By Dr. Stephen F. Grinstead, LMFT, ACRPS 

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Effective Chronic Pain Management is a Right and a Responsibility


People living with an ongoing chronic pain condition often give up trying to explain to their healthcare providers or even loved ones, what living with pain is like! They get tired and frustrated of being told it’s all in their head, that they’re malingering, drug seeking, or that they just need to learn to live with it.

Then there are some people who try to seek help, but sometimes in ways that are not in their best interest. Others are on a quest to find the magic solution: the right pill, procedure, healthcare provider or technique that will give them the relief they want, or some kind of plan that will just stop the pain. They get fixated on the traditional Bio-Medical Model and for many it is not very effective as it often fails to identify and/or treat the coexisting psychological and medication use problems often occurring with people suffering with chronic pain.

First of all, there is nothing wrong with wanting pain relief. However, it may be unrealistic for some people with certain pain conditions to ever be pain free. In this instance I ask my patients: even if you had a certain level of pain, would it be all right if you never had to suffer with it again? This is why I wrote the book Thank You Adversity For Yet Another Test.

In fact, I often have to apply the information I write about to myself.  Especially when I was recently experiencing acute pain flare ups that could keep me in bed, unable to work or participate in normal activities.  For many years I have been dealing with my own chronic pain condition, but it had several decades since I felt this kind of intense pain. It would have been easy to obsess about my pain and become depressed as a result.  

I almost slipped back into what I call the “chronic pain trance,” which is a state of mind that develops when someone has to live with pain on a daily basis over a long period of time. What is important to remember is that this state is an automatic and unconscious way of coping with chronic pain which can be self-defeating or sometimes even self-destructive. Fortunately, I did start to practice what I teach.

Developing A Positive Relationship With Your Pain Is Crucial

When working with patients, I ask them to examine their personal relationship with pain and how they currently manage it, as well as taking an honest look at their medication management plan.  The more proactive people are, the more they will improve their ability to manage their pain condition.  But no one has to take this journey alone.  I encourage my patients to share their journey with the people who care about them so they can understand more about what it takes to cope with a challenging pain condition.

People living with chronic pain that are ready to, can learn how to more effectively manage it, end their suffering, and improve their quality of life. But here is the challenge—effective pain management is not only a right, it is also a responsibility.  Patients must take responsibility for their health and healing.  In fact, they are the only ones that can.  The challenge is to help them decide if they are willing to do the work required for effective chronic pain management and to become free from suffering. 

One important suggestion for anyone living with chronic pain is to stop making pain the enemy.  This can be a challenge, but is nonetheless a crucial first step. When I talk to patients about living with chronic pain, I often hear statements such as “I have a bad knee” or “this stupid pain is killing me.”  These types of statements make clear to me that this person is still at war with their pain.  Unfortunately, this is an internal war — one that cannot be won through fighting it. 


People have to stop fighting their pain and make peace with it—pain is a part of who we are, so we are really just fighting with ourselves. When we make peace with our pain and learn how to manage it more effectively, we stop suffering. We become empowered to create a life worth living filled with meaning and satisfaction. However, in order to make peace with our pain, we need to move beyond the “quick fix.”

Effective Chronic Pain Management is NOT a Quick Fix

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Chronic Pain Management and the Impact on Family and Friends

 The Family Also Needs A Bio-Psycho-Social-Spiritual Approach To Heal

I’m writing this for people who are living with someone—or care for someone—who is suffering with a chronic pain condition and they are having a hard time coping because they’re not sure how to help. Unless someone’s been in your place they have no idea how challenging this can really be.  

I’ve seen many marriages and partnerships end due to one of the partners living with an undertreated or mistreated chronic pain condition. Sometimes family members and significant others develop their own healthcare problems while trying to help someone they love cope with chronic pain. Family and significant others often get burned out, or they become frustrated and resentful towards the person living with chronic pain. A spouse can become just as hopeless and helpless as their family member who is suffering with pain and may even develop a severe depression or sleep problem.

