Tips For Improving Life With Neuropathic Pain
By Deborah Barrett, PhD, MSW, LCSW

Stan’s type II diabetes diagnosis at age 45 was a wake-up call. He re-examined his diet and vowed to exercise and limit the hours he spent at work. As his lifestyle improved, Stan came to see his diabetes as a minor nuisance. He took pride in his increased fitness and engagement with his children, which included coaching Little League and soccer games.

Three years later, Stan developed pain in his feet and legs. His doctor confirmed he had peripheral neuropathy and reiterated the importance of managing his diabetes to prevent worsening of the neuropathy symptoms. However, Stan was frustrated with the unrelenting pain and feared nothing would help. He worried about having to work fewer hours, which he could not afford. Moreover, his family began noticing that he was often in a foul mood and he was less engaged in activities. His doctor suggested he consider antidepressant medication and counseling, but Stan was skeptical about their relevance to his situation.

Stan’s story is not uncommon. Treatment for neuropathic pain tends to focus on identifying and treating its underlying cause. While vital, this approach may not address some of the problems that can arise from chronic pain. Management of neuropathic pain often requires an interdisciplinary approach, centered on pharmacological treatment to control pain as well as strategies to minimize and/or prevent the vicious cycle of co-morbid problems, such as sleep disturbances, physical inactivity, depression, anxiety, and social isolation.

Living well with peripheral neuropathy and neuropathic pain often requires active engagement in your own medical care along with the aid of a wide array of resources. Here are some tips to consider:

1. Approach pain as a problem in itself–Medication, hot/cold compresses, breathing exercises, pacing oneself, biofeedback, and assistive devices can help ease pain and improve function. Unfortunately, what works for one patient does not always work for another. So, people with chronic pain benefit most from learning about and incorporating strategies that offer pain relief, while evaluating the effectiveness of these strategies.

2. See each day as an experiment–Don the hat of scientist and collect data to determine what helps (and what hurts). The more you understand the triggers for your symptoms’ ups and downs, the better control you will have over your pain.

3. Be open to adaptation–Accepting help, using assistive gadgets, and rethinking your work status and roles in various relationships can enhance your quality of life. Be wary of rigid ideas you may have about how things “should” be done, particularly when they no longer work for you. The more mentally flexible you are, the greater your ability to adapt.

4. Allow yourself to grieve–Chronic illness involves making unexpected sacrifices and accepting losses. It is difficult to move into a “problem-solving” mentality if you do not feel ready to accept your current reality or if you are stuck wishing things were different. Allow yourself to express painful emotions you experience. Through grief comes acceptance. You don’t have to like the situation, but acknowledging “what is” will enable you to contemplate “what can be.”

5. Explore supportive resources–There’s no need to go it alone:

- Seek out family members and friends who can help you with various tasks; 

- Partner with an interdisciplinary team of health care professionals who work together to help you with the difficulties of chronic pain; and

 - Reach out to one of the 150 Neuropathy Association-coordinated support groups to connect with people who share your diagnosis. Support groups enable sharing of information and giving and receiving support with people who understand.

Stan had felt stuck in fear and hopelessness about his pain, despite his “doing everything right” with his diabetes. With the support of his therapist, he grieved the difficult changes while adopting techniques that seemed to help most. He was also able to work with his doctor to find medications for pain relief. As he became more confident about his ability to influence how he felt, Stan’s mood improved, as did his relationships.

Deborah Barrett

Deborah Barrett, PhD, MSW, LCSW is a clinical associate professor of social work at the University of North Carolina at Chapel Hill and a psychotherapist in private practice. She is also author of “Paintracking: Your Personal Guide to Living Well With Chronic Pain,” in which she shares her approach to managing her own chronic pain in the hope of empowering people living with chronic pain to take back their lives.



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