Pain is a protector. It shouts when tissue is harmed. Chronic pain is different: the signal continues after the original injury has calmed, or it grows louder than the tissue damage explains. The nervous system has become more sensitive. That does not make the pain imaginary. It changes which treatments help.
People living with long pain often carry a second burden of doubt, from others and from themselves. Woody Folsom rehabilitation and primary teams start by believing the report. Then we map where it lives, what flares it, what eases it, and what the pain has taken from the week.
A plan with more than one door
Helpful care usually combines several modest tools. Guided movement keeps joints and muscles from tightening around the pain. Sleep treatment lowers the volume of the nervous system. Psychological skills, including approaches that change the relationship to pain rather than pretending it is gone, reduce fear of movement. Medicines have a role for some people and a poor fit for others. Opioid medicines, when they are considered at all, need a narrow purpose, a time limit, and a clinician who watches function, not just a number on a scale.
Progress is often a return of activity: a walk to the corner, a night with fewer awakenings, a morning that starts without dread.
What to bring to the visit
A two-week note of flares, sleep, and medicines is more useful than a perfect memory. Mention mood. Pain and depression amplify each other, and treating only one can stall both. Mention work and caregiving, because a plan that ignores the day you actually live will not be followed.
Sudden weakness, loss of bladder or bowel control, fever with spine pain, or pain after a major injury needs urgent assessment. For lasting pain, ask for a team that measures function. This article cannot diagnose the cause of your pain.
Rehabilitation
Patient educationWoody Folsom
From readers
Nora V. — The section on sleep gave me a question I could actually ask.
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