Lesson Three: smart ways to manage pain 

Learning Intention: students will understand different strategies for managing pain

Learning Outcomes

1. Understand different physical, psychological and social strategies to manage pain
2. Understand how to find support, including finding reliable information about pain

Managing Pain

Not all pain is the same. That is why it is important to learn about the different types of pain: so you know what to do when you feel pain.

Most of the time, pain will only temporarily affect a person’s life and will go away without much treatment, if any. For example, think of a stubbed toe, a graze on the knee or a headache. Even injuries that can be intensely painful at first such as a sprained ankle or a sore back usually won’t require much treatment. Simple strategies are best in these cases, things like:

1. Taking a break
2. Using first aid (e.g. RICE)
3. Distracting yourself
4. Gradually getting back to usual activities

In other cases, pain can last longer than expected or come back several times and have a much greater impact on a person’s life. It is important to remember that we can have pain even when an injury has healed. When this is the case it’s unlikely there is going to be one thing that ‘cures’ or stops the pain. Instead, they will most likely have to use a combination of strategies. The biopsychosocial model can help understand what is happening and what we can do to make things better.

Biopsychosocial Management

As we discussed last lesson, pain influences and is influenced by physical (biological), psychological and social factors. Just as we can understand pain through the biopsychosocial model, we can manage pain using the biopsychosocial model. Since pain can be influenced by physical, mental, and social factors, it can be managed using a combination of strategies that target the body, mind and social connections.

This diagram (below) shows how the biopsychosocial framework can be applied to pain management. Strategies may target the body, mind and/or social connections. Strategies can be specific (such as first aid), or general (such as staying involved in sports). As you can see, YOU are at the centre of pain management. Pain affects everybody differently, so pain management strategies are going to be different for everyone too. It’s more about the individual than the injury.

For example, Malik and Sophia had the same injury, but it affected the two of them differently, so the strategies to manage their pain will be different too.

The strategies you choose may depend on:

1. The reason for pain
   1. Injury?
   1. Condition/ illness/ disease?
   1. Other health challenges you may have?
   1. Related to life events?
2. The impact the pain is having on you
3. How long you’ve had the pain for
4. How severe the pain is
5. Advice from health professionals
6. You and your parents’ preferences
7. Access to services and supports (e.g. location, money, age)

Finding support for pain

There are various people who can provide support to manage pain if you need it, most important is that you find someone you trust. People who could help include:

• Health professionals: doctors, nurses, physiotherapists, exercise physiologists, dietitians, pharmacists, psychologists, counsellors, social workers
• Parents, family and friends
• Teachers and/or school counsellors
• Employers
• People in the community: coaches, group leaders, people trained in first aid, Elders

Think about Malik and Jasmine from last lesson. Using the biopsychosocial framework, what strategies could they use to manage their pain and who could support them?

Malik

• Biological: first aid, exercises, walking, gradually returning to sport, good sleep habits
• Psychological: stress management techniques, relaxation strategies
• Social: continue going to rugby training and games, speak to family and friends, speak with coach and teammates for support

Jasmine

• Biological: eating well, medication, staying active, good sleep habits
• Psychological: stress management techniques, relaxation strategies, helpful thoughts
• Social: support group, going to watch her friends play sport, spending time with her mum or dad, speak with family and friends, speaking to a school counsellor

Who could support Malik and Jasmine?

• Malik: coach, physiotherapist, exercise physiologist, doctor, counsellor, family and friends, teammates, apps such as Smiling Mind
• Jasmine: dietitian, doctor, nurse, exercise physiologist, school counsellor, social worker, community workers, family and friends, teacher

Talking about pain

As we discussed last lesson, people who experience persistent pain often suffer stigma. Their experience may be dismissed by people around them, including health professionals, as ‘over-dramatic’, ‘over- reacting’ or ‘faking it’.

Finding people who understand and listen to you is very important. When speaking to health professionals about pain you should:

• Feel they understand you and your situation
• Feel comfortable sharing your thoughts and feelings (not just what your pain is like)
• Be involved in making decisions about your health
• Understand what is being said about your health, and feel comfortable asking questions if you don’t understand what is being said
• Feel your pain/health is being taken seriously
• Feel the treatment and advice is specific to you and your situation

If someone you know is experiencing pain, you can support them by starting a conversation (R U OK?)

1. Ask
2. Listen
3. Encourage action
4. Check-in

When talking to someone about pain, remember that people can experience pain that is not directly following an injury or for which they don’t know the cause. This pain is just as real as any other. Remember also that pain always has sensory (how intense it is) and an emotional (how it makes you feel) parts.

Activity: imagine you are friends with Malik or Jasmine, how might talk to them about their pain?

Finding information about pain

Sometimes if pain is taking longer than expected to go away or having a significant impact on your life, you may start looking for information about pain online. While there is useful information online, there can be a lot of misinformation.

These are some key things to look out for:

• Does it try to sell you something?
• Does it create a sense of fear or panic?
• Does it only give you one choice or option?
• Does it rely only on one (or a few) cases or experience?
• Does it claim to fix or cure?
• Does it seem too simple?

If the answer is yes to any of these questions, the information may be unreliable. If you’re unsure, you can always check with someone you trust, such as a parent or health professional.

It’s also important to be cautious about information you may read about or hear on social media. Remember that people giving personal testimonials are often paid to do so, and therefore may be giving biased information.

Some examples of good quality information about pain are:

PainBytes | Pain Management Network (nsw.gov.au)

The mysterious science of pain – Joshua W. Pate – YouTube

Pain Australia – https://www.painaustralia.org.au/about-pain