Chronic pain is unique in that it manages to be both predictable and unpredictable simultaneously. While long-term pain becomes familiar and unsurprising, sometimes flares of pain come on seemingly at random. It’s common to wonder, “Gee, why am I hurting so much more today?” Sometimes, flares are truly random. But often, when we look through the chaos of the flares we can see that there’s some sort of underlying pattern that precedes periods of higher pain.
Understanding these patterns is difficult, because chronic pain is so multifaceted and private that it’s sometimes hard to notice which outside factors are affecting your pain. Pain journals can be helpful tools while trying to discover what pain triggers you have; use the journal to track your daily pain, along with your daily exposure to various triggers. After a couple months, patterns should begin to emerge. Most of the triggers are unavoidable, but recognizing them is an important step in being able to engage in preemptive self-care.
While each person’s pain is fiercely individual and thus no list can be totally inclusive, there are some common pain patterns Chronic Pain sufferers might want to track.
Stress. There’s no question that stress affects how we experience pain, but the way it affects pain is not well known. For example, in cases of acute pain, induced stress (like the stress from a test) may serve as a useful distraction against pain. However, chronic pain patients have internalized, chronic stress, and the prolonged pain often makes it impossible for the body to stop producing stress hormones. This is correlated with increased pain perception and depression. It seems likely that the association between pain and stress largely depends on whether the stress is chronic or acute, as the difference of their effects on the body can be seen on a cellular level. When keeping track of stress in a pain journal, try to identify the sort of stress you’re experiencing (short-term or long-term, good or bad, etc.) as well as any other symptoms you think the stress might be exacerbating, such as mood problems, digestive issues, sleep changes, etc. If you find that stress is aggravating your pain, learning some new coping mechanisms might help you manage times of stress.
Weather. Changes in weather, particularly changes in barometric pressure, are scientifically shown to have a significant effect on pain, particularly if your pain is inflammatory in nature. As the barometric pressure drops, there’s less air-pressure around us compressing our bodily tissues, so tissues that are prone to swelling will swell. Conversely, weather systems of increasing pressure can help relieve some pain. If you notice that changes in the weather seem to accompany a change in your pain level, tracking the barometric pressure, temperature and relative humidity is a fairly thorough way to record patterns. If you’ve kept a pain journal before and would like to compare your pain levels to the weather you can do so here. Some ways to deal with weather-related pain changes are by applying compression to areas prone to swelling, keeping warm, and gentle exercise to encourage movement of fluids in the body.
Food. Food sensitivities are extremely individual, but can be an important factor in pain management. Some people might find that particular foods actually trigger a pain flare; for example, people with migraines often find that consuming MSG directly triggers an episode. Other times, it may not be noticed that a type of food causes increased pain symptoms until you eliminate it from the diet; some have found this true of things like gluten, lactose or food dye. Keeping a dietary log along with your pain journal can help clue you in on any correlations between your food intake and your pain. Always check with your doc before starting any sort of restrictive diet!
Activity. The relationship between pain levels and activity is often complex; too much or too little can cause your pain to increase. Although it often seems the intuitive response to pain, remaining sedentary can cause the body to stiffen up and muscles to lose strength, resulting in even more pain. Activity is imperative to well being when living with chronic pain because it releases feel-good endorphins , but activities that are too strenuous may cause pain to increase. By writing down what exercises and activities you preform along with your pain level, you can begin to notice what exercises leave you feeling better and which ones leave you feeling worse.
Sleep. Sleep is the time that when the body repairs itself, so it’s no surprise that sleep affects pain levels so deeply. Not all sleep is created equal; deep restorative sleep requires the sleeper passing through 5 stages of progressive relaxation. When sleep is interrupted, the body must try to start the cycle over again. If you’re tracking your sleep, some things that are beneficial to write down in the morning are: how soundly you feel you slept, how many times you woke up during the night, and how easy it was for you to fall asleep. Don’t worry too much about tracking specific times, since looking at the clock often causes anxiety over getting to sleep—totally counterproductive.
Acute Illness & Injury. One of the cruel realities of living with chronic illness is that we still have to suffer acute illnesses, too. We may describe our illness to others by saying, “Every day feels like the worst flu you’ve ever had” as a way to shed perspective on how uncomfortable we are. So when a chronically ill person experiences a terrible virus, the results are basically like getting hit by a Mac truck; incredible pain. Even minor infections can sometimes play a huge part in increasing pain and fatigue. It’s the same with acute injuries; if you experience an injury in a place that already experiences pain, it can cause your pain levels to skyrocket. Interestingly, sometimes an acute injury can help distract from chronic pain in other places. Tracking these acute problems can help explain pain fluctuations.