Understanding Chronic Illness
 

Most chronic illnesses do not fix themselves and are generally not cured completely. Some can be immediately life-threatening, such as heart disease and stroke. Others linger over time and need intensive management, such as diabetes. Most chronic illnesses persist throughout a person’s life, but are not always the cause of death, such as arthritis.

Chronic illness has comprehensive effects, changing how much you can do, your moods, your relationships, your finances, your hopes and dreams for the future, and your very sense of who you are.

Complicating your challenge, there is an interaction between illness and other parts of your life. (See diagram.) Consider, for example, the two-way relationship between illness and activity. Illness reduces activity. In fact, one of the hallmarks of serious illness is that it imposes restrictions, forcing a person to live a different and more limited life than before.

But the relationship also works in the other direction as well. If you feel frustrated at the restrictions imposed by your illness, you may respond by doing more than your body can tolerate, which results in higher symptoms.

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Interactions of illness and other factors

The same pattern of reciprocal effects is true for other elements as well. Take the relation of illness and stress. Illness is a tremendous source of stress. Living with symptoms on a daily basis is inherently debilitating. In addition, illness often creates financial pressures, complicates relationships and brings great uncertainty about the future.

The same pattern of reciprocal effects is true for other elements as well. Take the relation of illness and stress. Illness is a tremendous source of stress. Living with symptoms on a daily basis is inherently debilitating. In addition, illness often creates financial pressures, complicates relationships and brings great uncertainty about the future.

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Understanding Chronic Pain. Why it Hurts!

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Chronic pain refers to pain that extends beyond the expected healing time and includes conditions such as spinal pain, post-operative pain, neuropathic pain and shoulder and knee pain. One of the problems with treating chronic pain conditions is that clinicians often view chronic pain the same as acute pain, seeing pain as a reliable indicator of the severity of the injury, the worse the injury the worse the pain. The issue with this approach is that in contrast to acute injury, with chronic pain the relationship between pain and injury uncouples. In this instance, other factors besides injury to the joints, muscles tendons and ligaments and tissues become very important in ‘how much it hurts’. 

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The longer pain persists the more important these ‘non tissue related factors’ become in driving the cycle of pain and disability. For some chronic pain conditions, such as spinal pain, fibromyalgia and chronic regional pain syndrome there is high level pain with no known cause identified. The best example of pain without injury is phantom limb pain which can persist for years after amputation. Here pain persists not only in the of absence tissue injury but in the absence of any tissue! Often it is very difficult for clinicians to work out how much of a patient’s pain is caused by tissue injury (e.g. disc injury, degenerative joint, etc.) and how much is caused by other factors (e.g. anxiety, depression, increased central nervous system sensitivity, catastrophic thinking etc). 

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Things can change with chronic pain

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• Increased attention to the painful area above other areas of the body 

• Decreased activity levels and decreased physical activity tolerance 

• ‘Software glitches’ in nervous system and brain which turn up the pain volume, it hurts more and other areas of the body can start to hurt 

• Increased anxiety, depressed mood and feelings of helplessness 

• Depressed immune system with frequent illness and general poor health 

• Guarded, compensatory and poorly coordinated movement 

• Heightened stress response evidenced by inability to relax, poor concentration and memory and disturbed sleep 

 

Chronic pain is best treated actively by focusing on pacing up and developing effective coping strategies to manage and cope better with symptoms rather than passive treatment (e.g. massage, manipulation, back braces, medication dependency, etc). 

 

Motion is Lotion! Exercise and Chronic Pain 

 

The body and mind love movement and gradually becoming more active is essential for treating and managing chronic pain. Some of benefits of exercise include: the joints get nice and lubricated and glide easier; some structures including the nerves and the discs of the spine need movement to get their nutrients and be healthy; the muscles get stronger and don’t fatigue as easily; the nervous system winds down promoting relaxation; reduced flare-ups; improves mood and helps with anxiety and depression. Most importantly, your body produces its own pain relieving medication (e.g. endorphins) that work like the pain medication doctors prescribe. After a bout of exercise your pain tolerance increases, things hurt less, and this can last for up to an hour depending on the exercise. 

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Exercise tips for chronic pain: 

 

All the research shows that exercise works best for chronic pain when it is delivered with education and knowledge about your condition, physical activity and pain. For example, education and reassurance that pain does not necessary equal further injury reduces anxiety. It is normal for people with chronic pain to experience discomfort/increased symptoms as they gradually become more active. Guidance with acceptable and non-acceptable pain can be very helpful and reassuring. In relation to exercise for chronic pain the motto is ‘know pain or no gain’ as opposed to ‘no pain, no gain’.