How to Improve Sleep When You Deal With Chronic Pain

If you deal with chronic pain, you know how important sleep can be to helping you feel better. 

When you get a poor night’s sleep, your symptoms might feel worse. You might have a harder time regulating your emotions, and find it harder to complete everyday tasks. Improving sleep quality is often a process of trial and error, but it can be an especially important part of the chronic pain toolkit. 

Why is sleep so important?

Sleep is one of our basic biological functions, and we can’t survive without it. Sleep is essential to our physical and mental functioning. Sleep allows our bodies time to repair and to reset for the next day, and can even support our immune functioning. 

Chronic sleep deprivation can lead to serious health problems like diabetes, heart disease, and stroke. In addition, when you don’t get enough sleep, it can be harder to think clearly and to do the everyday things that are required of you. 

Chronic pain impacts many areas of life, and sleep is no exception. Chronic pain can make it harder to get comfortable enough to fall asleep, and pain can wake you up during the night, reducing the amount of sleep you get.

If you’re dealing with chronic pain, a good night’s sleep might feel impossible. Here are some things to try to improve your sleep when you deal with chronic pain: 

Talk to your doctor about sleep 

Sleep is a critical bodily function, and when you have sleep issues it’s best to make your doctor aware. That might seem overwhelming, especially as someone who deals with chronic pain and has to deal with many medical providers already. There are some medical interventions that can make sleep easier, though, so it’s important to bring it up with your primary care physician to see if there are any options that can help you.

For example, sleep apnea can make it harder to sleep deeply, and wearing a CPAP machine while you sleep can help you sleep more deeply. Get a sleep study done if possible. You can do sleep studies from home a lot of the time now. They may also be able to help you find a medication that works for you to help you sleep better. 

Use light filter settings on your devices

There’s a lot of advice out there about not using screens in the evening because of the exposure to blue light that interrupts sleep. However, it’s much easier said than done to put down your devices after a certain time. Has anyone ever actually stopped using their phone before bed? Sometimes that’s not reasonable. 

If you are looking at your phone or at a device before bed, try using the built in color filters that most devices have to help block out the blue light. You can also try wearing blue light blocking glasses if you don’t have a filter on your device. 

Develop a wind down routine 

Developing a routine that signals to your brain that it’s time to wind down can be helpful in improving your sleep. See how it feels to stretch, meditate, journal, or read as you wind down before bed. 

If you’re able to, taking a hot bath with epsom salts can help you become more sleepy and help with winding down. If you don’t have a tub, try soaking your feet in some warm water with epsom salts to help you begin to wind down. You can also try drinking a warm beverage, like tea (make sure to choose a kind of tea that doesn’t have caffeine) to help signal to your brain that it’s time for sleep. 

Try to stick to a general bedtime

Another way to help signal to yourself that it’s time to sleep is to stick to a specific bedtime. It can be hard to go to sleep at the same time every night when your symptoms are causing you pain, but over time it gets easier. It’s going to be hard to sleep when your brain is wired, so it might take some time to get to a bedtime that works for you. Try shifting things by 5 minutes at a time and work toward the time you’d ideally like to go to sleep. 

It’s also important to be kind to yourself when you can’t stick to that bedtime. Being hard on yourself isn’t going to make it any easier to sleep. 

Use pillows to help support your body

Waking up feeling worse than when you went to sleep isn’t a fun experience. Sometimes movement during sleep can help contribute to pain during the day. Try using pillows to help support you as you sleep. 

Consider using a neck pillow for neck pain or a body pillow to help keep yourself propped up in a way that won’t increase your pain. Some people also sleep with a heating pad or an electric blanket on the parts of their body that tend to cause pain. Some of them have timers so you can make sure it keeps you warm all night. 

Set up your sleeping place for success

Studies show that sleeping in a cooler room can help with getting deeper sleep, so try sleeping with your thermostat turned down a bit lower or with a fan on you. You can also try using white noise, either from a fan or a noise machine, to help create an environment where you can sleep. 

Something else that might help is to be able to turn your electronics or lights on and off from your phone or using a remote. That way, when you’re comfy in bed, you don’t have to get back up to turn off the lights. 

