Chronic pain can seem to paint a dark cloud over everything. You might struggle to work, sleep , and do things you’ve always enjoyed, which might naturally make you more upset, angry, or depressed. Living with chronic pain is hard . It can also get lonely—especially if you feel like you’re constantly missing out on fun times with family and friends, and are unable to figure out pain management.
Your frustrated feelings are absolutely valid, and you’re not alone. It’s estimated that 50 million Americans live with chronic pain, according to the Centers for Disease Control and Prevention (CDC) . The best way to deal with chronic pain is to build a comprehensive pain management plan that addresses your pain from all angles.
What does a pain management plan look like? What strategies can help? Keep reading to learn more about treating pain holistically, and how Parsley Health's root-cause resolution approach to medicine can help.
Chronic pain is defined as pain that lasts 3 to 6 months, or longer. For some people, chronic pain can last years . Persistent pain can stem from sports injuries, car accidents, infections, and surgery. It’s also caused by hundreds of chronic conditions, including:
Diabetes: Nerve damage that results from high levels of glucose (sugar) in the blood, causing pain (or numbness) in the hands, legs, and feet.
Fibromyalgia: A disorder that causes pain all over the body in the bones, ligaments, nerves, muscles, and tendons. According to the Mayo Clinic , “Researchers believe that fibromyalgia amplifies painful sensations by affecting the way your brain and spinal cord process painful and non-painful signals.”
Osteoarthritis: A chronic joint condition that breaks down cartilage—protective tissue around your bones—causing pain and stiffness.
Rheumatoid arthritis: An autoimmune disease where the body attacks its own cells and causes pain in the joints.
Multiple sclerosis: A disease of the brain and spinal cord that can cause pain in different ways in different people, such as headaches, back pain, throbbing spasms, and burning, aching pain in the arms, legs, and feet.
“Pain is multifactorial,” says Christopher Coller , DO, a family medicine physician at Parsley Health . This is why, at its core, a holistic pain plan addresses the individual factors that cause and exacerbate someone’s long-term pain.
For example, Dr. Coller once worked with someone who got arthritis seemingly out of the blue. As Dr. Coller delved into their history, he learned that the patient had also recently developed diverticulitis , a condition where small, bulging pouches form in the lining of the digestive tract and become infected. They had been treated with heavy antibiotics and couldn’t eat much of anything for several weeks. The patient developed arthritis just a few months later.
Knowing the connection between the gut and systemic inflammation, Dr. Coller looked for nutritional deficiencies and abnormalities in the microbiome that may have triggered arthritis. He also worked with the patient to reduce pain without prednisone, which can have many unwanted long-term side effects.
The foundation of a pain management plan is a comprehensive evaluation. Dr. Coller notes that when people join Parsley Health , they have an hour-long visit with their medical provider to discuss their history and hone in on what’s going on. During that appointment, providers start putting the pieces together to identify potential solutions for each person’s chronic pain and form a plan for pain management. Ultimately, this means finally being listened to and given tangible reasons to hope, he says.
So, what tools and techniques might you find in a comprehensive pain plan? While each plan is highly individual, it might include these pain-reducing and wellbeing-boosting elements.
For many people with chronic pain, diet adjustments can bring some relief. For example, Dr. Coller notes, people with severe arthritis may benefit from cutting out dairy and gluten . In general, avoiding pro-inflammatory foods , such as alcohol, added sugar, saturated fats, and processed meats may reduce pain.
To know if your dietary changes are making a difference, keep a pain diary. In it, you might keep track of:
Importantly, make sure you’re still consuming the nutrients you need. For example, according to the Arthritis Foundation , to get your daily dose of calcium, you might try kale, chickpeas, collard greens, almonds, and soy milk. Parsley’s health coaches work with members one on one to make sure they’re meeting their nutritional needs.
“The way I think about it is that meditation means a million things to everybody,” says Dr. Coller. Ultimately, he views meditation as an “intentional time of taking care of yourself and tuning out the stress of life.”
Taking a breather from stress and doing what relaxes you is critical. As the American Psychological Association notes, chronic stress affects all the systems in our body. For example, when stress strikes, our muscles tense up in response. When that stress stays, our muscles don’t relax, triggering other reactions in the body–including tension headaches and migraines.
When Dr. Coller works with members, he tries to find a specific activity that resonates with them, encouraging them to make it a priority. These soothing activities run the gamut—from watching the pond down the street to listening to a guided meditation to concentrated praying to a good sing in the shower, he says.
