Manage Your Pain: Practical and Positive Ways of Adapting to Chronic Pain

by Michael K. Nicholas

Practical and positive ways of adapting to chronic pain. Chronic pain has been described as a silent epidemic. More than one in ten people - over ten per cent of the population - suffer from persisting pain. Over the last month, how often have 1. taken pain killers so you could do something you know would stir up your pain? 2. completed a task, regardless of pain, then 'paid' for it later with more pain? 3. found that pain is interfering with your sleep, work, sport and social activities? 4. had one or more long rest periods during the day because of your pain? 5. felt you cannot go on as your pain gets worse 6. worried that your doctors have 'missed something'? 7. been told to 'live with the pain' but not shown how to do it? If you answered 'yes' to any of these questions, then MANAGE YOUR PAIN will help to improve your life. All too frequently, chronic pain cannot be successfully treated - and drugs are not always the answer. But the combination of approaches provided by MANAGE YOUR PAIN can help you learn to minimise the impact of pain, and put persisting pain where it belongs - in the background of your life.

Genres: Health, Nonfiction, Psychology, Self Help

304 pages, Kindle Edition

First published October 28, 2006

Reviews

[Lyn Elliott · Rating 4 out of 5]

This excellent book on managing chronic pain was recommended to me by a friend who's been in that unpleasant territory for some years now.

It's written by a team who practiced together in the Pain Management and Research Centre at a major Sydney hospital and reflects their years of experience in helping people with chronic pain to live with it, using as few drugs as possible.

Ive had creeping arthritis for a while, but several months ago I slipped on gum nuts while I was walking quite quickly and landed on one knee cap which shattered. It's still going to take a long time for the muscles and tendons to recover and in the meantime it's painful enough to intrude into my consciousness far more than I would like. BUT I don't want to live on painkillers, so enter the pain team.

The first part of the book explains how pain works in your body and brain. Most of it is taken up with a recommended program of carefully designed stretching and strengthening exercises; and mental exercises to help manage the way your brain deals with pain. In short, the more miserable you feel and the more you catastrophise about your pain, the worse it will be. And the more time you spend in bed, the weaker your body will get and moving will be more difficult as you lose fitness.

It's written in a straightforward style, is useful illustrated with diagrams and many case studies.

Highly recommended for those who need it, or support someone who lives with pain.

[B · Rating 1 out of 5]

A book & program they declare is 'world renowned' and has been implemented by the authors for over 20 years so I did expect more, and they apparently tell their pain clinic patients (at the public hospital) to buy it at their first consultation and list it on their take home 'to do' list (would seem like a conflict of interest). Some people without much health or self enablement knowledge would perhaps find the book helpful, many others less so or not at all. Some might perhaps find a few useful tips, tools and ideas. The authors are obviously very confident (or even arrogant and patronizing) in their approach, reflected in the book title which indicates a directive success/ failure mentality and of course telling you what to do (which goes against enablement philosophy). It is a more left brained clinical western ego medical book/ approach if that is what you want. A more empowering, person centred, holistic, contemporary and broader approach incorporating the right brain, with a more empathic and compassionate flavor might be appreciated (and balanced with reality and more recent advancements in the 'pain' area at least from areas such as ozone, acupuncture, new meds, nutrition such as low/ no starch diet, treating inflammation and its causes, DMSO/ MSM, Lactoferrin (and any other natural iron chelation), MgCl Oil, Dr Birkmayer's Rapid NADH (not the copycat brands who use his name), turmeric/ curcumin, iron chelation, bioavailable copper deficiency, treating heavy metals and stealth infections inc candida and jaw cavitations, decreasing acidity, serrapeptase, infrared or ultrasound light, and yoga). Boron (as Borax) is also fabulous for pain. Wild p73 Oregano Oil has also been shown to surpass anti inflammatory drugs and be nearly as potent as morphine as a painkiller.

