According to the Institute of Medicine, a whopping 100 million Americans—that’s one in three—suffer from some sort of chronic pain. And if you’re one of them, chances are at least one doctor has told you, “It’s all in your head.”

The trick is that chronic pain wears many disguises. Sometimes chronic pain is psychosomatic, which does not mean it’s all in your head or that you’re faking (that’s another term: malingering), but does mean that your very real pain is caused by psychological factors, like stress or depression.

Other times, to everyone’s befuddlement, pain is caused by a mysterious injury that may or may not be visible on x-rays or MRIs. In other cases, there’s an underlying condition, like arthritis, fibromyalgia, or neuropathy. And if those weren’t enough options, sometimes chronic pain stems from damage to the the nerves and spinal cord—the pain system itself.

In the comprehensive book that inspired some of these tips, Managing Pain Before It Manages You, Dr. Margaret A. Caudill likens chronic pain to a fire alarm that keeps clanging long after the fire is out.  

But whether your chronic pain stems from any of these four sources, it’s still, well, a pain. For those with migraines, back pain, joint pain, or anyone else who knows tension headaches are for amateurs, here are five tips to manage your chronic pain.

Tip #1: This pain is not your fault, but you are responsible for taking care of it.  In other words, own your pain. Hear me out on this one. Too often, we get caught up in existential rumination like why we have this pain or what we did to deserve this. Most often, we expect the health care system to rescue us and, when its fails, we get caught up in blame and anger. The result: tension builds, which leads to—you guessed it—more pain.  To stop the cycle, decide that you will be the driver of your pain. Doctors and therapists will be there to help, but you are in charge of your pain.

Tip #2: Be active. Hear me out on this one, too. It’s counterintuitive. You may think you should rest and protect the painful part of your body. You may be scared to move, for fear of more pain.

While rest is essential for acute pain, like a sprained ankle or a pulled muscle, rest reinforces chronic pain. As your muscles get weak and stiff from inactivity, the pain may actually intensify.

So do what activity you can—slowly ride a bike, walk, swim, do chair exercises. Find a gentle yoga class. Lift light weights. And don’t skip physical therapy.

An important trick is to break up exercise into shorter chunks—try for three 10-minute walks rather than one long walk. Also, try not to leave activity until late in the day—you’ll likely be too tired or simply unmotivated. 

Being active has one last benefit: it makes you feel less like a prisoner of your pain. You can set goals, get outside, or team up with friends, all of which stave off depression and hopelessness in addition to reducing your pain.


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