For those of you helping someone living with a chronic pain condition who don’t have a personal experience of living with chronic pain I want to ask you to follow the steps below to see if you can develop a better understanding of what it must be like to live with chronic pain. To get the most out of this following exercise please make sure to do it when you have the time and space where you won’t be interrupted. It’s also helpful if you journal your reactions to this as soon as you’ve completed the four steps below.

Step One:  Think back to a time when you hurt yourself or had a painful condition such as a surgery, toothache, broken bone, or headache etc. 

Step Two: Try to remember what that felt like and what you wanted to do to stop the pain.

Step Three: Now imagine that you have that level of pain right now and have had it for the past six months without any relief. Every day when you woke up it was there. Every night you wonder if you’ll be able to sleep because the pain is so disturbing.

Step Four: Now imagine trying to explain this to your family and friends or your healthcare provider. What would you say? What would you want from them? Please make sure write down your reactions to this brief exercise.

What kind of healthy support can friends and family provide if a loved one is undergoing chronic pain management, experiencing significant quality of life problems and a decreased level of functioning? The most important thing is to understand what it must be like; if you answered the four questions above and reflected on what you learned, you should have a much better idea.  

Here are six additional starting points.

1. Make sure that you are practicing good self-care; take time to relax, sleep, play, eat healthy, etc.

2. Develop compassion and even empathy for your significant other—but never sympathy as that can cause even more problems. Remember the old saying “Sympathy Kills” that is often heard at Al-Anon meetings.

3. Do NOT do things for your significant other that they can and should be doing for themselves.

4. Don’t keep secrets from your significant other. This is especially true concerning medication use or abuse issues.

5. Remember the three (3) Cs of Al-Anon: You didn’t CAUSE it, you can’t CONTROL it, and you can’t CURE it.

6. Seek out a professional with experience in chronic pain and any coexisting problems for you and your family.

However, these are just starting points. In order to help someone else, you first must make sure to take care of yourself. You also need to be aware of the two major traps—enabling and resentment. Enabling is when you find yourself doing something for your friend or loved one that they can and should be doing for themselves.

When supporting someone living with chronic pain for long periods of time many people are at risk of burnout. What started as loving care and support sometimes turns into a major chore and the helper becomes angry and resentful of the person living with chronic pain. Just like many people who are living with chronic pain become isolated and depressed; many helpers also fall into these problems. 

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Defining Effective Chronic Pain Management


Given the biopsychosocial nature of chronic pain conditions it is imperative to utilize a multidisciplinary treatment plan for effective pain management. Living with chronic pain is very difficult. If you also have a coexisting addiction or other psychological conditions, it becomes even more challenging. People with chronic pain and coexisting disorders can become severely depressed and feel hopeless. Their self-esteem is practically non-existent and many of them lose the support of their significant others. 

Healthcare providers often become confused and frustrated when their treatment interventions are ineffective. Also, people living with chronic pain must educate themselves and be proactive consumers regarding health practitioners who claim to do pain management. Be wary, if they offer only one type of modality for addressing your pain, such as medication management, or chiropractic adjustments or acupuncture.

True multidisciplinary pain management involves interventions such as physical therapy, massage, medication management, counseling or therapy, biofeedback, occupational therapy, exercise physiology, an anesthesiologist or pharmacologist, and a case manager all at one site, at a minimum. It may also involve some type of movement therapy such as Tai Chi, classes on spiritual wellness, yoga or meditation.

Success Requires A Team Approach

In my experience, a multidisciplinary team is crucial in order to address the specific biopsychosocial needs of people living with chronic pain. In addition, the physical, psychological, and social implications of chronic pain and any coexisting condition—including the impact on family systems—must also be adequately dealt with.

Using a multidisciplinary team is crucial when treating the synergistic problems people and their families’ face that have been severely impacted by chronic pain, especially when addiction and other psychological problems are present. When these conditions coexist it creates a major challenge that must be addressed through a collaborative treatment approach. The inclusion of addiction, mental health and medical is vital to this process. 

When these coexisting conditions occur, the family problems increase synergistically. Effective treatment can be challenging and confusing for counselors, therapists and other healthcare providers, but especially for patients and their families. I have found that the strategic three-part approach mentioned in last month’s article improves treatment outcomes and gives people living with chronic pain and their families new hope.

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