By Michele Rice

There’s a beautiful and picturesque little town nestled in the embrace of the fluffy snow blanketed foothills. Sparkling in the filtered sunshine like an aquamarine gemstone covered in ice is a magnificent lake. Children, adults, and even a playful puppy can be seen gliding across it with playful whimsy, ice skates, mittens, and smiles galore, seemingly not a care in the world. It’s a perfect scene of a perfect moment in a perfect place.

I turn the object in my hand upside down and give it a few gentle shakes. A blizzard of snowflakes swirl fiercely around the little town, clutching the ice skaters in their icy grip. With the near whiteout of ice crystals whipping around the frozen lake, I can no longer see the happy smiles or the postcard perfect little town with its quaint happy houses.

Setting the snowglobe on the table in front of me, I watch the frantic tango slow to a waltz as the snowflakes gently come to rest. All appears peaceful and calm again in this glass-enclosed town, the smiles once again visible, the frozen lake once again glistening in the warm sunshine.

For those of us living with chronic pain, sometimes in life, it feels like we’re caught in a storm and can’t see what lies ahead. Then, when things settle, you can see clearly; just like a snowglobe. That’s what happens to me when an unexpected vicious pain storm gets me in its clutches. My plans, my hopes, my dreams, my happiness, and my good intentions, get caught up in the blizzard of self-doubt, hopelessness, despair, fear, isolation, sadness, and every pain sensation in my body. This storm can become so intense that I can’t clearly see a path back to less pain, hope, happiness, calm, and a more functional life.

It’s times like these that it is crucial for pain warriors to have a toolbox at their disposal. I’m not talking about a toolbox with hammers, screwdrivers and wrenches, but one that has lots of ideas of things to try to bring our pain levels down and elevate our mood.

When I’m in a terrible flare-up, I find it very difficult to see through my pain haze and remember all the tools that I can use to help myself. And if I don’t use these tools, then I’m at risk of very negative thinking, such as, “This pain flare-up will never end,” “I can’t handle this anymore,” or “I’m never going to feel happy again.” These gloomy thoughts are not helpful. In fact, they are very detrimental and can create the perfect storm. Pain can lead to negative thoughts and emotions, and negative thoughts and emotions can make our pain worse.

So what can we do to help when these unpredictable flares try to take us down? Here are five tips from my own personal toolbox:

When I feel like the pain is unbearable, the first thing I do is stop and become very aware of my body and my breath. It almost never fails that I’m holding tension in my body and am taking shallow breaths. This is not good for helping to relieve pain. In fact, it has the opposite effect.
I remember at the beginning of my pain journey, I would get so angry when someone would suggest that I, “Just breathe,” or “Relax, and you’ll feel better.” If breathing and relaxing is all it took I would not be sitting in this ER crying my eyes out!!

Over the years, I have come to realize that although taking deep, slow, and relaxed breaths, letting go of the tension in my muscles, and doing some kind of meditation or guided imagery may not always work to make my pain flare go away, it does always keep it from getting worse. It also helps me to cope with the pain until it comes down to a more tolerable level. Plus, there are rarely any negative side-effects from breathing properly and relaxing. So get comfortable, close your eyes, and take yourself to your happy place, all from the comfort of your own home!

Distraction is one of my best go-to tools for particularly bad flare-ups. This will look different for all of us, and it will even look different for you depending on how severe your flare-up is. For example, if my pain level is off the charts high, then getting together with a group of friends at a loud restaurant is not going to be very distracting. In fact, it may make my pain levels higher. When my pain feels out of control, one of my best distractions is getting as comfortable as possible in my bed where I can adjust the temperature, the blankets, the pillows, the lights, etc. to what suits my needs best at that moment, and then I try to lose myself in a really good movie or Netflix series.

“Movement is medicine.” This is what my physical therapist is always reminding me. As my pain levels rise during a flare-up, I have a tendency to want to retreat to my bed and hibernate until the flare passes. I know it may sound counterintuitive, but movement truly can help you to feel better. It doesn’t need to be anything major. Start with some gentle stretches and maybe a short walk outside. Going for a short walk, even if only for five minutes, especially outside if it’s warm enough, almost always brings my pain down a bit. If it doesn’t, it keeps me from getting stiff and having more pain, and if I get outside in nature, then my mood is definitely lifted. That in itself is a great reward because the better my mood, the stronger I feel to cope with my pain.

“I can’t take this anymore!” “I can’t do anything to help myself!” “This is never going to end!” This is a sample of some negative self-talk I’ve caught myself engaging in when I’m in a particularly bad pain flare-up. These are not only unhelpful as they can lead to increased tension, crying, and feelings of helplessness and frustration, but they are not true. I started paying attention to my self-talk, and I realized that although pain increases are scary, if I focus on reminding myself that I’ve been through pain flares before, the pain flares almost always do end, and I have tools in my toolbox to help me get through it, I feel better, both physically and emotionally. Try paying attention to your self-talk, and “see if you can challenge the distortions and thoughts that are unrealistic. Come up with more realistic, action-oriented thoughts and phrases: “The reality is that I can take it and have. I don’t have to like it. I have many things I can do to manage my pain flare-up.”“ “Managing Pain Before it Manages You” by Margaret A. Caudill, MD, PhD

Finally, I suggest participating in one of the U.S. Pain Foundation’s chronic pain support groups via Zoom. These groups are led by trained leaders that are living with chronic pain themselves, and they are a perfect way to get additional support and tips from others from the comfort of your own home. Participating will also help with the isolation that often accompanies severe pain flares, as well as the depression and anxiety. They remind you that you’re not alone.

So, the next time you feel caught in a blizzard of pain and unable to see a path to relief, try to remember that, just like in the snowglobe, the storm will pass. You have tools at your fingertips to calm your mind and body and to help you cope until the pain subsides.