If you’re not sure what activity to try, Dr. Coller recommends deep breathing. In this 2017 review , researchers found an association between paced, slow breathing and pain reduction. The power of breathing practices may stem from stimulating our parasympathetic nervous system. This “rest and digest” part of our nervous system also redirects us from the sympathetic nervous system’s stress response (our fight-or-flight mode).
Experiment with different breathing techniques to see which works for you. To start, simply inhale for three counts, and exhale for three counts. Or focus your attention on your breathing, without trying to change it.
Naltrexone has been around for decades—originally approved by the Food and Drug Administration in 1984 to treat alcohol and opioid addictions. Today, doctors are using an ultra-low dose (between 0.1-4.5 mg) to help patients reduce chronic pain.
Low-dose naltrexone may fulfill the “4 Ls”: low risk, low side effect profile, low dose, and low cost . Experts aren’t exactly sure how it works (like many medications), but here’s a working theory: Low-dose naltrexone may reduce inflammation caused by overactive glial cells in the central nervous system.
When our bodies are attacked by foreign invaders—like an infection—microglia, a type of glial cell, springs into action by releasing inflammatory substances called cytokines to destroy them. The problem? When microglia are functioning normally, they stop firing after stamping out the foreign invader. However, with repeated infection and other injuries, microglia don’t rest, and the brain remains in a constant inflammatory state.
Plus, low-dose naltrexone may boost the production of endorphins, stress- and pain-relieving chemicals in our bodies. Reviews published in 2020 inThe Journal of the American Dental Association andCurrent Pain and Headache Reports found that low-dose naltrexone reduced pain intensity in different chronic pain conditions, including fibromyalgia, inflammatory bowel conditions, and multiple sclerosis.
Yoga can help with chronic pain in multiple ways: In addition to reducing pain intensity and stress, yoga can increase strength, flexibility, and mobility. Yoga also can boost your mood, energy, and overall wellbeing.
For example, according to a 2020 review , 20 studies showed that yoga improved back pain and reduced depression and anxiety . In this 2018 meta-analysis of 1557 people with knee osteoarthritis and rheumatoid arthritis (RA), yoga helped to reduce knee arthritic symptoms and boost overall wellbeing.
Even more so, this 2019 randomized controlled trial found that after 8 weeks of yoga, participants with RA had a significant reduction in depression symptoms and various RA inflammatory markers.
Acupuncture is commonly used to treat pain. In acupuncture, the practitioner inserts super-thin needles into your skin at different points throughout your body. A 2017 meta-analysis published in the Journal of Pain concluded that acupuncture is effective for headache, musculoskeletal, and osteoarthritis pain—and those effects persist over time. And if you’re hesitant to try acupuncture, an acupressure mat might be a good alternative for inducing relaxation and reducing pain.
Pharmaceutical-grade supplements , also called nutraceuticals, may be a good substitute for over-the-counter or prescription pain relievers to reduce joint or nerve pain. Nutraceuticals are sourced from food and provide health benefits. They include dietary and herbal supplements.
If you’re regularly turning to ibuprofen to ease your pain, says Dr. Coller, you might try an anti-inflammatory herb instead. Dr. Coller points out that ibuprofen “is really hard on the stomach and has been implicated in a lot of GI problems, like acid reflux.”
Quercetin is a plant pigment that belongs to a group called flavonoids, which are antioxidants. A small study found that women with rheumatoid arthritis who took 500 mg a day of quercetin experienced less stiffness and pain in the morning and less pain after activity.
Curcumin, found in turmeric, has anti-inflammatory effects. According to this 2017 review , curcumin may help to reduce arthritis pain. Similarly, this smaller, more recent study found an improvement in pain severity in knee osteoarthritis.
Overall, this 2020 review and meta-analysis published in Scientific Reports found that some nutraceuticals improved pain intensity and physical function in people with knee or hip osteoarthritis.
In general, think of supplements as medication: Proceed with caution and work with a healthcare professional trained in supplements, like those at Parsley Health, to find the best and safest supplement for you.
While pain is complex and every person’s needs around chronic pain is individual, the takeaway is that you have a range of evidence-based treatments and techniques to choose from (well beyond what we’ve covered here!) for pain management.
Margarita Tartakovsky is a Florida-based writer with 10+ years of experience in mental health and wellness. She’s written for websites such as Psych Central, Healthline, and Spirituality and Health. She’s passionate about helping readers feel less alone and overwhelmed and more empowered and hopeful.