Use your pain relief toolkit

When you’re dealing with chronic pain, sometimes you need to try multiple ways to manage it so you can make it through the day and night. 

As someone with chronic pain, you probably have your go-to ways to manage your pain, like using a TENs unit or using a pain relief gel. See what you have on hand that can help make you more comfortable through the night. 

Are you looking for more support as you deal with chronic pain? Our therapists can help. We have therapists who can support you with chronic illness, chronic pain, &  medical stressors. Contact us today to make an appointment! 

Strengthen Your Relationship with Your Body With These Six Blogs

What does it mean to have a strong relationship to your body?

Does it mean you need to be body positive? What about body neutrality? Or body trust? What do all these different terms mean? Do you have to embody all of them to have a strong relationship between yourself and your body? Where can you even start?

Having a strong relationship to your body helps your health holistically. It helps you tune into your physical and your emotional needs, and tend to them consciously and intentionally. But getting there isn’t an easy journey and it can be hard to know where to start. 

These six blogs are our starting point for you if you’re looking to strengthen your relationship to your body. 

They’re all about reflecting on your relationship to your body, learning to adjust your perspective and expectations, and practices you can take with you as you learn to engage with your body's needs and cues moving forward. Check them out below:

What Does it Mean to Engage in Self Care When You’re Chronically Ill

Your practice doesn’t have to be perfect all of the time. No one is keeping score at how well you’re taking care of yourself or what you’re falling behind on.

Determine for yourself what you can maintain, and try your best to maintain it–and trust yourself to know when you need to just relax.

Keep reading. 

3 Ways to Build Trust with Your Body

You might not even realize the messages that you’ve taken in about bodies throughout your life. There may be cultural messages that you disagree with on an intellectual level but have a hard time disconnecting from for yourself. You’re not alone. It’s hard to disengage from the constant messaging that your body is not good enough and that you can’t trust what it’s telling you.

When you don’t trust your body, you might have a harder time picking up on body cues like hunger or thirst. You might ignore your body’s needs, like needing to take a break, because you feel you should push through.

Keep reading. 

Separating Healing from Healthism

Your health is not insignificant–when you are sick or injured or unwell in any way you deserve care and medicine and support. The rejection of healthism isn’t a rejection of taking care of yourself, but shifting the motivations behind it.

Instead of caring for yourself because you want to be healthy so you can deserve love and care and support, can you care for yourself because you are alive and deserve it? Can you shift your habits of caring for yourself so they come from a place of love and joy, rather than guilt and shame?

Keep reading. 

Learning How to Connect Emotions & Body Sensations

Do you know how emotions feel in your body?

Emotions aren’t only felt in the mind. Our bodies react to our environments just like our brains do, and it can be helpful to connect emotions with body sensations so we can better understand what’s going on within us.

Keep reading. 

Can I have a Healthy Relationship with my Body Without Loving it?

While it would be wonderful to get to a point where your relationship with your body is a loving one, it’s possible to have an emotionally healthy relationship, even a caring relationship, without love. Think of human social relationships–you might not love your coworker or your neighbor or your barista, but you’re likely able to at least provide them the respect and dignity they deserve, and possibly even have a positive, friendly relationship with them. You care about not being rude to them, you don’t think they are unreasonable for having boundaries, and you probably don’t think they’re shameful for asking for what they need!  

Keep reading.

Gentle Movement tips for a Healthier Relationship with Exercise

Gentle movement or moving our bodies in some way that feels good is important for our health–not for the reasons we often hear about in intense fitness environments, where fitness is more of a sport focused on pushing your body to extremes–but because our body and our brain feel better when we find ways to incorporate movement into our routines. Keep the purpose of feeling good at the center of your search for a gentle movement routine: if it starts to feel like drudergy or punishment, it’s time to find something new. 

Keep reading. 

If you’re looking for support as you heal your relationship to your body, therapy can be a great place to start. Contact us today and our expert clinicians can help. 

What Does it Mean to Engage in Self Care When You’re Chronically Ill?

What does it mean to engage in self care when you’re chronically ill?

