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When pain won't go away

Pain isn't necessarily a bad thing.

How long would your hand rest on a hot radiator if the burning didn't cause pain? How would you know your appendix was inflamed if it didn't hurt?

"Pain is what brings people to the doctor," says W. Hayes Wilson, MD, a former board member of the Arthritis Foundation.

Pain is your body's way of telling you that something's wrong and that you need to act. It gives your body a voice.

But that voice loses its purpose when pain becomes chronic and unrelenting.

What is chronic pain?

Everyone is familiar with the temporary pain of a stubbed toe or sprained wrist.

That's acute pain. It can usually be relieved, and eventually it goes away entirely.

Chronic pain isn't easily relieved and doesn't go away. It might be caused by an injury, such as a sprained back, or a disease, such as arthritis.

Chronic pain can make the ordinary tasks of daily living extraordinarily difficult. "Pain is there to modify our behavior," Dr. Wilson says. "But when something so ordinary as sitting at a desk causes pain, that's a real problem."

It's a problem that can overwhelm your life, causing fatigue, anxiety and depression. But there are steps you can take to manage pain.

Your pain management plan

Once you're told you have a condition that causes chronic pain, your first questions will probably center on finding relief.

That's where your pain management plan begins. You should work with your doctor and other healthcare providers to design your plan. You may need to try several different treatments before finding the combination that works for you.

Your plan might include medications, an exercise regimen and other therapies. You'll want to track what methods you've used and which have worked best. It's a good idea to keep a list of your providers and local resources—and their contact information.

A pain diary

You can manage pain most effectively by working with your doctor. That requires good communication from each of you.

Keeping a pain diary can help, according to Dr. Wilson. Carry a notebook or tape recorder with you and keep track of when your pain occurs, where it hurts and for how long.

"Be as detailed as you can," says Dennis Turk, PhD, a past president of the American Pain Society. "How severe is the pain? What kind of activities does it stop you from doing?"

Keep a record of what helps too.

"It is extremely helpful when patients know their medications, particularly ones that really helped as well as ones that caused side effects," says Dr. Wilson.

Medication and beyond

Your doctor will probably prescribe one or more pain medications.

But don't be surprised if he or she also suggests you try an antidepressant. That doesn't mean your doctor thinks the pain is in your head.

"Pain often brings on anxiety and depression because people worry so much about their pain," Dr. Wilson says. "And one of the reasons why antidepressants can help is because they cut down on some of that worry and anxiety."

Medications are an important part of your pain management plan, but they aren't your sole coping tool.

"There are many other things people can do," Dr. Turk says.

Exercise. It can loosen up tense muscles, relieve stress and help you sleep, according to the Arthritis Foundation. Ask your doctor or physical therapist to design an exercise program for you.

Distraction. Reading, listening to music and watching television are just a few ideas. Use pain-free time to make a list of distractions so you don't have to scramble for ideas when you're feeling poorly.

Relaxation exercises. These can range from controlled breathing exercises to using imagery. "Use your imagination to place yourself in a pleasant situation," Dr. Turk says. "Use all your senses to remember a vacation on the beach, for example: the warmth of the sun on your face, the smell of the water, the sand against the skin of your feet."

Support groups. Ask your doctor to refer you to a support group, where you can get tips from other people with similar conditions.

Don't give up

What works for someone else won't necessarily work for you, so it's important to keep trying new ways to cope, Dr. Turk says.

"The idea is to not feel like you are helpless," he says. "The more you feel that you're doing something, the better."

Remember that the pain is real and isn't your fault. It deserves the same care and treatment as any other health condition.

reviewed 2/13/2019

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