At the moment it seems that western medicine has little to offer people with pain, and mostly offers patients lifelong dependence on pharmaceuticals to cover up the pain (not reduce it), with terrible side effects, and has even served to assist in shutting down many of these therapies. Since western medicine has little to offer, they then just assume a 'pain acceptance model' of 'the patient has to learn to put up with it'. It is also well worth people looking into the works of people like Dr Klinghardt who ran a large pain centre; he found that unless attempts were made to eradicate toxins, heavy metals and microbes from the body, you usually could not reduce intractable pain (which has also been my experience), when these attempts were made, over 80% of people achieved substantial improvements in pain (of course to the detriment of the BigPharma profits). This will be the 'pain medicine' of the future.

I didn't get the impression that any of the authors had themselves experienced any significant pains, and like it is said 'until you have experienced terrible ongoing pain, you have no idea'. I do worry how suitable/ helpful this is for those with more severe/ excruciating levels of chronic pain and nerve pains (the book is idealistic at that point and any suggestions for these people?), those for whom medication is essential and useful as part of 'managing their pain' and enabling function in life (this program includes having to cease pain meds), and those who don't just have your average structural stable mild-moderate pains. In this context I heard a prominent pain specialist say that this book/ program is 'OK, but is overly one size fits all'; it would be good if the book acknowledged this so that people don't feel bad when they cannot squish into their box, and more could be offered. I also found the book depressing to read in its flavor, which is neither necessary nor helpful and actually goes against their supposed philosophy. I have heard that some pain doctors and clinics (and their allied health staff) robotically use this book/ program for their approach and groups, which is a concern. I also don't know why it is not ok to be human and just say 'pain is sh*t'. It is also completely inhumane to deny pain medications (including opiates or possibly medical cannabis) for those suffering from and dying in terrible pain (this is still often neurotically and poorly managed by doctors in many 'developed' countries). I make these comments as someone who has worked in this area, and also suffered severe pain. I have also discussed this with eastern spiritual masters who say that leaving someone in pain is inhumane and that it is only a Buddha who could transcend pain.

[Ausjenny · Rating 4 out of 5]

My doctor recommended I read this book because I have chronic pain which I will have to learn to live with. I found the book to be interesting. While my pain is chronic headaches I have other pain in my knee and found this book to be useful. I am already doing some of the ideas suggested but it did help with setting goals and with exercise and stretches to find a baseline and slowly increase. I was getting frustrated with not being able to walk far now I have changed my mindset and instead look at is as at least I can walk that far. It also has strategies for different areas of life. I wish I had read this when I had hurt my knee as I live with knee pain all the time and having this book would have been of use.
If you do read the book I would suggest you talk to your doctor before you implement the program as they can help advise you.

Also many libraries have a copy which saves having to buy the book.

[Olwen · Rating 4 out of 5]

Excellent reference for anyone facing chronic pain. Lots of techniques and inspiration.

[Cassandra C · Rating 5 out of 5]

Extremely helpful.

[Angie Dong · Rating 1 out of 5]

It’s helpful insofar as it is an honest portrayal of the opinions of the authors of the book. But it reads more like a hospital brochure, and less like the cutting edge and authoritative pain management handbook it claims to be.

For instance, there are a range of treatments offered by private clinics in Australia and by hospitals in the US/Europe, which have not been included in the book, and rather coincidentally, these treatments are not offered by Royal North Shore. The book also very much encourages active physical rehabilitation as the primary treatment, which is in line with medical practises in Australia, but is somewhat inconsistent with the greater variety of treatment options available abroad.

It does not make different recommendations for severe/long-term chronic pain vs minor/recently diagnosed chronic pain. It does not reference specific treatments for specific chronic pain conditions (E.g. neridronate for CRPS). It asserts that medications are usually bad and it does not recognise that ketamine can prevent the development of chronic pain conditions after injury.

The parts that I liked were the comprehensive lists of the pros and cons of every treatment routinely offered by pain clinics in Australia. I also liked that it advised patients to have realistic expectations of treatments, doctors, and prognosis.