In general, self-care is the habits or practices you engage in in order to meet your emotional, physical and social needs. Unlike self soothing, which is concerned with providing comfort in the moment, self care is typically some sort of proactive care that has a noticeable effect on your life. It’s basically making sure you meet what you’ve determined to be the essentials for living a fulfilling, happy and healthy life. Some simple examples of self care are: 

• Establishing healthy sleeping habits

• Finding meals that are both enjoyable to eat and provide you with nutrients you need

• Carrying a water bottle around to make sure you stay hydrated

• Putting your prescriptions on auto-refill, or having them delivered to your house if that’s an option

• Taking a walk around your neighborhood

While self soothing often focuses on things that make you feel good in the moment–taking a long shower, a mindfulness exercise, watching a favorite movie, etc–self care is more about the long term maintenance of your wellbeing. Which means it's not always (or ever) a breezy, effortless thing. It can mean using up a lot of energy, both physical and mental, which is something chronically ill people don’t usually have in excess. 

So how can you realistically engage in self care when you’re also managing a chronic illness?

First, as we’ve said before, stop all or nothing thinking:

Life is rarely all or nothing. 50% is pretty much always better than 0%.

Getting started is often the hardest part, especially when the task itself is so massive it feels like even if you start you’ll never finish.  When you tell yourself “I don’t have to finish the dishes, I just have to start them” you’re easing that pressure. Chances are? You’ll realize doing the dishes isn’t actually that bad and you’ll just finish them. And if not? Then some of your dishes are clean now when they weren’t before! 

Your practice doesn’t have to be perfect all of the time. No one is keeping score at how well you’re taking care of yourself or what you’re falling behind on. 

Determine for yourself what you can maintain, and try your best to maintain it–and trust yourself to know when you need to just relax. 

Self care practice: keeping yourself nourished.

When you look up self care, so much advice is centered around food. And food is important! It keeps us alive! But the advice you often stumble upon when looking to take better care of yourself is to cook for yourself more. Cooking is a great way to practice taking care of yourself but it’s not always a realistic solution. Maybe you only have the energy to cook once a week. Or your live with too much pain to stand in a kitchen for a long time, so cooking is extremely rare. Maybe you’re so busy with different doctors appointments that you don’t have much time for grocery shopping or meal planning. 

Chronically ill approach: find your cheats. 

What are easy, filling foods you can throw together when you don’t have more than 10 minutes of kitchen energy in you? Make a list of things like this and use the components as the starting point for your regular shopping list. For example: a bag of frozen fruit & veggies, some yogurt, and juice can be quickly thrown together for a protein rich smoothie that takes little time and effort including prep and clean up. Consider your regular schedule and think of when you tend to have the most energy/feel the best. Is there a predictable time in your week where you could make time to cook? When you do, try to cook enough to yield leftovers so you can have another filling, low energy meal later in the week. 

Self care practice: move your body every day.

Physical wellness impacts our mental wellness and our overall holistic health, so it’s good to find ways to tend to it! While exercise is often a primary example of self-care, that can be tricky to navigate for chronically ill people. What if you’re in too much pain? What if your illness inhibits exercise? 

Chronically ill approach: but listen to it first.

At the root of the advice to move your body each day is the idea that your body’s needs deserve to be recognized and prioritized with regularity. This is actually very important for chronically ill people, even if it doesn’t show up in practice as exercise. Instead, it can be waking up and doing a body scan, assessing how you’re feeling, what your symptoms are–if any sort of gentle movement or stretching would be helpful or if other needs (taking medication, getting hydrated and fed, etc.) need to be taken care of first. And if you have the physical wellness to engage in exercise, remember it doesn’t have to be the aggressive, strenuous type of exercise we often associate with gyms and workout culture. It can be taking a long walk around your neighborhood, volunteering at a community garden, tending to your own house or yard, playing with a nibling, playing with a pet, etc.  

Self care practice: develop routines. 

Having dependable routines can be great! You can learn to prioritize your time and make room for everything you need to do and practice regular rest. But routines themselves depend on you having the same energy and interests all of the time–which is not really true for anyone, but fluctuating and unpredictable health or energy is a major obstacle in life with chronic illness. 

Chronically ill approach: but prioritize your needs over your expectations. 

If you have it in your routine to cook over the weekends because you usually have more time and energy to take care of yourself, but you suddenly get a flare up over the weekend, remember it’s more important to take care of yourself and what you need right now than to live up to the routine expectations you’ve set for yourself. If you push yourself to maintain routines through poor health, you only run the risk of feeling worse for longer. Instead, know when you need to show yourself some grace and let go of your to do list in favor of taking care of the needs pressing for your attention. 

