10 Basic Tips for Managing Chronic Pain & Fatigue

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Managing chronic pain and fatigue is an uphill struggle. You can get stuck in a cycle of drudgery, and it’s extremely hard to break out on your own.

Overall you need help. Adopting new methods to manage chronic pain can also be helpful to do with someone else, even if you live alone, or don’t have many friends, it could be helpful to join online groups for activities or support.

All these tips are really tips for everyone, whether you have chronic illness or not, it’s just they are even more important for someone with chronic illness. You’ve likely heard them all before, because they are all widely discussed. The issue is really that these topics whilst simple on the surface, are actually very deep and involved when you start to seriously practice them, and sometimes it’s a shift in perspective that is needed to make progress with them.

Breathing & Posture

Something as simple as breathing can help switch the brain from the sympathetic to parasympathetic nervous system. A deep sigh or repeated deep breaths can take the tension away from the body, which has likely been put into heightened tension due to constant or frequent pain signals.

Posture is also important in reducing tension, how we sit, stand and lie down affects the tension of our muscles, and adjusting yourself into a more neutral state can relieve this tension.

Pacing / Avoiding Post Exertional Malaise(PEM)

Pacing is something that can be hard to accept as necessary but the sooner you accept that you are not your old self and limit what you do, you will be able to preserve more energy for managing your pain. It’s simply a matter of doing less, expecting less and avoiding overdoing things. This means splitting up chores into smaller parts, saying “no” to physical exertion asked of you and not feeling guilty about any of it, because it’s necessary for your self preservation.

It’s a must to avoid PEM, because it can cause you a miserable time for no benefit. PEM is when you over-exert yourself and end up with a prolonged fatigue after the activity. Similar to one step forward, two steps back.

Body Scanning / Progressive Muscle Relaxation

When you live with chronic illness, you can become so wrapped up in avoiding pain, managing fatigue and consumed by negative thoughts that you get disconnected from your body’s signals.

By focusing on your body part by part, relaxing each part, and observing your body, it can help to reset yourself. Sometimes you realise that you are unconsciously tensing up certain muscle groups, and the release can be very helpful.

Breathing is a good entry way into realising how your body feels, by focusing internally on breathing, you can align your observation to your body.

Drug and Supplement Usage

First, it’s doubtful that any medication or supplement is going to cure you. Your ideal scenario is usually 5% improvement, so it’s best to keep expectations low. For certain people it may be true that they are missing one specific chemical and a drug or supplement can improve their symptoms vastly, but for most people this isn’t going to be possible, since their chronic illness likely has a complex solution.

That said, no one is in perfect health, there’s always some possibility for improvement. The problem is often that drugs and supplements can take a long time to even give you a small improvement. At the very least you need to try them for 6 weeks, and for many substances, 6 months is necessary to start to see positive change.

Redirecting Anger & Frustration

Anger and frustration can harm you if left uncontrolled, but if channelled, they can help somewhat fuel your lack of energy. The idea is to be angry and frustrated at your illness and not at yourself. You need to separate the two.

It’s very common that after years of chronic illness, we form an identity around it. Our ego latches onto our symptoms and defines itself by them. That situation is doing you no favours, and for some is part of what is holding them back from improvement.

You can learn to foster an anger towards your condition, and use that as fuel for self-care.

Your body over time learns to limit your energy and limit what it wants you to do, for fear of pain. In some ways this is good, because we do want to limit ourselves from over-exertion. The problem is the pendulum swings too far back, and you end up doing very little.

This is actually the most difficult situation to be in because it’s very hard to know how much is too little when you can be bed-bound or wiped out on a daily basis.

The only solution is to take baby steps, to be realistic with what you can achieve and to never give up hope.

Comfort

Comfort is very important for chronic illness, but a lot of times, it can be associated with guilt. There’s a societal expectation that everyone should push themselves in discomfort, and that the only worthwhile things are hard to achieve.

However there’s a cognitive dissonance with comfort and hard-work. People can be made to feel lazy if they seek too much comfort.

It’s my opinion that you can’t have too much comfort when you are chronically ill. Comfort should be your main medication, so don’t feel guilty about descending into comfort frequently.

