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Looking after your Mental Health whilst Living with Chronic Pain

19th May 2022

During Mental Health Awareness Month, we should all look inward to check in on the state of our mental health. Suffering with chronic pain, like the pain you experience with knee OA, can create an even bigger strain on your mental health. Today, nearly 50% of patients with chronic pain experience severe depression at some point in their lives (1).

Chronic pain and depression share certain neural pathways and chemicals, how your brain perceives them is quite similar. So, these two conditions are in a vicious cycle, where one exacerbates the other.

There are some precautions you can take to help protect yourself against the harmful effects of depression and chronic pain.

Mental Health Awareness


Sleep Quality

Depression or poor mental health can discourage you from pursuing a healthy lifestyle, that would otherwise help ease your chronic joint pain. For example, 75% of patients with depression suffer from insomnia, while 15% have poor sleep quality because of sleep apnea (2). Inadequate sleep is one of your biggest enemies. Several studies suggest that poor sleep increases pain sensitivity and triggers inflammation, amplifying your pain (3).

You need 7-9 hours of uninterrupted sleep, which can be easier said than done. There are healthy practices you can do to help towards a good sleep pattern. These include:

  • Stopping heavy food consumption 3-4 hours before bedtime.
  • Going to bed and waking up at the same hours of the day
  • No electronics one hour before bed
  • Taking a warm bath before bed

Reaching Out

Limited physical activity can lead to a feeling of isolation. Social isolation and loneliness are two of the leading causes of depression and stress. There is even emerging evidence linking loneliness to a decline in immune function, cardiovascular diseases, and dementia (4).

The importance of reaching out to people cannot be emphasized enough, as it can significantly improve your mental health. Doing your favourite activities with your loved ones can provide you with support by boosting your confidence and self–image, which might have been impacted by the effect of chronic pain. Talking to others can also help you gain a more realistic outlook on your circumstances.

We have created a Facebook Community Group, which a space where you can connect with other people in a similar position, share your experiences and make new connections –

www.facebook.com/groups/oakneepaincommunity/

Therapy

Therapy

Chronic pain often causes you to have a negative and distorted self-belief system, involving low self-esteem, self-image, social life, and filtering or ignoring the positive aspects of your life. Some think there is a stigma around reaching out to a therapist, mental health professional for therapy, but therapy is an incredibly useful tool that helps with a range of issues, from anxiety to sleep, relationships, past trauma. A psychotherapist can help you reframe your negative thoughts while also helping you develop coping mechanisms for future scenarios.

We also realize that face-to-face psychotherapy is not affordable for everyone, so we recommend that you check out online therapy options. Various mobile platforms like BetterHelp and Talkspace give you access to qualified professionals for reasonable prices.

Meditation

A common problem with chronic pain is that the more you try to ignore it, the more amplified it gets. Meditation offers a different approach, inviting you to become aware of your pain in the present moment. Research shows that this technique could make your brain less sensitive to pain by encouraging the secretion of the body’s own opioids (5).

Meditation comprises several types, such as breathwork, body scanning, visualization, or a combination. There is no “one size fits all” formula, so you need to figure out what works the best for you. You can find numerous meditation apps, such as Calm and Headspace, with guided meditations and mindfulness tips.

Physical Activity

While your pain might make you want to stay in bed or the house, it won’t be helping your mental health or ease your pain in the long-term. For many chronic pain conditions, including knee OA, physical activity is an integral part of treatment. The National Institute for Health and Care Excellence (NICE) have recently updated their guidelines to say categorically ‘exercise is good for joint with wear-and-tear arthritis’. Read the full article here - BBC News Health

Exercise is one of the most effective solutions for chronic pain and depression. 30 minutes of daily exercise can alleviate your knee pain by improving muscle strength, maintaining a healthy weight, increasing flexibility, and reducing inflammation. In addition, it encourages the body to secrete endogenous cannabinoids that can regulate your pain and mood, among several other bodily functions (6).

The best type of exercise depends on the cause of chronic pain. For example, knee OA patients should refrain from activities that put too much strain on the knees. Walking, swimming, cycling, and tai-chi are often recommended for such cases. We recommend working with your healthcare professional or physiotherapist to create a tailored exercise plan for you.

Healthy Lifestyle

Medication

If you feel overwhelmed by the chronic pain and the negativity that comes with it, you could consider medication. Antidepressants, such as Selective Serotonin Reuptake Inhibitors (SSRIs), help elevate the mood by regulating the serotonin available in your brain. Furthermore, certain types of antidepressants, such as tricyclic antidepressants, are also known to be effective against chronic pain (7).

In any case, we strongly encourage you to consult with your GP or healthcare professional to discuss your options, with any medication there are possible side effects, and risk of substance abuse.


Living with pain and maintaining your mental health at the same time can feel like an uphill battle that you want to give up on. But you are doing amazing, and taking steps to look after both will help in the long-run. Finding what works for you, taking each day as it comes, and having a support system around you will help you along your journey.

If you are struggling with your mental health, please reach out to a GP or healthcare professional who will be able to help you.





(1) Fishbain, David A., et al. "Male and female chronic pain patients categorized by DSM-III psychiatric diagnostic criteria." Pain 26.2 (1986): 181-197.

(2) Nutt, David et al. “Sleep disorders as core symptoms of depression.” Dialogues in clinical neuroscience vol. 10,3 (2008): 329-36. doi:10.31887/DCNS.2008.10.3/dnutt

(3) Staffe, Alexander Torp et al. “Total sleep deprivation increases pain sensitivity, impairs conditioned pain modulation and facilitates temporal summation of pain in healthy participants.” PloS one vol. 14,12 e0225849. 4 Dec. 2019, doi:10.1371/journal.pone.0225849

(4) Cacioppo, John T, and Stephanie Cacioppo. “Social Relationships and Health: The Toxic Effects of Perceived Social Isolation.” Social and personality psychology compass vol. 8,2 (2014): 58-72. doi:10.1111/spc3.12087

(5) Zeidan, Fadel, and David R Vago. “Mindfulness meditation-based pain relief: a mechanistic account.” Annals of the New York Academy of Sciences vol. 1373,1 (2016): 114-27. doi:10.1111/nyas.13153

(6) Watkins, Bruce A. “Endocannabinoids, exercise, pain, and a path to health with aging.” Molecular aspects of medicine vol. 64 (2018): 68-78. doi:10.1016/j.mam.2018.10.001

(7) Verdu, Bénédicte et al. “Antidepressants for the treatment of chronic pain.” Drugs vol. 68,18 (2008): 2611-32. doi:10.2165/0003495-200868180-00007

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