[Chloe Graetz · Rating 4 out of 5]

Finally some real and practical methods for managing chronic pain. I read through this whole book but expect I will read different sections many times as I go through my journey. It's quite hard to wrap my head around the fact that the goal isn't to reduce the pain at all, but to be able to do more despite the pain. It would be really great if my family and friends would read this too. Only criticism is there are about 10 different charts/tables you need to draw up and exercises to do several times a day. It would be better if there was a section at the back with all of that so you could tear out and easily photocopy the pages.

[Stephanie · Rating 4 out of 5]

Though fairly good overall, the whole strategy is dependent on the idea that after a certain point with chronic pain you are not actually doing yourself any damage anymore, and it's just residual effect. This would work for a lot of people, but if you can't be confident of that fact, much of the advice in this book becomes much less relevant.

[Trent · Rating 2 out of 5]

Most of the content was really obvious and very outdated. E.g., there is no discussion of how neuropathic pain can be cured. The "programme" seemed so generic and the book had so many random sections and bits of advice I ended up skimming a lot of it. Can't remember a single thing from it that I felt I learned and could help me -- though I would say I have read a fair number of pain books at this point!

[VvTired (Lauren) · Rating 3 out of 5]

My thoughts on this book are almost identical to my thoughts on the book “The Pain Survival Guide: How to Become Resilient and Reclaim Your Life” so I’m just gonna repost the same review:

Not bad advice but not really helpful for those who have been living with chronic pain and have already sought out extensive medical treatment. I probably should have figured that but this book was recommended by a pain psychologist and I wanted to give it a fair chance.

[Ang · Rating 4 out of 5]

Probably the best one out there on this topic (recommended to me by my pain specialist), but very much matches the tone of most books on this subject: doctor or expert telling patients what to do from a position of power. Can be a been overwhelming on bad pain days (or weeks), so worth reading when you're feeling well and detach a bit from the personal nature of the topic.

[Kira Luther · Rating 5 out of 5]

Was recommended this by my psychologist and even though my chronic pain is due to a chronic illness, and therefore has an underlying cause, I still found this book had helpful strategies to navigate the ebb and flow of pain through my day to day.

[Jennifer · Rating 5 out of 5]

One of the most practical books on pain.

[Jenny · Rating 5 out of 5]

Very good, lots of up to date information and good advice. Definitely worth reading if you have chronic pain

[Rachel Wakeman · Rating 4 out of 5]

Great book with loads of advice and charts to follow. Gives information on different medications and ways to improve your health.

[Oz · Rating 4 out of 5]

I’m a bit wary of any book that claims to help anyone with their health – bodies just don’t work like that. That said, the info in here was fairly helpful for me, and I appreciated the “start at the level you’re at now” message

[John · Rating 3 out of 5]

This is essentially a manual for participants in the Royal North Shore Hospital ADAPT 3-week pain management program, which has been released for sale to the public. For broader appeal, it would be much information specific to that program and the Australian context was moved to a separate document just for those participants so as to not needlessly weigh down the content of this book.

Also, the book spends a good deal of time arguing in defense of itself and the techniques it contains, which makes tough reading at times especially in the first part of the book. Rather than trying to browbeat the reader to engage with the content, the book would have been greatly improved if the authors had instead applied the strategies they outlined in ch9 to engage the reader’s motivation to use the pain management techniques- perhaps written by a suitable educational author.

Some content in this 3rd edition (published 2011) is already dated: It precludes the possibility of peripheral neuropathy from it’s definition of chronic pain; types of imaging technique doesn't include PET; an outdated version of the decisional balance sheet is included in ch.9 (supplanted a few years previously to overcome limitations)

However, the general advice seems to be good and generally follows what is now widely accepted in the field as best practice. I hope that future versions are able to overcome the limitations of this edition.

[Toni · Rating 4 out of 5]

I have enjoyed many returns from better understanding chronic pain after reading this book. I know how to graduate my tasks and mix my approaches to different activities. I can avoid pain killers stronger than paracetamol and understand that chronic pain is a trigger for anxiety.