THE RECENT PANDEMIC HAS BEEN A TIME OF UNPRECEDENTED UPHEAVAL FOR ALL OF US, CREATING CHALLENGES IN MANY AREAS OF OUR LIVES. BUT FOR THOSE PEOPLE WHO LIVE WITH PERSISTENT PAIN, THE UNCERTAINTY FOR THE FUTURE AND THE REDUCED LEVELS OF SOCIAL INTERACTION DURING LOCKDOWN CAN HAVE A BIG IMPACT ON THEIR DAY TO DAY EXPERIENCE OF THEIR SYMPTOMS.
IN THIS PIECE, FIX OSTEOPATH SANJA MARETIC DISCUSSES SOME OF THE ISSUES THAT MIGHT BE EXPERIENCED BY THOSE LIVING WITH LONGER-TERM PAIN AND MAKES SOME SUGGESTIONS AND OBSERVATIONS GAINED FROM HER TIME WORKING WITH A RANGE OF PEOPLE LIVING WITH LONG TERM PAIN.
Social isolation due to lockdown and the consequential disturbance in our daily routines, feelings of fear and not knowing what tomorrow brings have profoundly impacted all of us and our senses of self on multiple levels. Our physical, psychological, emotional, and our spiritual sense of being and sense-making in this world have undoubtedly been challenged. After all, we have all been asked to collectively re-invent and to review our lives in this new reality.
People living with persistent pain are well acquainted with these tasks by constantly having to rebalance functional and social activities to accommodate the insubordinate features of persistent pain. As Kathy Charmaz in her exploration of chronically ill persons’ social identities says, loss of self and loss of meaning is the very essence of suffering in persistent pain. If you live with persistent pain, it is highly likely that you had found yourself asking some of these questions during this pandemic: What of my ongoing care and medication? Will my suffering become even more invisible now that healthcare professionals are diverted to the overwhelming demand of Covid-19? How will this affect me moving forward? What if my flare-ups increase? and many more questions of uncertainty.
These reflections are perfectly normal; you are not alone. Know there are so many things you can do to help yourself and here is a list of some of those things. Much of what I say here is based on my own research of interest and experience in working with people with persistent pain. I am not a chronic pain sufferer myself and everybody’s situation and experience are unique, therefore I will never know how it feels to be you.
UNDERSTANDING YOUR PAIN AND MAKING SENSE OF YOUR DIAGNOSIS
Pain is a shared human experience, yet it is incredibly personal. Nobody knows your pain better than you do. You may have been given a label, a diagnosis for your suffering providing you with a sense of relief and recognition, but that label also has to make sense to YOU, in the context of YOU. For example, Mary’s diagnosis of Fibromyalgia nests in the background of her life as she is still able to go to work and enjoy singing, whilst Ann’s Fibromyalgia is situated at the forefront of her life preventing her from living the life she used to enjoy. Ann feels sick whilst Mary doesn’t. One label, two very different meanings. If you feel like you don’t have an understanding of what the name of your condition means to you, within your own unique narrative, do get in touch with therapists who will assist you in collaboratively reconnecting with the meaning and best ways of moving forward. Oftentimes, the pain in persistent pain does not equal harm; it is important that you understand the pain mechanism that dominates in your condition. When you understand your pain and the nature of it, then you can be in control. You can predict and plan.
BREATH AND ACCEPTANCE AND COMMITMENT THERAPY (ACT)
If you have persistent pain there is a high likelihood that you have been introduced to some of these strategies already. Spending some time taking deep breaths in and out, especially whilst you are experiencing a flare-up or you’re feeling stiff, can feel incredibly grounding. As a final year student of osteopathy, I undertook an elective called Osteomap, which is a clinical framework that integrates osteopathic manual therapy with Acceptance and Commitment Therapy (ACT) which is designed for people living with persistent pain. Here is the video of Professor Tamar Pincus sharing her story “Pain and Me” where she describes her views on ACT:
This strategy may or may not work for you and both are fine. Just know that there are possibilities in management approaches.
CONNECT WITH YOUR VALUES – BE ALIVE IN THE CONTEXT YOU ARE LIVING IN
A study conducted by Thompson et al. (2019) highlighted that amongst those people who live well with chronic pain, one of the core concepts which enables this to happen is that they manage to maintain a connection with what is meaningful to them as human beings. This shows that even with pain and fatigue, one can still explore life. Whether your values lie in music, nature, crafting, spending time with your children or writing, try to connect with your values. Think about what matters to you – if the old strategies are not working anymore, think about how you could generate different approaches. Be alive in the context you are living in. If this feels difficult, get in touch with healthcare professionals who are trained to assist you on this journey. You are not alone!
CREATE AN OPPORTUNITY FOR MOVEMENT
Not everyone has big gardens and not everyone lives in the countryside. If this holds true for you, this is your reality, but you can still practice movement. It is the cheapest and most accessible medicine. Try to create yourself an opportunity to move, even if that means sitting on the floor of your living room and doing gentle stretches. Your brain loves to be stimulated with movement. This does not mean going to a gym or orchestrating some detailed exercise regime. Just remember every little step matters. Perhaps document your achievements; write down…
““Today I walked 1k. Yesterday this felt impossible but today I did it. I am proud of myself”.
…Give credit where credit is due!
DO NOT SUFFER ALONE
The European Pain Federation has recently created a specific working group, the EFIC COVID-19 Task Force, whose aims are to synthesise quality research and provide a neutral overview of the evidence surrounding persistent pain in the context of COVID-19. The International Association for the Study of Pain (IASP) has released some useful booklets and videos for educating people in pain which can be found here: http://my.livewellwithpain.co.uk/resources/video-and-audio/.
This is just to show you that there is a sea of healthcare professionals and scientists working behind the scenes to make sure that the quality of care in persistent pain is not interrupted during the pandemic. If you have any question or fear, do get in touch with your healthcare provider. We are here to help you. Do not suffer alone.