Pain Concern’s links with Astley Ainslie hospital
Pain Matters Magazine
In 2021 Pain Concern marked the twenty fifth anniversary of the very first Pain Concern (UK) Lothian Group newsletter, later to become the Pain Matters magazine that we know today, by going back to where it all started – Astley Ainslie Hospital.
The Lothian Group was a patient support group set up by members of the Astley Ainslie Hospital pain management programme, so the issue was guest-edited by the Chronic Pain Management Service from NHS Lothian, based at the same hospital.
This issue’s theme was compassion focused therapy, with the team showing the different ways they use compassion as part of a holistic pain management approach. Below you’ll find an article from the edition.
At the time of writing the author Ruth Lewis was Specialist Physiotherapist in the Pain Management Team at NHS Lothian Chronic Pain Management Service.
The drive to be fitter
Many people with chronic pain would like to be fitter, to enjoy life more or to be able to distract themselves from their pain. Our biology ensures we feel good when we achieve; the chemical dopamine is released, and this gives us feelings of pleasure, energy and reward. The way this natural chemical works means that, once we experience these feelings, we crave doing so again. Our society values action, and sometimes it can feel like we are what we do.
This drive for activity can be hard to manage. If you push on and do too much, ignoring pain or fatigue, you tend to feel worse. If you focus too much on the way you are feeling, you may never get started. Low mood can really have an impact on motivation. Energy levels and other demands in life can also get in the way. For many people living with pain, becoming more active could be one of the most important and effective ways to improve quality of life.
Understanding is key
A helpful start can be to accept how understandable it is to struggle with activity. Pain, fatigue, fear and low mood do make it harder for anyone.
It is not your fault that you have pain, and trying to ‘just get on with it’ can feel really unhelpful. It goes without saying that activity can become more challenging in the presence of chronic pain.
12 practical steps to being more active
The next step might be to think about how you can help yourself become more active in the most effective and supportive way:
- Break down your goal into smaller and smaller steps
- If you start to feel frustrated or critical of your efforts, remember how understandable these feelings are
- What music, images or smells could motivate you?
- In your mind’s eye, imagine achieving a step towards your goal, think about this in as much detail as you can. What are all the good things that could happen?
- Think about writing down some motivating statements, such as ‘this is hard but I can do it’, ‘enjoyable activity is a powerful medicine’
- Try acting. Research has shown that adopting a confident posture and facial expression can help you feel more positive and motivated
- Practice a kind inner voice; try not to be hard on yourself
- Take time to think about what matters to you. What brings you a sense of pleasure and reward?
- Focus energy and commitment on what you can do rather than what you can’t. Write down as many ideas as you can
- Involve people you trust
- Think broadly about activity: singing, crafts, home improvements, studying, connecting with friends, reading or researching areas of interest
- Think broadly about exercise: dancing, cycling, Tai Chi, health walks, gardening, DIY. Search for the Chartered Society of Physiotherapy’s Love activity, Hate exercise campaign. Their website has lots of ideas and real people’s stories.
Pain Management programme feedback
Here are some responses from pain management programme graduates:
‘Walking at lunchtime was manageable, because I didn’t have a lot of time. Half an hour break meant I couldn’t push myself.’
‘I changed my mindset. If you don’t try anything different, you’re not going to get anything different.’
‘Knowing it’s safe to move helps.’
‘Muscles tense, and that brings on pain, so I am trying to slow down, relax.’
‘When you do breathing exercises and let everything go, it is easier to move.’
‘I started introducing things I was missing, things I enjoyed. I’ve been getting back to gardening; I’ve been walking the dog.’
‘I took some time off work, and I have never done that before for any reason – being kinder to myself.’