How to Relieve Chronic Pain: An 8 Step Guide to Finding Relief

A guide for managing chronic pain

By: Rachel Sabey, Chronic Pain Recovery Coach

So you’re in pain…I am not going to sugar coat it...pain sucks. And it is impermanent. This post aims to support you to settle your nervous system into safety, which in turn will decrease the intensity of your pain. Although following these steps will not necessarily resolve your pain today (but they might!!) the more competent you become at deescalating nervous system activation (which is showing up as pain), the more effective these tools will become. Additionally, over time, you will become more familiar with what is and is not helpful to you. In order to benefit from these exercises you do not have to complete every step. Take what is useful and leave what isn't.

This post is for pain that is physically and/or emotionally intense. If you are experiencing somewhat mild pain that doesn't trigger strong emotions, I would recommend you take a few deep breaths and then do somatic tracking (here is a link to a guided video). If, however, your current experience is distressing, continue reading and I will help you through this difficult moment.

*Although all pain starts in the brain, this post is targeted towards neuroplastic pain. Most chronic pain is neuroplastic, but it is always wise to see a doctor and rule out any serious conditions before committing to a brain based approach for chronic pain relief.

Step One: Self Compassion

Start by tuning into self compassion. Place a hand on your heart or give yourself a hug, and lovingly say: I am sorry you are in pain. This is a difficult moment. It will pass and you will be free from these sensations soon. I love you and want to help and care for you. Let’s figure out what we can do together.

*Adjust the language so it feels genuine to you. Speak to yourself like you would a friend or child.

Step Two: Somatic awareness and messages of safety

During this process, your pain may or may not vacillate. However, pain is rarely truly consistent, so it is very likely to shift at least slightly. Every 10 minutes or so, curiously check in with your pain levels, sensation(s) and location(s) to see if/how they have changed. When you check in with your body, send yourself messages of safety such as, “my brain is sending me these danger signals, but my body is totally healthy”, or “I am resilient and no matter what, I will get through this.”, or “I am healthy and I know that this pain is neuroplastic, I will not respond to it with fear”, or "the mere fact that my pain has shifted, is a sign that my brain is generating it and my body is healthy". Pick one of these or choose your own message of safety. Observe the baseline of your current pain experience so you can notice what shifts might occur as you check-in with it throughout this process.

Step Three: Broaden your perspective

Now I want you to find an area in your body that feels pleasant or neutral. If you can’t find a neutral area, find an area with less pain. Try to fully focus on that area. Is there a color or a shape that you would use to describe the sensations or lack of sensation in your chosen area? Do you have any positive memories associated with this region? Is the positive/neutral sensation shifting at all? Maybe it is expanding or contracting, moving up or moving down? Sit with this awareness for as long as it feels nurturing. 

Check in with your pain and send yourself a message of safety/compassion

Step Four: Use breath to calm your nervous system

It is time to take some deep breaths. First you are going to do a few physiological sighs; two sharp inhales through your nose followed by one long exhale through your mouth (example). Next take some deep breaths at whatever pace feels good to you. Aim to fill your diaphragm with air and focus on your belly expanding and contracting. It can help to imagine a baby sleeping in a crib and how their little belly gently rises and falls. Be open to staying with your breath for a while, or to moving on. Try to follow your internal cues, rather than forcing anything. 

Check in with your pain and send yourself a message of safety/compassion

Step Five: Respond to your body’s messages

Now it is time to get comfortable! Is there anything you can do to ease your physical experience? Maybe your pants are squeezing your waist and putting on some sweatpants would feel relieving. Are you warm or cold? Would a jacket, blanket, air conditioning or taking a layer off feel considerate to your bodily experience? When was the last time you hydrated yourself or used the restroom? Would hot tea, ice water or a bathroom break benefit you? Do you need a snack or a meal? This step is all about prioritizing your physical comfort. Do whatever you want or need to respond to your body with love and compassion. Sometimes we habitually ignore our body’s whispers, forcing it to scream (pain) to get a response.

Check in with your pain and send yourself a message of safety/compassion

Step Six: Look Inward and Respond to your Emotions

After getting more comfortable, find a cozy spot where you can take some time to be introspective. I recommend that you put your devices to the side so you can be fully present with your internal world. Consider grabbing a notebook or journal so you can jot down any insights, thoughts or ideas.

All pain is a danger signal that is generated in the brain. Knowing this, take some time to ask yourself why you might feel unsafe, or what your subconscious might be processing that made it feel like it needed to warn you of danger (pain). Some questions that might help with this self inquiry are:

Are you suppressing anger, shame, disappointment, fear or grief? 

