Chronic pain affects a massive number of people. In fact, according to the U.S. Department of Health & Human Services, it affects more Americans than diabetes, heart disease, and cancer combined, and is the most common cause of long-term disability. Despite that, though, chronic pain sufferers have a notoriously difficult time being diagnosed and an even more difficult time being treated. And every time there's a crackdown on opioids, chronic pain sufferers have more trouble accessing one of the few viable treatment options.
This often leaves people with chronic pain with one major way to try to lessen their pain: Learning their chronic pain triggers and how to avoid them. As someone who lives with chronic pain after having an ACL reconstruction surgery in 2014, I've learned there's a broad range of triggers that tend to apply to a lot of people, but also that chronic pain is a uniquely individualized problem. For example, I can ride a horse through grueling exercises for hours with no issues, but walking a mile or so, even wearing the nicest shoes, will have me in pain for days.
So keep in mind that the triggers below are simply common ones, not an exhaustive list, and that methods for handling them are simply suggestions, not one-size-fits-all solutions, and you should speak to your doctor about a treatment plan if you're experiencing chronic pain.
1. Anxiety and Stress
Emotional anxiety and physical stress can both take a huge toll on the body, but when you're prone to chronic pain, their effects can be even worse. Both anxiety and stress cause your muscles to tighten, often in key areas like around your neck and shoulders. For some folks who have chronic pain, the extra tightness, no matter how slight, can trigger a pain attack, so if you find yourself getting stressed to damaging levels, it's imperative that you find ways to relieve as much of your stress as possible.
For people with anxiety, the solutions can be a little trickier. According to the Anxiety and Depression Association of America (ADAA), there are quite a few chronic pain disorders associated with anxiety disorders, including arthritis, fibromyalgia, migraines, and chronic back pain. And for folks who have both anxiety and a chronic pain disorder, symptoms can be exacerbated because they may have a lower tolerance for pain, the ADAA reported. ADAA-suggested treatments include medication — you may be able to find one medication that addresses both anxiety and pain — cognitive behavioral therapy to help reduce anxiety, and relaxation techniques to loosen anxiety's strain on muscles and joints.
2. Bad Sleeping Habits
According to the Cleveland Clinic, folks with chronic pain are especially susceptible to insomnia — which frankly sucks, because insomnia can trigger chronic pain. "Pain worsens sleep patterns and sleep disturbances worsen pain — it’s a vicious cycle," Dr. Robert Bolash of the Cleveland Clinic wrote for the clinic's website. So once you're trapped in that cycle, you can become anxious about bedtime, even if you don't have an anxiety disorder. The thought of going to bed and lying awake, in pain, can cause you to begin to associate your bedroom with stress, anxiety, and pain, and your insomnia worsens with your avoidance.
Bolash suggested a few ways to improve your sleeping habits to prevent you from entering the cycle at all. First, go to bed only when you're actually tired. If you're already having a bad pain day and you know your pain is going to keep you awake, stay out of the bedroom until you're ready to crash. Also, I know I'm particularly fond of taking daytime naps when I'm having a rough day, but that can add to the potential for insomnia, Bolash said. Avoiding naps and maintaining a regular bedtime and wake time are essential to keeping your sleep schedule on track, and keeping you away from the pain-insomnia cycle.
3. Temperature Swings
Here's my No. 1 trigger. I don't need anyone to tell me winter is coming, because my knee knows the minute the air pressure begins to drop. My sensitivity has lessened in the years since my surgery; right after I had it, I could tell when it was going to rain (without ESPN), and the changing of the seasons could put me out of commission for days. According to Spine Health, the correlation between weather changes and chronic pain has yet to be concretely proven, but "[t]he strongest evidence points to weather's effects on those with joint pain conditions like rheumatoid arthritis and osteoarthritis."
Carrie DeVries writing for Spine Health added, "Patient experiences tell a different story. Many people [...] report that damp or cold weather worsens their pain."
And as for when the temperature swings higher, that can be an issue too, Dr. John L. Pappas, medical director for the Beaumont Centers for Pain Medicine, told Everyday Health. "Heat and humidity affect people with chronic pain because patients with these conditions have difficulty regulating their system with extreme changes of temperature and moisture in the air," he explained.
Unfortunately, there's no magic weather-controlling balloons, so those of us whose pain is worsened by temperature pretty much just have to stick it out. In the winter, you can try using electric blankets or microwave bags that you can put on affected areas to try to balance your temperature. Hot packs are especially helpful to me. And do the opposite in the summer — don't skimp on air conditioning, and don't be afraid to reach for an ice pack.
Overexertion is one of the most difficult chronic pain triggers, because it's so unique to everyone. I mentioned riding a horse is no problem for me, but even getting themself into the saddle may be a no-go for someone else whose triggers are different from mine. I can't walk too far, and am not able to run anymore, but my doctor once told me of another ACL patient who slalom-skis on the regular. With overexertion, the most important thing you can do is to understand your own limits and to stick to them, even if you get frustrated with yourself.
It's also important to realize that overexertion isn't limited to exercise. It can stem from any physical activity. Jodie Barber writing for The Mighty described one of her experiences with chronic pain, where, having worked more hours than usual and done more around the office, she ended up being triggered. "I don’t know exactly what triggered it; if it was the sudden movement after sitting for so long, or the exhaustion catching up with me or even my medication kicking in, but something triggered," she explained. "Long story short, I spent all of Saturday in bed, in pain. I was unable to move my body; even my jaw was clenched, shut stiff. I hardly slept due to the pain and to top it all off, my immune system completely shut down."
Mitigating overexertion means knowing your limits, but also treating your body well, with good sleep, good food, and self-care.
5. Inflammatory Foods
Like every other trigger on this list, inflammatory foods is an individualized one that will vary from person to person. You may not have food triggers at all, or you may be super prone to them. If you suspect you've got food triggers, the best way to find out what exactly triggers you is to treat yourself like a baby just starting solid food. By which I mean: You should try one thing at a time, eliminating potential triggers, until you find the culprit(s).
There are plenty of common food triggers that can mess with your chronic pain, according to Mercola. The top thing that may be affecting you? Sugar. And unfortunately, "this would typically include fresh fruit juices," Mercola reported. "Increased insulin levels will typically dramatically worsen pain."
Insert sad trombone noise here. Mercola also suggests avoiding gluten, caffeine, nightshade-family vegetables like tomatoes and potatoes, and additives like MSG. Instead, try eating a lot of fresh foods.
Chances are you've encountered at least one of the triggers on this list, and hopefully the solutions offered here will help you lessen your pain. But remember that new triggers can crop up, and that old ones can fade or worsen, so you should always keep in tune with your body and listen when it's telling you to change up your routine.