Learning that you have a chronic illness diagnosis is often a life-changing experience. Chronic illness tends to impact every aspect of life, from work to leisure time to money to relationships. Remember, chronic illness is not your fault. If you would like more support in coping with chronic illness, our therapists at Hope+Wellness can help.

7 Blogs to Read if You’re Dealing with Chronic Illness

Living with chronic illness impacts your whole life. 

From your relationships, to your work life, to your self-image, chronic illness finds a way to influence everything. Many of us prefer to think that chronic illness is something we’ll never have to deal with, so it can seem jarring or even frightening to consider what our lives would be like if we dealt with chronic illness.

Part of the fear that comes from imagining life with chronic illness is that we live in a world that was not designed for disabled or chronically ill people to move through. We understand, on some level, how difficult it is to navigate a world that is at best indifferent to you and at worst hostile to your participation. 

When we understand more about the experience of folks living with chronic illness, it's easier to be empathetic and to extend compassion to others and to yourself. Studies show that six out of every ten adults in the United States are living with a chronic illness, so chronic illness is definitely not as rare as we might like to think. 

Especially in the wake of a mass disabling event like the Covid-19 pandemic, it’s important to consider what the world is like as a chronically ill person and what we can all do to make things a little easier on folks who do live with a chronic illness. 

To help make a difficult experience a little easier, we’ve gathered 7 of our blog posts related to living your best life with a chronic illness: 

The majority of people in the United States will experience chronic illness at some point in their lives. 

There’s no doubt about it - living with a chronic illness has an impact on your mental health because our mental and physical health is interconnected. Just because you don’t have to worry about chronic illness right now doesn’t mean that will always be the case.

It’s critical to understand the ways that chronic illness can impact mental health because the odds are that you will experience chronic illness at some point in your life, whether for yourself or through someone you love.

Read 5 Ways Chronic Illness can Affect Your Mental Health

Do you have a loved one who deals with chronic pain?

It’s not always easy to know how to show up for someone when they’re going through something serious or life-changing, like dealing with chronic illness or pain. It’s also difficult for folks who don’t live with chronic illness or chronic pain to really understand all the different ways that it impacts everyday life. 

Learning ways to be more conscientious about making plans and prioritizing accommodations for your chronically ill friends can make them feel safe and cared for, which is ideally how we want our friends to feel in our presence, right? 

Read How to Be There for A Friend with Chronic Pain

When you can have reasonable expectations for yourself & your limits, you can start to develop compassion for those limits. 

It can be frustrating as a chronically ill person to feel like your limits change from day to day. Your energy levels change, your symptoms shift, and it can be hard to find a routine that you can sustain for more than a few days. At times it can even feel like you’re working against your own body, which can feel heartbreaking and confusing. 

It’s important to learn how to be compassionate with yourself when you’re chronically ill. There are already enough things to deal with when you’re in pain or symptomatic without being hard on yourself on top of it. 

Read Developing Self Compassion While Living with Chronic Illness

Are you parenting a child with chronic pain?

Watching your child suffer is devastating as a parent. You might feel helpless when your child is in pain or stuck, like you don’t know where to turn for help. It’s also logistically difficult to parent a child with complicated medical needs, and parents of chronically ill children often feel isolated or burnt out. 

Finding ways to support both children with chronic pain and their parents as they navigate this complicated experience can help improve quality of life, even in the face of pain. 

Read 3 Tips for Parenting a Child with Chronic Pain

Since chronic illness is longer term than acute illness, it tends to ripple out and affect even more of people’s everyday lives, including their relationships. 

Unfortunately, the reality for many chronically ill people is that their relationships change after their diagnosis. There are lots of reasons why this happens, but it often feels extremely personal and painful. 

Many people don’t realize how isolating and exhausting chronic illness is, and since it’s a long-term condition, the impacts on relationships can be long-lasting. Practicing speaking up for your needs, setting boundaries, and practicing coping with grief can all help you navigate changing relationships in the aftermath of your chronic illness diagnosis. 

