Addressing Chronic Pain: A Holistic Approach
by Dr. Kathryn Bacigalupo, PT, DPT, GTS
If you experience pain on a regular basis, a recent study suggests you are not alone. An article published in April 2021 seeked to better understand the prevalence of chronic pain in America. In this study, more than 20% of adults in America reported they experience pain every day or most days
- A few other studies have revealed some other disconcerting statistics about chronic pain in America
- The annual cost of chronic pain in America is 635 million
- At least 10% of the world’s population is impacted by chronic pain
- 85% of adults with chronic pain have experienced depression
- 20% of chronic pain patients who visit a physician receive an opioid prescription, despite research showing it doesn’t improve quality of life
While these statistics definitely prove that more needs to be done on a national and global level to improve the ways that we address chronic pain, that is not what this article is about. This article is about you. This is about your pain, how you can better manage it on your own, and what options you have if seeking professional help. In order to better address your chronic pain, you need to better understand what pain is, and when it becomes dysfunctional.

Why do we experience pain?
Let’s start off by establishing pain is a normal, and necessary, part of life. Here’s an example: if you accidentally brush your hand on a hot stove, the automatic reflex is to immediately pull away. The heat from the stove sends pain signals from your hand to your brain, allowing the brain to communicate back with your hand to pull it away before damage is done. This is the purpose of pain. It is nothing more than a signal to communicate with the brain of potential dangers or threats to the body. But when does it become dysfunctional?
While pain is normal and necessary, there are instances when the pain you are experiencing is not actually the result of a direct cause, but more so due to some level of imbalance and dysfunction within the body. This is often the case with chronic pain.
What is chronic pain?
Chronic pain is typically defined as any pain that persists for greater than 3-6 months. While both acute and chronic pain may initiate in response to an injury, or tissue damage, acute pain will go away when there is no longer an underlying cause for pain. This is not always the case with chronic pain. But why? To put it simply, chronic pain is complex.
Why is chronic pain so complex?
Sometimes chronic pain has an obvious cause. You may have a long-lasting condition such as arthritis that can cause ongoing pain. In other cases, chronic pain can be more mysterious with a less direct cause. And in many cases, prolonged exposure to pain may cause your nervous system to be in a persistent state of high reactivity.
Because of the complexity of chronic pain, your overall wellbeing will have a profound impact on the likelihood of developing chronic pain. Mental and emotional health are closely tied in as well,
with lifestyle habits arguably having the highest impact overall. The presence of chronic pain can be impacted by things like:
- High stress levels
- Poor sleep habits
- Dehydration
- Undiagnosed food sensitivities
- Poor work/home life balance
- Alcohol consumption
- Lack of routine
- Lack of physical activity
How can I manage my chronic pain?
Typically, when we experience pain, we want a quick solution. We want a simple answer as to what is causing it, and how to fix it. We often seek guidance from professionals, expecting a quick fix. Unfortunately, with chronic pain, that quick fix usually does not typically exist due to the complexity of the pain.
Especially now, during the COVID-19 pandemic, it is no wonder many may be experiencing some level of pain at this time. The pandemic has led to complete disruption of routine for many, leading to poor work/life balance, changes in activity level, and higher levels of stress and anxiety.
There are simple ways to start to have an impact on your pain, and it starts with prioritizing yourself, and your self care. Self care is more than simply pampering yourself. It is more than a spa day or shopping spree. Self care is the act of allowing yourself to put in the work to better yourself physically, mentally, and emotionally, and comes from a place of love. Self care is self love, and it is not selfish. It is necessary in order to fully participate in life, be present for others, and especially important when looking to manage chronic pain. Simple acts of self care can be all it takes to get moving again.
Here are 5 simple steps to start managing your chronic pain now:
- Stay hydrated.
How? Motivate yourself. It is recommended to drink at least eight 8-ounce glasses, which equals about 2 liters, or half a gallon a day. Hydration seems like a no brainer, but unfortunately for many people, it is not prioritized, and often forgotten. Finding ways to stay motivated to stay hydrated can help. A motivation water bottle with time markers can be a great way to remind you to hydrate and stay motivated.

- Improve your sleep habits.
How? Be consistent. While it is ideal for adults to have 7+ hours of sleep per night, for most adults this is unfortunately not always possible. Perhaps instead, you can start out by striving for consistency. Trying to go to sleep at the same time every night and waking up at the same every morning could have a profound effect on your sleep, and how it impacts your wellbeing.
- Remember to breathe.
How? Take 5 minutes each day each day to just breathe. Practicing a few minutes of deep breathing daily can help reduce stress levels, and allow you to be more present and grounded. Not to mention, those with chronic pain typically hold a lot of tension around the chest and ribcage, leading to more shallow breathing, and in some cases, more pain. Simply working on breathing into the rib cage can be enough to start reducing tension in the mind and body. You can start with working to breathe more from the diaphragm and less from the upper chest. Then start to work on breathing into the sides and back of your ribcage, know as 360 breathing.

- Connect with your body.
How? Be more present. Finding ways to be more present and listening to your body can be a great way to start. Oftentimes with chronic pain, there is an initial cause, and then the pain continues long after. Prolonged pain can lead to increased tension throughout the body, which in turn can lead to more pain. A simple body scan can help to become more mindful of where you are holding tension, which brings you one step closer to being in less pain.
Follow the QR code below to a recent instagram post to learn more about the importance of connecting with your body.

- Find pain free movement.
How? Move more mindfully. This is perhaps the most important, but in some cases the hardest to get started. When living with chronic pain, the thought of exercise can be daunting. The human body is built to move. When we are in pain, we tend to move less, which can in turn increase pain and tension in the body. It is important to learn to listen to your body, while learning to move more mindfully. What this means is you find movements that reduce your pain, or at least don’t increase it, and start to be more present as you move. Practicing forms of exercise that encourage mindful movement, such as Pilates, could be a great way to get your body moving again. Follow the QR code below for an instagram video that is an example of mindful movement.

Follow the QR code below for the full video to learn more about: DIAPHRAGMATIC BREATHING, 360 BREATHING, BODY SCANNING, and MINDFUL MOVEMENT

When should I seek help from a professional?
When managing chronic pain, lifestyle management is not always enough, and professional guidance may be needed. If you are experiencing chronic pain, it may be good to check in with your doctor first to rule out any direct causes that may need to be addressed. In many cases, the combination of professional guidance along with lifestyle changes may be what is needed to better manage pain. The collaboration of multiple specialties, including pain management and physical therapy is a great place to start when looking for guidance.
References:
- Yong, R. Jasona,*; Mullins, Peter M.b; Bhattacharyya, Neilc Prevalence of chronic pain among adults in the United States, PAIN: April 02, 2021 – Volume – Issue – doi: 10.1097/j.pain.0000000000002291
- https://www.thegoodbody.com/chronic-pain-statistics/