Information for Family and Friends

Watching someone close to you suffer with chronic pain can be upsetting, frustrating and confusing. We know that chronic pain impacts on a number of different aspects of a person's life and this includes their relationships with others. This information is designed to give you some knowledge about chronic pain so that you can be more informed about what the person is experiencing and support them in their efforts.

What is chronic pain?

The term "chronic pain" refers to any pain that has persisted for more than three months. When the pain has persisted for this long changes start to occur within the nervous system and the body generally. Chronic pain is often experienced long after the original injury/damage has healed. This does NOT mean that the pain is not real, but it does mean that patients experiencing chronic pain are not necessarily hurting themselves or causing further damage.

This happens when the pain messaging system has become 'faulty' and the messages are being turned up, or amplified. This occurs when either the messaging system that sends pain signals to the brain as become more sensitive and/ or the threshold for pain messages being sent has been lowered.

How long will they have chronic pain?

Chronic pain is something that is likely to be with them for the rest of their lives. This can be a frightening prospect for those who suffer from chronic pain as well as for those people who are close to them. There is no "cure" or "quick fix" when it comes to chronic pain. There are, however, a range of strategies that allow people with chronic pain to live more fulfilling lives even while experiencing chronic pain.

What can be done to help manage chronic pain?

When it comes to acute pain, medication, rest, heat packs, ice, etc, can be helpful to reduce inflammation and allow the healing process to occur. By comparison, in chronic pain these measures are ineffective for providing long-term relief or management of pain. Although medications may reduce the intensity of pain, there may be a range of different side-effects that will also impact on the person (e.g., drowsiness, weight gain, etc.) Further, medications are often not helpful in the longer term if the person is relying on them as the sole strategy for chronic pain management. 

Rest and inactivity are never helpful in the longer term as they also lead to muscle wasting and stiffness that will further exacerbate the chronic pain problem. Instead a structured upgrading of physical activities and improving coping strategies is going to be most helpful when it comes to chronic pain management.

Exercise and activity

Becoming more physically active is a very important way of improving day-to-day life when living with chronic pain. People living with chronic pain often become less active over time, as rest is a commonly used approach to cope with chronic pain. However, more rest and less activity means that over time a person becomes less and less fit. Exercise becomes harder to do, muscles become weaker and even basic activities can become a strain. As a result, a person with chronic pain often gives up a lot of their activity, even things they used to enjoy.

As well as helping people with chronic pain regain normal function and independence, regular exercise also has important benefits for general health. The best thing you can do is to support the person to continue a daily exercise routine. This may simply mean encouraging them or even engaging in some of these activities, such as stretches, encouraging pacing activities and walking, with them.

What is pacing?

This is a strategy that has been shown to be effective in gradually increasing activities in a variety of different areas (e.g. walking, sitting, standing, gardening, cycling, etc.) Pacing ensures that the person is not over doing or under doing activities. This means that even on days in which they are experiencing more pain or a flare up, they are still able to safely engage in the activity. Sometimes it will be tempting to encourage them to rest or stop doing the activity if they are experiencing an increase in pain, however, this will not be helpful for them in the longer term. Instead it is better that you encourage them to get up and continue with activity levels and reassure them that they know that the activity is not harmful.

Managing unhelpful thinking

People with chronic pain often experience a range of thoughts that are unhelpful to them in managing their chronic pain. These thoughts may be around believing that they will do more harm if they exercise, they will never be able to manage their pain without medication, or that nobody understands them. These thoughts can be quite distressing and influence the way in which a person manages their chronic pain.

Helpful coping strategies include mindfulness meditation, accepting that chronic pain is part of their lives and being open about what is happening for them. Again, this is not easy. Having people around them who support them in a helpful way will assist them in dealing with their chronic pain more effectively.

How can I help?

Families and friends of people with chronic pain are important in appropriately supporting a person as they manage their chronic pain. This support should include encouraging them to engage in activities and maybe even getting involved in some of the physical activities such as stretching, walking etc. It is also important that you show an interest in what they are doing. Finding out about what their goals are for activities will help you be more involved and aware of what they can be doing.

Telling a chronic pain patient what they should or shouldn't be doing is not going to be as helpful as supporting them in their own efforts to manage their chronic pain. For example, encouraging them to rest, offering them pain relief medication or remedies, or doing tasks that they are capable of doing for them is not helpful in the long term management of chronic pain.

If you have any further questions about chronic pain, please contact the Pain Management Centre.