Self-Managing Chronic Pain (Part 1)

There’s no cure for chronic pain—that’s what makes it chronic. But there are dozens of things we can do to make it better, and lots of places to get help. That’s what I’ll be writing about for the next few weeks.


As I wrote last week in “The Mysteries of Pain” and the week before in “An Epidemic of Pain,” chronic pain isn’t like the acute pain from a burn or a broken bone. It travels on different nerve pathways and goes to different parts of the brain, parts that deal with anger, fear, and sadness. You might want to read those blog entries if you haven’t yet.

But both chronic and acute pain have the same purpose. They are warnings to stop something or do something else. For acute pain, the message might be “Rest that leg” or “Take that hand out of the fire.” In chronic pain, the brain has found that there is some danger, that things are getting out of control. But the brain can’t communicate exactly what the problem is. So how do you know what to do about it?

Four Ways to Control Chronic Pain
There are at least four levels at which chronic pain can be controlled. We can treat the area where the pain is felt. We can treat the nerves that carry pain signals. We can treat the part of the brain that interprets pain. And we can increase our sense of control.

Some of these we can do for ourselves; for others, we’ll need help, perhaps from family, other pain patients, or professionals. Some of the following suggestions came from comments readers posted here in the last two weeks.

At the place where the pain seems to come from, we can treat the body directly. As Karen from Tennessee wrote, “massage is helpful when you can afford it.” But there are other ways to get massage than paying for it; a family member or friend may be good with back rubs—maybe you can exchange massage with them.

There are affordable back massage pads that I find very helpful. Find one online and search for the best price. (I saw some on eBay for as little as $50.)

You can also massage yourself to a degree. Bodies appreciate that kind of attention. You can rub your feet and legs or apply pressure to your back with your fists. Consider learning some basic acupressure, which means pressing on the body points used in acupuncture to provide pain relief and healing.

Movement as Therapy

As Millie mentioned, stretching can help with back, hip, leg, and other pain. For me, stretching is not a once-a-day thing. The more you can do of it, the less pain your will have. But do it gently! Farther is not necessarily better.

Yoga is widely used for back pain and makes your whole body feel more relaxed and alive.

Physical therapy can include heat, cold, vibration, electrical stimulation, passive stretching, and more. You can do a lot of these things for yourself. Ephrenia mentioned hot baths as a good pain reliever for her.

Water Exercise is a safe way to move and stretch, with very little weight bearing.

Strengthening—Calgary Diabetic reported, “I have cured my back pain completely since starting weight lifting exercises on the horizontal and inclined bench presses for the last 1 1/2 years. I started with 50 lb and built to 150 lb now. The benches are good since they provide complete back support.”

Strengthening muscles eases pressure on the joints and tendons. It also gives you a greater sense of control, which, in my opinion, is the most important treatment for chronic pain.

Some Other Tips
Weight loss takes a lot of pressure off your back and other joints. Blood glucose control can help your nerves heal. Getting blood sugar down frequently cures neuropathy substantially or completely. Relaxation reduces muscle tension, relieving pain. Relaxation tapes, meditation, breathing exercises, or programs like this one or this one can get you started.

The National Sleep Foundation believes that two-thirds of chronic pain sufferers experience sleep problems. Sleep disruption caused by chronic pain exacerbates the pain, which in turn interrupts sleeps. Learn some tips for getting sleep here. Both Beth and Karen posted that CPAP (Continuous Positive Airway Pressure) machines helped them sleep and reduced their pain.

OMG, I’m past the end of my allowable words, and we’re just getting started. All these physical therapy measures are helpful, but most chronic pain is more in the nerves and brain than in the back and feet. So that (along with medications) is what we’ll look at next week.

Please write with any questions or comments.

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  • Florian

    I have some arthritic discomfort that is helped by weight resistance training. But I was wondering if Neuropathy and nerve damage can mask chronic pain?
    Florian T1, dx 1967

  • hemplydi

    I was diagnosed with type 2 diabetes in January 2007 after 20 years of having post prandial hypoglycemia. I primarily have high glucose readings in the morning without medication. My A1C levels have never been above 5.8 because my disease was detected very early. Lately I have been having increasing numbness in my left foot with slight swelling and sensitivity to simple pain. Why is this happening when I don’t have out of control disease? I am tightly controlled because I have changed my diet to reflect my diabetic status although I really didn’t have to do this.
    Diane in MN, T2, dx 2007.

  • David Spero RN

    I don’t think neuropathy is masking pain – some people get pain, others get numbness. However, people with neuropathy DO tend to have much less senstitivity to pain from infections or injuries, which is why you have to be so careful about checking your feet.
    Hemplydi, not sure why you’re getting symptoms of neuropathy now. Have you had this checked out by your doc? There could be another cause. But it is also possible that even tighter control would help, and there are other things you could do. See my next blog.

  • Jo Ann

    I was diagnosed with Type 2 Diabetes about 3 years ago but have had Peripheral Neuropathy for many years before that. I only had it in my feet in the beginning but now have it in my hands also. I have pain & numbness. The 2 medications that help me the most are Gabapentin & Metanx tabs. Not all brands of generic Gabapentin work though & ANYONE who says all generic Gabapentin are the same are totally wrong!!