Managing pain



When you have pain it is usual to try and protect the area and to rest but when your joints and muscles are rested for any length of time they start to become weaker.You become less fit and tire easily so when you exercise you may feel very stiff. This may increase your pain so you’ll want to avoid any activity that causes this and so a vicious cycle is created.


Pain cycle 1


The pain cycle


Long term conditions can sometimes leave people feeling low and depressed. Changes in bodily appearance can often affect the way a person feels too. Conditions such as arthritis often cause fatigue, which can make it more difficult to deal with pain. It is possible to be caught in a cycle of pain, depression and stress. This is very frustrating and can be upsetting. Learning to manage pain will help to break the cycle.


pain cycle 2


Most people with  arthritis will experience pain. This may be due to a number of reasons.  It may be due to that fact that because of muscle wasting excess strain is put on other joints. It may also be due joint damage.For people with rheumatoid arthritis pain may be due to inflammation in a joint (synovitis). In one person the cause of pain can differ between joints – this is why it can be difficult to find one therapy that is completely effective at relieving one person’s pain. Below are a number of ways in which pain can be managed:


To appreciate how you experience pain, it is important to understand these two principles:


● everyone reacts to and manages pain differently


● how you deal with your pain can actually affect the way in which you feel it.


How you were brought up can make a difference to how you respond to pain. During your childhood, how did your parents react to pain? Were you allowed to show it, or was pain considered bad or embarrassing? Were you able to feel comfortable showing you were in pain, and allowed to deal with it positively? All these things, and a variety of other factors such as anxiety and fatigue, determine how your body will react chemically to pain and whether your nerves will transmit or block a potentially painful message.


Experiencing daily persistent pain from arthritis can be a real challenge, but it is one that many people have faced successfully. It may always be there, but you can work hard at not letting it interfere with your lifestyle. Try to re-focus yourself and shift your pain into a tiny corner of your life.


The amount of time you spend consciously thinking about pain will influence how much pain you feel. If you get locked into thinking continuously about your pain, you are probably experiencing it more severely than you would if you managed to turn your thoughts away from it. Try to distract yourself by doing something you really enjoy. Pain is your body’s message to you to take appropriate action, and not necessarily to stop all activity. Saving energy involves listening to your body for signals that it needs to rest, and pacing yourself to avoid exhaustion.




Pain is a very distressing experience and it can be difficult to ignore and just get on with life as normal. You are in the best position to understand your own pain experience and you are the best person to manage it. However because long term pain is often accompanied by loss of confidence, depression, anxiety and fatigue it can be difficult to feel motivated to make active changes to improve your situation.  Depending on how we think, what worries us, how we feel and what we do when we are in pain, we can increase or decrease our discomfort. There are many different ways of breaking the cycle:




One way to help deal with pain is relaxation. Sometimes when we rest, we do not have good quality rest because our brain continues to work and our muscles are tense. Relaxation exercises can increase the quality of rest, make the tense muscles relax and reduce pain.


Many people find relaxation an effective way of managing their pain. Relaxation helps to reduce stress and can produce a general sense of wellbeing. Various forms of relaxation are available and techniques can be easily used to complement pain-relieving medication. Listening to relaxation audio tracks is popular. Some approaches take you off on a scenic journey describing restful locations such as a beach ( guided imagery), while others focus on tensing and relaxing various parts of your body (progressive muscle relaxation) or use other visualisation approaches. It’s worth trying a few different approaches to decide what works best for you. Self-directed forms of relaxation include meditation, which involves concentrating on breathing or a sound (called a mantra) that you repeat to yourself. Alternatively, specific breathing techniques can be used which, once mastered, can be performed on the spot to ease anxiety. You’ll probably need to attend a class to practice in order to perfect the technique, but the effectiveness of relaxation improves with practice.Sometimes brief periods of relaxation that you can build into your activities are best.




Another way to help deal with pain is distraction. Distraction works because it is difficult for the brain to focus on two things at once. This is why it is difficult to rub your head while you pat your stomach. Learning how to use distraction to break the pain cycle can be of great benefit. This method is especially good when you have to carry out short activities that you know are painful, such as walking up a flight of stairs. It is also useful when you have trouble falling asleep or are concerned by negative thoughts.


Distraction trains your mind to move its attention away from your pain. Our minds have difficulty focusing on more than one thing at a time, so if we can focus our thoughts on something other than the pain we can help the feelings of pain decrease. There are a number of ways to distract your thoughts:


a. One simple method is to really involve yourself in what you are doing. For example if you are cooking really concentrate on the feel and the smell of the vegetables as you cut them. Concentrate on the smell of the food as you cook it and the sounds of the sauce bubbling in the pot. Concentrating on what you are doing leaves less space in your brain to feel pain or other symptoms.


b. Focus on what you will do after doing whatever it is that you will find painful or uncomfortable. For example if climbing the stairs is painful focus on what you will do when you get to the top not how you are feeling as you are going up the stairs.


c. Play games in your head. For example think of a person’s name for every letter of the alphabet. If you get stuck on one letter go on to the next one. You can do this with anything, for example places, animals, cars. Remember the words to your favourite song or all the characters in your favourite TV programme.


Just by focussing on something else you can take your mind off your discomfort. When you go to the cinema, are gardening, reading, etc. you often forget the pain and other symptoms. Here you are actually using a method of distraction. It is good to be aware of this, because then you can use it actively when needed.




Visualisation is like a guided daydream, where you transport yourself to another time and place. You can achieve deep relaxation by imagining yourself in a peaceful and tranquil environment. With practice visualisation will help you to relax and will help you manage your pain. For an example go to:


For information on medication to control pain please see the page “Page relief”

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