How I use a multifaceted approach to chronic pain management

Pain affects people differently, and strategies should be individually tailored

Jen Cueva avatar

by Jen Cueva |

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When the late afternoon rolls around and I’m ready to wind down, my body often has other plans. These moments seem to bring out the worst of my pain, and I find myself curled up in a fetal position on the couch. Yet, I’m hesitant to take pain medication because I still want to do so much for myself and my family before the day ends.

In my nursing career, before my pulmonary hypertension (PH) diagnosis, my passion was to help others relieve their pain and stay comfortable. So why can’t I do the same for myself?

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The consequences

Living with chronic pain is a complex battle, and finding effective pain relief is a journey. I experience frequent muscle pain, a side effect of my PH treatment, as well as leg heaviness and spasms. My osteoarthritis causes back throbbing and stiffness, which lead to neck pain and headaches. Chest pain, a symptom of my PH and congestive heart failure, feels like an elephant sitting on my rib cage. For over a decade, pain has been a constant struggle in my life, although I initially ignored it.

As one narrative review in The Clinical Journal of Pain notes, pain is subjective, meaning that others cannot directly observe it. This makes it challenging to treat, as only the patient knows its intensity, and everyone copes with it differently.

Pain affects every aspect of life, from work and social interactions to sleep and mental health. Managing pain alongside PH and other conditions is an ongoing challenge. Balancing medications and other treatments is exhausting.

I often feel overwhelmed, frustrated, and defeated by chronic pain. Though I’ve had mild success, overall, the efforts to ease my symptoms have been inconsistent. Pain has forced me to cut back on activities that used to bring me joy.

Despite these hurdles, I maintain an optimistic outlook and unwavering determination to manage my chronic pain. I’ve come to accept that there will be good and bad days, and I strive to focus on the positives, no matter how small they might seem.

How I respond

Often, trial and error is necessary to determine the best treatment plan. There are various options, from hot and cold therapy to light exercise, prescription medications, and holistic treatments.

My first pain management doctor was caring and compassionate and expressed concern about my ability to find comprehensive relief due to delayed intervention.

Today, I work with a new pain management team after moving across the country a few years ago. Our approach combines medication, physical therapy, exercise, cognitive behavioral therapy, and lifestyle changes. I’ve started weekly physical therapy, and I exercise at home. The goal is to stretch my muscles and preserve my strength while avoiding weakening further.

I also use heated pads and a heated vest and soak in warm Epsom salt baths with relaxing essential oils. I’ll hopefully soon add massage therapy, because my back and neck always feel so tense. Of course, I have prescription pain medication to take routinely as needed.

None of these strategies entirely eliminate my pain, but they can take the edge off a little bit.

Last week, I mustered the courage to go for injections to ease my back pain. I was a bit of a scaredy cat, but to my surprise, the procedure was quick and painless. Doctors administered six injections in various areas along my back. Although it won’t magically solve everything, I’m hopeful it will significantly reduce the need for oral pain medications. Here’s to hoping for some relief!

Do you or your loved one struggle with chronic pain? Which multifaceted approaches do you find work best for you? Please share in the comments below. 

Note: Pulmonary Hypertension News is strictly a news and information website about the disease. It does not provide medical advice, diagnosis, or treatment. This content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read on this website. The opinions expressed in this column are not those of Pulmonary Hypertension News or its parent company, BioNews, and are intended to spark discussion about issues pertaining to pulmonary hypertension.


Ruby Midkiff avatar

Ruby Midkiff

I had all of my pain managed. My wonderful dr retired and my new doc won’t refill what I need for horrible headaches. I do find coloring is good for pain management.

Jen Cueva avatar

Jen Cueva

Oh no, I hate to hear that your new doctor is not taking your pain management concerns serious. It's frustrating and unfortunate that many of us go without adequate pain management because of the stigmas. I hope and pray that you will find a new doctor who validates and helps offer relief or your current one will have a change of heart.

I know many of the simple things we can do to try and offer pain relief is crucial.Heat is often my best friend. Have you tried an ice pack to your head? Or, maybe alternating heat and cold? My hubby, Manny suffers with migraines and we try those remedies to help with his.

Hugs to you and prayers that you'll get some relief from these headaches soon, my dear PHriend.

Thanks for taking the time to read my column and offer your thoughts, Ruby Nan. It means more than you realize. Take care.


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