My enduring love of mountain biking has made me a regular visitor to hospital emergency departments. Over the years I have fallen off mountain bikes in all sorts of creative ways, enabling me to sample pain in many of its forms.
What I have learned from my periods of post-crash convalescence is that I quickly become a miserable grump. Try as I might to remain chipper, my mood inevitably sours and I turn into a far less pleasant person to be around.
The part of my body that is causing me to say ‘ouch’ is generally not the worst thing about being injured. Instead, it’s all those things I can’t do.
The activities that most fill my cup and support my mental health are active, outdoorsy things that doctors specifically advise against when you are fitted with stitches, a cast or a moon boot. Instead of gloriously bodysurfing down a wave, I find myself in a shower awkwardly holding up a plastic bag covered arm, so I don’t get a wound wet. It’s not nearly as enjoyable.
When injuries affect my ability to work, things can get worse. I worry about not getting work done, feel bad about putting extra pressure on those around me and catastrophise that everything will fall apart unless I use my one good arm to answer that email.
When pain gets in the way of sleep everything becomes a whole lot harder. Sleep is incredibly important for mental health and without the nice deep, undisturbed variety, I become sullen and snappy.
Thankfully, over time each of my mountain biking injuries have healed and the pain has gone away. I’ve got back on my bike, and I’ve quickly transformed into a happier human being.
Many Australians however face a sustained battle with chronic pain (pain that lasts longer than three months or continues after the expected healing time of an injury or illness). Chronic pain and mental ill health are deeply intertwined. Around 44.6% of Australians living with chronic pain also experience depression or anxiety. They may also be at significantly greater risk of substance misuse, sleep disorders and suicidality.
Treatment for chronic pain is fundamentally different from treatment for acute pain. Chronic pain is treated as a condition in its own right, involving changes in the nervous system, psychology, and physiology. The aim is not just to reduce pain intensity, but to improve function, quality of life, and coping.
For chronic pain sufferers there are many types of practitioners that can provide invaluable support. A GP is often the first point of contact and may refer to a pain specialist for co-ordinated care and management of medication. Physiotherapists can help build movement, function and confidence, while exercise physiologists can provide structured physical reconditioning. Occupational therapists can help with daily life, independence and return to work.
Psychologists, particularly those who specialise in pain treatment, can also play an incredibly useful role. Pain has wide-ranging psychological impacts, affecting mood, stress and identity. Psychologists can teach skills to help us interact differently with pain and reduce factors that may amplify pain signalling. They can also put in place practical strategies to support ongoing mental wellbeing and manage other psychological challenges that may emerge.
While we may be tempted to try and push the pain aside and battle on alone, this common approach is associated with poorer outcomes. Without appropriate treatment, pain intensity and disability often worsens, limiting what daily activities sufferers partake in. Commonly, mental health can also deteriorate, and feelings of hopelessness may emerge.
Keeping connected is hugely valuable when experiencing pain and it shouldn’t be left to those who are suffering to reach out. Whenever we have a colleague, friend or loved one who is experiencing pain, it’s important to check in on them regularly. Never underestimate the value of a good chat, a good laugh or someone simply caring enough to call.
Workplaces can play an integral role, with the level of support they demonstrate linked strongly to rates of recovery. Whenever a colleague goes on leave, make sure they are not ‘out of sight, out of mind.’ Find ways to include them, encourage them and connect them with services that can support their safe return.