DEAR MAYO CLINIC: My spouse suffers from chronic pain after a back injury five years ago. The pain affects his ability to work and enjoy day-to-day activities with our family. Seeing him in pain and not knowing how to help is difficult for me. How can I support him on the challenging days when the pain is more severe and encourage him on the good days?

ANSWER: For millions of people, living with chronic pain can significantly affect their daily activities, relationships, work and well-being. Chronic pain is typically categorized based on the duration of pain experienced.

The pain or discomfort people feel while recovering from an injury or illness is considered acute or subacute. Pain lasting beyond usual recovery from a trauma-related event or surgery, typically 12 weeks, is considered chronic. Pain can transition from acute to chronic, depending on a person's recovery process.

Chronic pain can cause a person to avoid activities that cause further pain. This can lead to muscle weakness, joint problems and being more prone to injury. These avoidance behaviors also can lead to psychological isolation and stress. Moving the body and being physically active are crucial for long-term pain management. Encouragement from family, friends and caregivers to stay active and motivated is vital in improving physical health and psychological well-being.

Central sensitization pain presents additional challenges, including mood changes and fatigue. Patients with central sensitization pain may experience heightened pain responses during physical activity.

It's important that loved ones understand the effect of chronic pain on a person's daily life. Not being able to engage with family and friends can lead to mood symptoms, such as anxiety, helplessness and hopelessness.

It's beneficial to encourage people with chronic pain to maintain a sense of normalcy, remain involved in social activities and stick to a routine sleep schedule.

However, caregivers should balance encouraging activity and enabling passivity, as helping can exacerbate physical and psychological limitations and dependency.

When supporting someone with chronic pain, here are some ways a loved one can help:

• Understand the nature of chronic pain.
  Recognize that chronic pain differs from acute pain and can last beyond the expected recovery period. Be aware of the different types of chronic pain and their effect on your loved one's life.
• Encourage movement and physical activity.
  Motivate the person to do gentle exercises, stretching or physical therapy, even if it initially causes some discomfort. Gradually increasing activity levels can help improve pain and overall functioning.
• Support a balanced routine.
  Help establish a regular sleep schedule and ensure the person is exposed to daylight during the day. Encourage healthy habits, such as maintaining a nutritious diet and avoiding substances like drugs or smoking. Understand that someone with chronic pain may have fluctuating levels of pain. Encourage them to participate in social events and integrate into family meals or outings when they feel up to it.
• Provide emotional support.
  Chronic pain can take a toll on a person's mental health. Listen when needed, offer emotional support and encourage open communication about their feelings and experiences. Help them seek professional help if needed. Understand that pain can be unpredictable, and the person may have good and bad days. Practice patience, flexibility and adaptability to accommodate their needs and limitations.
• Avoid enabling behaviors.
  While being empathetic is important, avoid reinforcing a sedentary or inactive lifestyle. Encourage independence and motivate the person to participate in their daily activities as much as possible.
• Stay informed and advocate for proper medical care.
  Educate yourself about the specific condition causing pain, available treatments and strategies for managing pain. This knowledge will help you better understand and support the person's journey. Help the person find healthcare professionals who specialize in chronic pain management. Advocate for their needs and ensure they receive appropriate medical attention, including seeking second opinions if necessary.
• Encourage self-care.
  Remind the person to prioritize self-care, including practicing relaxation techniques, pursuing hobbies and engaging in activities that bring joy and reduce stress.

Remember, people's experience with chronic pain is unique to them, so it's essential to tailor your support to their needs. — Dr. Qasim Raza, Pain Medicine, Mayo Clinic Health System, Barron and Eau Claire, Wisconsin

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