Did something happen that triggered fears of abandonment or failure?

Did you agree to something you wanted to say no to? 

Did you feel hurt or offended by someone? 

Did you or someone else invalidate your feelings and make you feel like they are wrong, bad or too much? 

Do you have too much on your plate?

Are you feeling resentment towards someone who you can't or don't want to express it to?

Was a boundary violated (even if it was/is an unspoken boundary)?

After spending some time with these questions, see if you can feel into the emotion that might be underneath the physical pain. Sense into your body and try to be curious about what the emotion feels like in your body. If you feel an urge to cry, cry. If you want to scream, try screaming into a pillow. If you need a big hug, wrap your arms around yourself and hold yourself or ask a loved one for a long warm hug. If you want to be understood, try placing two hands on your heart and saying “I see you, you make sense to me.”. Consider journaling non-judgmentally. Let all of the fears and shameful thoughts stream out of your mind and onto the paper, knowing that you are safe to express yourself, and that all of these parts of you are simply human. Thoughts and emotions have no moral weight. It is okay, and so very human to feel shame, anger, sorrow and all other human emotions. Allow yourself space to express the emotions that you have been conditioned to see as dangerous, wrong or bad. 

Check in with your pain and send yourself a message of safety/compassion

Step Seven: Make an Empowering Action Plan

After you’ve allowed yourself the space to feel your feelings, it is time to empower yourself with any insights you've garnered. Take steps towards reducing the pressure/stress/fear/etc., that contributed to the onset of pain. This will send your body a message that your needs matter and are worth working towards. If you aren't sure what that might look like, use the following questions to guide you:

What can I do to make the rest of my day a little easier?

What is one thing I can commit to doing today that would make me feel joy?

What boundary do I need to set and how can I take one tiny step towards setting it?

Can I back out of something I don’t want to do, or write up a contract with myself outlining my commitment to saying no next time something similar comes up?

Who can I ask for help/support?

How can I lower my expectations for myself today?

What is a comforting activity that I can do that will help me relax and feel safe? 

What is one tiny step I can take towards a bigger change that I know needs to happen?

If I were the protagonist in a novel I was reading, what would I want their next step to be?

How can I show myself love today?

How can my family support me?

Can I spend time in nature today?

How can I break this overwhelming project down into bite sized pieces?

How can I reduce the pressure I feel today?

*As you answer these questions, really listen to your body and see what answers resonate within your body rather than your intellect. 

After you determine an empowerment plan for the day, act on it. Remind yourself that following through is an opportunity to teach your brain/body that you can trust yourself to take care of your needs. It might feel foreign or “selfish” and although those feelings can be scary, recovering from chronic pain conditions requires you to learn some new behaviors like how to effectively take care of yourself. Be gentle with yourself and offer yourself loads of compassion while simultaneously holding yourself to the commitment you made.

Maybe you made the commitment to stay in bed and get the rest you so desperately need, but when you go to silence your phone this voice pops into your head saying that you are lazy, a bad parent/partner or being unproductive. Allow that voice to be there. Like an uninvited guest that showed up to your party you don’t need to give it loads of attention. You can just allow it to enjoy the party on the other side of the room. Conversely you may have made a commitment to go outside despite the pain. A fearful voice may arise saying “going outside will make the pain worse”, you can respond to that voice similarly (unwanted guest at a party), and also remind it that the brain is the generator of pain, so going outside to feel the breeze on your skin, breathe in the scents of nature, feast on the sights of trees, and bathe in the sounds of birds, can be supportive of your brain finding safety and your nervous system settling. It is totally safe and healthy. 

Check in with your pain and send yourself a message of safety/compassion

Step 8: Continue on with Your Day

Now it is time to stop trying to figure your pain out and to do your best to accept whatever happens next (I know it's a big ask!). Continue sending yourself messages of safety but try to abandon any hypervigilance or constant awareness of the sensations. If you are stuck perseverating about the pain, it will reinforce the fear/danger/pain cycle. Remind yourself that you have done what you can today, and now you are safe and free to move through the day focusing on other important parts of your life.

I hope this journey has helped with relieving your pain! From personal experience I know that sometimes these steps work their magic and sometimes the pain persists. If your pain has persisted through this I want you to know that you are strong, capable and resilient. I wish you didn’t have to go through this pain. I know that you desperately want the pain to end. I want that for you, too. Don’t give up because with time, perseverance and an effective brain based approach, it will resolve! 

As you continue on with your week, know that pain comes and goes. When it comes to visit you again, it will leave because nothing is permanent, not even chronic pain!