Aching, throbbing, excruciating and relentless—chronic pain can be all of those and still difficult to describe for people experiencing it.
“I compare chronic pain to a snowball that grows bigger as it rolls downhill,” said Cheryl Van Demark, PT, C-IAYT, Physical Rehabilitation Services, Yavapai Regional Medical Center (YRMC). “The good news is that snowballs can be melted.”
Guiding people as they learn how to melt that metaphorical snowball is something Van Demark does very well as the facilitator of YRMC’s Chronic Pain Self-Care Program. An important part of her role is helping program participants understand how the nervous system adapts to chronic pain.
“Our protective reaction to pain is imbedded in our nervous system,” explained Van Demark, a YRMC Physical Therapist and Yoga Therapist. “How we respond versus how we react comes from how we have learned to approach adversity throughout a lifetime.”
And it gets more complicated with chronic pain, which is defined as pain that lasts three to six months or longer and is present at least 50% of our days. Chronic pain can be the result of an injury, illness, surgery or nerve damage. However, it does not always involve tissue damage, as in the case of a phantom limb pain, for example.
The Snowball Effect
To understand the scope of chronic pain, let’s return to Van Demark’s snowball analogy. As the snowball rolls downhill, making rotation after rotation, other factors come into play: stress, exhaustion, lack of physical activity, rising blood pressure, weight gain (or loss), anger and fear, to name a few.
“Now it’s no longer just the initial event that led to the chronic pain. All of these other factors are involved,” Van Demark said.
YRMC’s Chronic Pain Self-Care Program focuses on treating the factors in the chronic pain cascade. In fact, Van Demark uses the words “pain treatment” or “pain care” as opposed to “pain management.”
“Pain is not just something you learn to live with,” she said. “People absolutely have the capacity to change their experience.”
A Pain Program Participant’s Story
In recent years, the complicated nature of chronic pain has gained national attention. A staggering 20% of the general population and two-thirds of older adults live with chronic pain every day.
Prescott resident Cassandra Culver is among that 20%. An injury she sustained in 2013 triggered a spiral of autoimmune diseases and persistent pain. By 2017, Culver needed a walker to get around. That’s when she began physical therapy through YRMC’s Physical Rehabilitation Services and soon after joined the Chronic Pain Self-Care Program. Today, Culver walks without an assistive device the majority of the time.
YRMC’s Chronic Pain Self-Care Program – developed by members of the Physical Rehabilitation Services team and other YRMC healthcare professionals – features:
- Ten hours of instruction, delivered during two-hour sessions over five weeks.
- Knowledgeable speakers from YRMC’s Nutrition Counselingand Pharmacy as well as an interventional pain management expert.
- Support materials with specific self-care practices to pursue each week.
- Ongoing contact (every six weeks) with program participants to share tangible information and keep them connected to their self-care practice.
How do YRMC’s Chronic Pain Self-Care participants benefit from the program? Most participants say they have less perceived stress, reduced fear of movement and a greater understanding of their pain.
“The program helped me believe that I can have quality of life,” Culver said.
Pain Program Empowers
After their five weeks of learning, program participants meet every six weeks as part of the “Empowerment Group.” Its goal is to support people as they apply what they learned during the instructional sessions. During COVID-19, the Empowerment Group has continued via thought-provoking email messages and links to helpful video resources that Van Demark shares.
“Through the program, participants learn to reframe their pain stories and embrace the story not yet written,” she said. “It’s about living life on their terms.”
That’s exactly what Culver continues to do. She recently took up sewing, something she would have shied away from previously for fear it could increase her pain.
“Part of what Cheryl brought to light with the Chronic Pain Self-Care Program is empowerment and enrichment,” Culver said. “You can find ways to bring activities back into your life that you enjoy and to learn new things.”
The Chronic Pain Self-Care Program approach is considered a best practice in pain care. It also supports YRMC’s mission and vision for a Total Healing Environment.
Submitted by Yavapai Regional Medical Center