consent.

    For the most part we are enduring our pain in isolation and I am still not convinced that without appropriate support and encouragement we can in isolation stay clear of this vicious cycle. We can all see elements of ourselves within C, s quote and for the most part trying to evade, this continuing circle.

    Pain is a multifaceted happening and we need all our guile to keep one step ahead if at all possible, each of us in on a spectrum of improvement be that at a slower pace than others or even marking time. We have to see that we are improving and acknowledge them, however inconsequential them may seem individually, collectively that could assist our situation.

    Cognitive behaviour therapy attempts to address all those issue of C,s quote before they become more habit forming, behavioural or negatively influential. Early intervention is the key to staving off the overall impact and lesson the possibility of them developing unaided into the more extreme facets of our chronic element.

    At its most corrosive this is what pain and chronic pain especially can become, surgery may not have eradicated the origin of our pain as had been envisaged at the start, we are mandated to then seek to improve all these aspects away from the half empty status, in being unrealistically positive even when we know the in our hearts the pain will continue unabated.

    As ever Mark107 said it is about attitude and it is, even when at its worst many seasoned CP patients have learned to be more and increasingly positive and see the joy of life in all this fog of restriction. My physical pain is none the less for me being positive, it still hurts like ****. Learning to let go takes experience it is a skill and not focussing on the ever present pain when it is screaming inside, is difficult. For me distraction has a finite daily usage before the reality of restriction wins for the day and I concede to fight another sunrise.

    I have knowledge and experience that the storm or flare-up will pass, I dry my eyes and pretend it never happened, this quote is a list of things not to do if possible and develop improving strategies to reduce the impact and change our behaviour if possible.

  • All quite inspirational and quite humbling at the same time....

    When I read all the posts and than look at the history I am amazed at how you folks continue to function and remain upbeat. Thank you all for your posts.

    Honestly I was really angry for a very long time and there are days like yesterday where I just want to yell and scream as I feel pain by simply driving home and than I pass the cyclist and wonder how could a few feet fall from a van change my life in such a negative way. I was once that cyclist.

    I have decided to instead delve deeper into my business and family. While my time at the gym is not the way it was I try to make sure I can still sweat and feel like it was worth it.

    I am not sure if the pain will ever just stop eventually but I believe I have learned alot about myself. In the beginning I would explain to others I am the "living dead". All my muscles work, my brain functions, no broken bones but really not alive. I no longer feel that way. There will always be change in life as I am sure there will be more change to come...I just have to adjust to the changes but never accept them.


  • I think the issue is less that we can't do this or we can't do that, but that we have to make choices. Everything takes just a little bit more energy, and we can't do it all.

    I am understanding of the concept that, with modifications, we can do most of the things we used to do. But some of them just become more trouble than they are worth to us, and even though they might not have been our favorite activities we still notice when they are gone (like movies for me- I don't enjoy movies enough to go through all of the trouble it would take to go to one, but I still feel sad when my family goes without me).

    Eating out, on the other hand, is something I've always really liked, so I do it even though it does usually end up hurting anyway.

    But we didn't used to have to make choices. I think that's where the anger comes from. Maybe it's something we didn't even really want to do, but dang it we should be able to do it anyway!
  • Perspective is a powerful weapon in our defense against chronic pain controlling our lives. As John pointed out, chronic pain will and does change us without our consent and sometimes without our knowledge. That's where having someone else or something else to show to us the improvements or accomplishments no matter how small or seemingly insignificant is so important. However, just like dieting to lose weight, some people find that if they focus every day on how much or how little they have lost or gained, they find it impossible to stick to their diet and wind up gaining more instead of losing. Information and knowledge is power, but it can also become a double edged sword.

    Outside intervention via behavioral pain management can be a blessing. Even our families and friends can be a blessing. People around us can also be a measure of how we are doing. All those people who we get upset with who constantly ask "how are you doing", can also be a great measure when they say "wow you are having a much better day". Even if inside we don't feel we are, obviously something is showing that we cannot see. I have been learning to see those signs and use them to my advantage.

    I heard something recently that was totally unrelated to chronic pain, yet at the same time is a great analogy. It said something to the effect that when we get lost, if we only look, we can see all the wonderful things we would not have seen had we not gotten lost.

    In my journey of chronic pain, I have gained so much in personal friendships, personal triumphs and personal growth. Had I not been forced off the path by chronic pain, I may not have had the fortune to meet these people and learn these things about myself.

    Life is after all a journey. I have learned to roll down the windows and smell the fresh air. Learned to pull over and take in the majesty of the scenery around me. I have learned that no matter how many times the road turns or doubles back, there's always something new to discover around the next bend.

    So by changing my focus and my perceptions, I can see things that I would have normally missed. I can't say that I am grateful for chronic pain, but I can say that I am grateful for the lessons it has taught to me.

  • C,
    It is important in some way to try and replicate what we did in our previous life so that it imitates what and who we once were in our mind’s in that even when that physical opportunity to be the person we once were has faded over time, finding those elements and getting oneself into the acceptance that in some way we are still valid and that equitable worth in doing similar rather than an exact things of our healthy persona is continually vexing and covers the range of goal setting and adaptation.

    Being honest with yourself displays that capacity that it was an important part of our historic existence and the benefit here is that many see those achievements that on occasions and at emotional times fail to register in what we have achieved, with the concerted effort needed to do less.

    With time, patience and support we can attune our chronicality which is maluable and the best example is that it is reflective of our emotional status, the pain may have only increased incidentially in tandem of our perspective, Sternbach the eminent Pm doctor, suggested that we ignore the negatives and only focus on the positive, align ourselves with those who can be best placed to help and support us. When and where our individual perception changes our behaviour is questionable and for the most part many replicate a similar blue-print of existence, this should not negate our own responsibility to be encouragingly influential.

    Change what we can and learn to live with what we cannot, we know more about ourselves that many others dare to question and all that insight needs to be use that innate capacity to cater to the most prominent need of the day, as our cerebral needs rotate, we are ready and waiting to stifle those negative thoughts before they become actionable.

    Make’s you think.

    Take care and be kind to yourself. John
  • I wish I had any of your+ attitude. My doc cut me off all meds after 4+ years the month before Christmas-not good I guess I could make 'cold turkey' jokes... Thnx 4 + attitude. Maybe I'll get out of bed someday.
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