Identifying and removing problem foods from your diet

Diet is one of those overbearing constant reminders in the health crisis of modern society. You are what you eat. But the pitfall with diet is that it can become obsessive and destructive.

The only two factors that you should care about is how food makes you feel after you’ve eaten it, and how much food you eat overall.

Try to get into the habit after eating, of asking the question to yourself, “how do I feel”. The worst you feel, the more likely that the meal in question needs to be changed. This is where it can get difficult to identify which ingredient is causing the discomfort, as even a cooking method or the way you eat can be the culprit.

With overall eating, calorie in and calorie out should be the only concern, intermittent fasting can be helpful to control overeating, and regularly timed meals and with set portion sizes for eating enough.

Don’t worry too much about “healthy” foods, it’s far more important to listen to your body and remove those foods that make it feel worse first, leave making healthy choices as a long term goal, not something that you will do for 2-4 weeks and likely give up because you don’t enjoy eating it.

Journaling

Writing down your biggest worries can be helpful to get rid of overbearing thoughts. However it won’t be helpful to you, if you simply dump only your negative thoughts out. In fact confronting these worries can sometimes make them worse if you don’t have a plan to deal with them.

The most important part of journaling is self-observation. Try to write down your observation of how you are managing, how you feel, how you are thinking.

It’s important to come up with a solution to your biggest worries at the time of journaling. Is there anything you can do about these worries now, tomorrow, this week, this month, this year? If you can’t do anything about it, it’s simply not worth your mental energy, and remind yourself of this.

Writing your positive thoughts out last can also be uplifting, even the smallest win is worth focusing on.

Ask for help and support for both mental and physical issues

If you don’t ask, you often don’t get. Avoiding asking for help is very understandable, after all it’s very easy to feel like a burden to everyone around you when you have chronic illness, how can you then ask for more? Everyone has problems, and so the enormity of the world’s suffering can make you feel insignificant on top of the guilt of needing more help.

But the logical solution to this warped way of thinking, is simply that you need help to improve. If you need something, you deserve it to yourself to try to acquire it, that’s self-care.

Society scolds us for looking out for number 1, but the unfortunate situation of chronic illness, is that you simply don’t have much energy to share. Don’t see self-preservation as being selfish, just as fatigue isn’t laziness, and being in pain constantly isn’t just being “over sensitive”.

Ask for help from those around you, ask for help from your local services and wider government services.

Stretching and regular exercise

Morning and evening stretching, can help loosen up your tense muscles. In some ways, the main goal of exercise is to promote better sleep.

People with chronic illness, likely have sleep disturbance, and sleep is one of the most important health outcomes in our lives.

Think of your body as a machine like a car, if you leave your car parked doing nothing for months, the battery will drain, tyres will de-pressure and form flat spots, brakes will rust and fuel degrades. Cars are far less complex than the human body. You can be chronically ill doing very little for decades. Lack of any meaningful activity will definitely damage your body. You can start to attempt to solve this with even 5 minutes a day of light movement.

Exercise should never be overdone, but you need to do something, however small every day. If 10 minutes of walking exhausts you, do 5, and don’t plan to increase it. Set limits, and don’t feel like you need to keep expanding them to “improve”. Just doing something habitually that helps you is a massive improvement.

Just the act of moving your body, can metaphorically sweep out the cobwebs in your body. Stiffness is a major problem in chronic illness, and it’s not an easy thing to confront. Ideally take some kind of painkiller before or after exertion, but never overdo things.

Your target is to do the minimum, not the maximum. Achieving the minimum is better than achieving nothing, even if it’s 5 seconds of moving around your arms, neck, legs, etc, every 1 hour to just loosen up.

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The irony of being ill, is that you have less physical resources but have an even bigger requirement for self-care than normal people, yet are often expected to “get yourself together”, when barely anyone normal has done so either.

None of these tips are meant to judge or play down chronic illness, for example exercise can be something that’s very hard to achieve when you are literally fatigued all day, or experience excruciating pain. At some point however, there is the reality of what your actual choices will result in.

You need to work out what you can achieve, set limits and realistic goals. Don’t guilt yourself into doing too much, don’t overdo things, and pace as best you can. In a cliché way you might think of chronic illness as a war, and yourself as a warrior. You won’t win every battle, but with the right strategy, luck and perseverance, you might win the war.