Just as there are different types of illnesses, there are different types of pain. Acute pain typically lasts between three and six months. Some examples are a sprained ankle or a cut. Generally, this form of pain resolves itself as the injury heals. 

Then there is chronic pain. Unfortunately, this is the type of pain that many stroke survivors deal with. Chronic pain can last for months or years. Different types of pain respond better to different treatments. Also note that one can experience more than one form of pain at the same time.

What Does This Have to Do With Psychology?

Living with chronic pain can negatively affect every aspect of your life. When a condition has this much impact, is it any wonder it can also affect you psychologically? Chronic pain can cause you to lose interest in activities, negatively affect your ability to concentrate, lead to sleep disturbances, changes in appetite, and feelings of isolation and low self esteem. Ultimately you find yourself constantly feeling down and losing hope. The result is depression.

Anxiety starts to creep in. You begin to worry about the cause of your pain and become fearful. Will anyone be able to help me? Will I ever get relief from this pain? Am I ever going to enjoy life again?

If your chronic pain is preventing you from completing tasks, like household chores, working, or therapy, feelings of guilt may begin to enter your mind. These feelings can be overwhelming —further leading to depression and anxiety.

This is where things get dicey. Chronic pain can lead to psychological pain. Psychological pain and stress can cause physical pain. To further add to the dilemma, it can also cause a decreased pain tolerance and intensify existing pain. This is a vicious cycle. It is extremely important when seeking assistance for your pain, that both your physical and psychological health be addressed and treated. 

How Can This Insight About Different Forms of Pain Help Me?

The greatest probability of receiving a treatment plan that helps ease your pain relies on your health care provider successfully diagnosing what type or types of pain you are experiencing. 

You can assist this process by starting a pain journal. 

A pain journal is simply a diary containing lots of vital information about your pain. It includes:

  • A thorough description of your pain. Is it burning, throbbing, stabbing, a dull ache etc.? Write down as many words as you can to describe your pain. 

  • Does it come and go, or is it constant?

  • Document the location(s) of your pain. 

  • Does it radiate? The pain starts in my left foot and spreads up my entire leg. 

  • Keep track of your activities and pain level while completing them.Describe this on a scale of 1 to 10 where 1 is the lowest and 10 is the highest. When I sit quietly, my pain is a 4, but after walking it elevates to a 9. 

  • What makes it better? Document anything you have tried that has helped. 

  • What makes it worse? Document anything that makes your pain worse. 

  • What have you tried that hasn’t helped? Keep a list of anything you have tried that has not been helpful; this includes any medications you have taken that offered little or no relief.

  • Is there a time pattern? Is it better in the morning and then intensifies as the day progresses? Is it worse when you first awaken and eases during the day? Is it constant all the time? 

  • Document any changes in your mood. As already discussed, this is extremely important information. 

  • Do you have any other symptoms with the pain? My pain makes me nauseous. My pain makes me dizzy. My pain affects my appetite. 

  • How is it affecting your life? What is it preventing you from doing? I can’t sleep or complete therapy because of the pain. 

  • Mark down anything you feel your health care provider needs to understand about your pain.

Having this documented reduces the chance that you will forget to give valuable information to your health care provider. I can’t even count how many times I’ve left my doctor’s office and then remembered many things I wish I had mentioned. 

The better your health care provider understands your pain, the better chance they have of creating a successful treatment plan.

Also, keeping a pain journal can help to give you some sense of control over your pain and treatment. I am a firm believer that once you feel even the slightest bit of control over a difficult situation, it can help to ease stress.

Continue to document your pain once a new treatment plan begins. This helps you monitor what’s helping and what isn’t and is valuable information for follow-up appointments. Also, if you see other professionals for your pain, they can refer to your journal for valuable information. 

After my stroke, I started experiencing an excruciating burning pain in my foot which radiated up my leg. I also had burning pain in my affected hand. It got worse with any activity and nothing I tried offered much relief. It prevented me from sleeping, limited my physical activity, and made life miserable. By keeping a pain journal and having it reviewed by my neurologist, he was able to diagnose it as neuropathic pain. It took some trial and error, but eventually, he developed a treatment plan that eased it enough to make it bothersome but not unbearable.

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