Read How to Cope With Losing Relationships as a Result of Your Chronic Illness

One thing that might surprise folks about living with a chronic illness is the amount of grief there is to navigate. 

Chronic illness has a way of changing everything about your life, from the way you relax to your job to your relationships. Major changes and upheaval in your life often lead to grief, and learning how to cope with that grief can make it easier to navigate. 

The grief that comes up in response to chronic illness can come from your changing relationships, the dream of what could have been if you hadn’t gotten sick, and even from the way the world treats folks with chronic illness. Learning how to move through the world in this new way takes time and lots of self compassion, and you’re not alone for feeling this way. 

Read Understanding Grief and Chronic Illness

If you suffer from chronic pain, the idea of body positivity might feel like asking a lot. 

It can be hard to feel positively about a body that is letting you down or causing you pain. Learning how to love your body and feel positively about it isn’t the only way you can have a healthy relationship with it, though.

You might need to practice readjusting your expectations and understanding your new limits. Remember that you and your body are worthy of respect and care, no matter what else is going on.  

Read Can I Have a Healthy Relationship with My Body Without Loving It?

If you would like more support in coping with chronic illness or dealing with body changes, our therapists at Hope+Wellness can help. Reach out today to make an appointment! 

Can I Have a Healthy Relationship with My Body Without Loving It?

If you suffer from chronic pain, the idea of body positivity might feel like asking a lot. 

It can be hard to love something that causes you severe amounts of physical pain, not to mention the emotional pain that can come with that sort of prolonged discomfort and distress. So if you’re someone who manages chronic pain, and you find yourself rolling your eyes a bit at the idea of body positivity–I get it! It’s okay and you’re definitely not alone. 

But living with chronic pain doesn’t mean you don’t deserve an emotionally healthy relationship with your body, even if that can’t be one filled with love. While it would be wonderful to get to a point where your relationship with your body is a loving one, it’s possible to have an emotionally healthy relationship, even a caring relationship, without love. Think of human social relationships–you might not love your coworker or your neighbor or your barista, but you’re likely able to at least provide them the respect and dignity they deserve, and possibly even have a positive, friendly relationship with them. You care about not being rude to them, you don’t think they are unreasonable for having boundaries, and you probably don’t think they’re shameful for asking for what they need!  

The same can be true of your body. 

The first step to getting to that emotionally healthy relationship with your body is to let go of unrealistic expectations. 

Just like with your other relationships, unfair expectations just set everyone involved up for hurt and disappointment. When you expect your friends to read your mind, you’re putting the burden of a role they’re not equipped to manage on their shoulders, and it can never end in positive feelings. The same is true of your body. When you expect your body to be able to do things like: 

• Operate at 100% every day 

• Persist through prolonged exertion or labor without breaks 

• Function without proper nourishment 

…You’re putting unrealistic expectations onto your body. No one’s body can really manage those things! And if you experience chronic pain or chronic illness of some kind, your limits are going to feel even more rigid. But it’s important for you to figure out what it is your body can reasonably handle on a given day so you can make sure you’re not asking too much of it. 

Take stock of your limits, of what different things cost you in terms of energy, pain, emotional regulation, etc. 

When you take time to notice the effect different activities or situations have on you, your body, the severity of your symptoms, etc., you’re able to better respond to those effects, preemptively plan for how you will manage an increase of symptoms, or set limits on those things. When making plans, remember to keep those limits and boundaries in mind and to be respectful of your relationship with your body. If you push it past those limits, the lack of care you show to your body’s needs will show up in that relationship through worsening pain, increased symptoms, etc. 

Remember healthy relationships are reciprocal

It’s okay if there’s a lack of love between you and your body sometimes. Not every relationship needs constant love and affection to be healthy. They do however need respect and reciprocity–which means however you treat your body is how you can expect your body to treat you.Instead of punishing your body for its needs and limits, try to respect them. Because when you punish your body, it will only turn that punishment back on you for neglecting its needs, whether that’s through increased pain or flare up of symptoms, or getting sick in some other fashion. When you notice your body’s cues and tend to them, you’re showing your body respect and care. This in turn gives you a cared for place to live and exist. 

If you’re looking for support as you heal your relationship to your body, therapy can be a great place to start. Contact us today and our expert clinicians can help. 

