Pain is inevitable; suffering is optional. Let’s take a closer look at this old adage
One of the things that makes pain different when compared to other sensory systems, such as vision, hearing, and touch, is that pain is often directly associated with suffering. While you can get annoyed with a bright light, or irritated with an annoying sound, pain is unique in that prolonged experience with pain in most cases results in at least some degree of distress or suffering. Suffering by its nature encapsulates negative affective or emotional phenomena. A brief look at synonyms for suffering is telling: distress, anguish, hardship, torment, and adversity.
It is important to recognize that pain and suffering are not the same things. You can have pain with very little distress. A look at high-level athletes provides a ready example of this – they can have significant pain, but may not be impaired or particularly bothered by it. Many athletes see pain as a part and parcel of their sport. Similarly, everyone has had experience with pain that is more of a nuisance than disability, including aching and cracking knees, sore muscles after a good workout, or a hefty bruise you get from a lovely day of hiking.
Suffering and Pain
However, it is also important to recognize that suffering from pain can truly produce an agonizing experience, and is one of the primary causes of disability. Physical pain can have many psychological consequences, particularly if adequate treatment cannot be found.
In both my clinical experiences and in my research on psychological factors that can impact pain, many patients report that their most significant distress is not associated with disability in respect to employment, but revolves around their inability to do basic life activities, which include interactions with their loved ones and family members. Patients with chronic pain often report significant distress with their inability to play with their children or grandchildren, inability to provide support for their family members or spouses, and so on.
Patients also report suffering from respect to the inability to engage in activities that they used to enjoy, ranging from grueling physical activities like running or lifting weights, down to minimally challenging physical activities like gardening, or hiking, or just walking in the neighborhood. Suffering, just like pain, is a very subjective experience. Some people can have tremendous pain, and experience very little suffering, while others can have what seems like minimal pain to most people, but which is completely debilitating to them.
How To Reduce Suffering
So, what are the action steps that we can take to reduce suffering from pain? Some of these are very basic – like seeking medical attention when it is needed, including alternative medical practices when traditional medicine does not provide the relief one might desire. Medications, including anti-inflammatory drugs, opiate analgesics, and anti-convulsant, can act directly on the pathways that transmit pain information in the body.
There are also other medications, like anti-depressant drugs, which have also shown some benefit to pain patients. It is not known if the relief comes from a reduction in pain itself (through descending control pathways for pain), or more from a reduction in the depression that may be associated with debilitating pain (research clearly shows that if a person is depressed, they will focus more on negative experiences, including pain, which can amplify that pain).
Similarly, medications that impact a specific neurochemical, serotonin, may also be involved in the pain transmission system located in the brainstem and may help individuals block out some pain messages. However, many of these medication therapies can only reduce pain, but cannot eliminate it, so incorporation of other techniques is important in learning to live with your pain. With the widely publicized opioid crisis, it’s also critical that any medication regime is carefully monitored by your doctor.
Alternative therapies can also reduce suffering from pain, including chiropractic, acupuncture, reiki, aromatherapy, and often most important: psychological therapies that address the frustration, anxiety, and depression that accompanies pain.
Psychological Strategies for Dealing with Pain and Suffering
Psychological methods can provide a powerful resource for those with chronic pain that cannot be resolved with traditional medical management and can also improve a person’s ability to deal with the pain even if they do respond to medical therapies. Using these kinds of strategies can particularly help you in increasing your levels of activity. This is important because research is very clear that increasing activity can both decrease physical pain and improve psychological mood states. This does not require high-intensity exercise, but can be accomplished with some mild walking, resistance training, or yoga.
Psychological techniques like cognitive behavioral therapy (which tackles distorted thought patterns and irrational thoughts) and acceptance and commitment therapy (which helps a person to accept where they are, to find out what they can actually accomplish given their limitations) can significantly improve a person’s quality of life and can reduce the actual amount of pain that a person has to deal with.
Alternative Methods for Dealing with Suffering and Pain
There are other ways to impact suffering, when pain may not be amenable to direct management. Increasing activities that bring you pleasure can definitely reduce pain-associated distress. Research demonstrates that any means that can distract you from the pain can not only help reduce your distress but can also, to a limited extent, reduce the actual pain you experience. Literally, if your brain is busy doing other things, it cannot dedicate as much of its territory to the conscious perception of pain sensations.
In a more psychological vein, research also shows that the more control you have in dealing with your pain, which is called self-efficacy, the less negative emotions will be associated with that pain. Reducing psychological patterns like catastrophizing can also help to improve a person’s ability to deal with pain.
Perhaps the most important thing to dealing with suffering from pain is to do what you can – in other words, to increase your activity levels, and do your best to participate in your daily activities as much as you can. While pain can limit potential strategies for dealing with suffering and psychological distress, usually there are at least some potential pathways that can improve your experience.
You may not be able to get your old life back, but you should be able within limits to find a new, rewarding life. Acceptance of the new situation that includes dealing with pain, as well as making an effort to change expectations for what you can do given your pain can make a substantial difference in your daily life.
Research is very clear that the more deconditioned someone becomes, the less active they are in their lives, the more pain they will feel, and the more debilitated they will become. Similarly, acceptance of the limitations that your pain might place on you while fighting to do what you can, has clearly been shown to improve the quality of life for those with chronic pain.
Respect that you may need to ask for help to find that pathway to try to live your life as well as you can. And as bitter as it may sound, the words of Nietzsche are informative here – “What does not kill us makes us stronger.” People who have pain, and have the experience of fighting through it to get the best life they can, can find that the coping strategies and techniques they develop in those experiences can also benefit them in other challenging aspects of life.
Precision Pain Care and Rehabilitation has two convenient locations in Richmond Hill – Queens and New Hyde Park – Long Island. Call the Richmond Hill office at (718) 215-1888, or (516) 419-4480 for the Long Island office, to arrange an appointment with our Interventional Pain Management Specialist, Dr. Jeffrey Chacko.