How to Be There for A Friend with Chronic Pain

Do you have a loved one who deals with chronic pain?

If you don’t experience chronic pain, it can be hard to understand just how much it can impact someone’s life. While for most people, pain is unusual, a sign that something needs to be tended to immediately, for folks who manage chronic pain, it is a constant state. 

The baseline, rather than comfortable or content, is typically still some underlying degree of pain, even when on a pain management routine of some sort. Chronic pain impacts the sufferer from the moment they wake up until the time they go to sleep (and often in between as well, as chronic pain commonly impacts sleep!) so it can be hard to know how to help! 

If you’re looking for ways to support a loved one with chronic pain, here are 6 ways to be there for them:

Consider obstacles before proposing plans

Even something as simple as going for a walk can be difficult for someone with chronic pain. That doesn’t mean it’s impossible for them, but when you’re planning outings that you want your friend with chronic pain to take part in, try to consider what problems it may bring up for them, and what accommodations can be made so that friend can still come and have a good time. Again, if you’re planning something like a hike or a walk, it could be as simple as making sure to pick a path with benches along it so there are places to rest along the trail without having to sit on the ground (which can be uncomfortable, embarrassing, or even impossible depending on the pain your friend experiences). 

Don’t leave them out of the planning

Even if you’ve considered the obstacles, you’re not the one with the chronic pain, so you’re not the expert on whether things have been taken care of! Make sure you let your friend know what you’ve thought of, but also ask them to please let you know if there’s something else they are concerned about so that you can make accommodations for them. For the above example it could be as simple as saying, “Hey, I’d love for you to come hiking with me. I found a trail with lots of benches so we can stop as often as we need to. Is there anything else I didn’t consider?” 

Don’t make them ask to use the accommodations: 

If you know something is an issue for your friend, try to offer the accommodations without waiting for them to ask for it. It can be vulnerable and even feel embarrassing to ask for accommodations others don’t need–especially if you’re in a large group–so they push through pain or discomfort rather than call attention to the fact that they need help. Using the hiking example, you can offer to take a break before your friend asks for one. It’s as simple as saying, “Hey let’s stop at the bench up there for a water break!” You don’t have to call attention to their discomfort, and you can show them you’re actively thinking about them & their needs. 

Understand there aren’t always accommodations that work: 

Your friend with chronic pain might not always be able to find a way to make your plans work. Whether it’s because they’re having a bad flare up, making the usual accommodations useless, or because there just isn’t a way for them to mitigate the pain they’d be experiencing if they participated, there just isn’t always a way to make it work. It’s not a personal judgment if they say they can’t come, and while you might feel tempted to over apologize, that might actually make them feel worse–then they have to comfort you because their pain prevents them from participating. Instead, let them know you’ll miss them and that you do something with them soon. 

Offer help if you can: 

Not everyone has the energy or the time to take on some extra responsibility for their loved ones, but if you’re able to, offering to pick up the slack for your friend every now and then can be a wonderful way to support them. Living with chronic pain can make it difficult to stay on top of things like dishes or laundry or grocery shopping–basic maintenance things. Because often the pain is so severe it is difficult to function or focus on anything else. Severe pain also makes sleep difficult, exacerbating the cycle. If you have some spare time in your week every now and then, check in with your friend, ask if there’s anything you can help them out with. If they’ve been complaining of their pain more and more frequently, let them know you’ve noticed and ask if there’s anything you can do to lighten the load! 

Believe what they tell you, not what you see:

Folks who have been living with chronic pain for years may not look like they are in pain from the outside. When there’s no break from the pain, it becomes a new normal that they have had to adjust to–however that doesn’t mean they aren’t in pain. If your friend has chronic headaches, but looks “normal” when they’re in pain, that doesn’t mean they are faking. The way they look “normally” is what they look like when they’re in pain, because pain is normal for them.

Do you know someone living with chronic pain who needs support? Reach out today to get in touch with one of our clinicians! 

3 Tips for Parenting a Child with Chronic Pain

It can be challenging to parent a child with chronic pain. Not only is it difficult to see your child in pain, but parents often feel helpless, stuck, and unsure of what to do to help ease the pain and mitigate its impacts on their child’s life and daily functioning. For instance, children with chronic pain often begin to miss school, become socially isolated, and feel increasingly depressed and anxious over time. So how can parents help support their children get back to life and functioning even in the face of pain?

1. Interdisciplinary Assessment and Treatment of Pediatric Chronic Pain

   One of the things that makes parenting a child with chronic pain so challenging is that what seems most intuitive and most natural when treating acute, short-term pain, such as rest, time off from school, can often worsen chronic pain. So it’s important to get a proper comprehensive evaluation done prior to treatment. You can find an interdisciplinary clinic which specializes in pediatric pain. These clinics specialize in appropriately assessing and diagnosing pain and will help you determine appropriate treatment. Specialists there can help your child learn to manage and maintain normal age-appropriate functioning despite the chronic pain.

   Because chronic pain is so complex, treatment must also be multifaceted and interdisciplinary to appropriately tailor treatment and target critical domains involved. Interdisciplinary programs often involve evaluation by a physician, psychologist, physical or occupational therapists. There are a few of these programs across the country, including here in Washington DC, at the Pain Medicine Care Complex at Children’s National Health Systems. Below is a list of a few programs with interdisciplinary pediatric pain programs:

   • Cincinnati Children’s Pain Management Clinic

   • Nemours/Alfred I. duPont Hospital for Children Pediatric Pain Management

   • Kennedy Krieger Institute Chronic Pain Rehabilitation Program

   • Children’s Hospital of Pennsylvania (CHOP) Pain Management Program

   • Boston Children’s Pain Treatment Center

   • Stanford Children’s Health Pediatric Pain Management

   • Seattle Children’s Pain Medicine Clinic

   • Cleveland Clinic Pain Rehabilitation Program

2. Work with your child’s physician, psychologist, and physical therapist to understand what activities can be tolerated by your child.

   Parents play an incredibly important role in treatment and in their child’s outcomes. The treatment of chronic pain is highly complex, so it is important to work hand in hand with your child’s specialist providers.

   It might seem counterintuitive, but oftentimes, parents are recommended by specialists to encourage normal, age appropriate activity by their children. It’s important that children maintain functioning despite the pain. It makes sense when you consider that children who begin to lose functioning such as frequent school absences, fall behind, become stressed, increasingly depressed, anxious, and socially isolated, which are factors that can all contribute to worsening pain. Therefore, parents are often asked to provide positive reinforcement and praise for engaging in normal daily activities. Avoid questioning about the presence of pain. Consider whether the pain may have secondary functions such as avoidance or escape from undesirable activities. Work closely with your child’s treatment team to understand how you can best support your child emotionally and behaviorally. Because pain is so complex, all lifestyle factors must be considered and targeted.

3. Help your child get good sleep

   Sleep is often significantly affected in children with chronic pain. Pain and discomfort can make it very difficult to fall asleep and stay asleep. This can result in increased and worsening pain during the day. Therefore, it is important for parents to help promote healthy sleep behaviors and a regular sleep-wake schedule in their children. Healthy sleep hygiene includes:

   • Limiting use of the bed for sleep (and not homework, watching TV or other activities)

   • A consistent bedtime routine

   • Limiting use of electronics

   • Consistent bedtime and waketimes

   • Limiting intake of caffeine, tea, coffee

   It can help to work with a psychologist who specializes in working with children with chronic pain. Sleep is an important area to address as it impacts pain, mood, as well as energy and ability to function and attend school, all of which in turn are also related to pain.

In sum, chronic pain in children can be difficult and stressful to navigate, but with time, appropriate specialized care, and parental support, children with chronic pain can manage it and reclaim their lives again for greater health and happiness.

Please read blog disclaimer below; this blog does not replace medical advice.

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pediatric psychologist in mclean, falls church, arlington and vienna

Victoria Chialy Smith, PhD is a licensed clinical psychologist providing individual therapy to children, teens, and adults with chronic pain, anxiety, and depression. Our practice provides Cognitive Behavioral Therapy (CBT), mindfulness based therapies, and other premier evidence-based treatments, and serves the Falls Church, McLean, Great Falls, Vienna, Arlington, Alexandria, and the greater Washington DC region. Call, email, or schedule an appointment with us online today. We’re happy to help!