Pain Acceptance Linked With Reduced Disability, Pain Interference in Migraine

Migraine sufferers often avoid triggers and activities thought to precipitate migraine. In line with the fear avoidance model of pain, however, some findings have shown that avoidance can lead to headache disability by reducing pain thresholds and preventing pain habituation.2,3 In addition, psychological factors have been found to have a greater influence on the fear-avoidance cycle than symptoms like headache severity, suggesting that targeting such factors in patients with migraine may improve outcomes.4

In contrast to avoidance-style coping, pain acceptance consists of 2 components: pain willingness — the recognition that pain avoidance efforts tend to be ineffective — and activity engagement, consisting of participation in life activities despite being in pain.5

This study was looking at overweight women in particular with a BMI over 25.  There were 126 subjects. They found there was reduced headache disability with acceptance and less disruption there was in their lives. It is limited due to its focus but the idea is that acceptance therapy is beneficial with chronic pain and may very well be with migraines as well.

This is a strategy my psychologist takes. You should engage in life because you will be in pain anyway. You should do all the strategies to manage that pain, but also not avoid interaction, social activities and other things due to pain that will always be there.

I find it a lot more difficult with chronic migraines than say, when I only had fibromyalgia. The Limit is a harder line. You see you can’t exceed your pain limit and push through the pain all the time. For me, that lead to depression and suicidal ideation. Loss of hope. Too much suffering for coping strategies to encompass. For that reason, my pain psychologist acknowledges that working full time is impossible for me. Working part-time is likewise very problematic. When I exceed my pain limits and try to function like that, and fail to function, I cease to want to thrive and exist. Clearly counterproductive to coping. So you have to acknowledge that pain has limits. You can only cope with so much. Only function with so much. Acceptance or not, that is a Hard Line.

But chronic migraines are chronic pain and we do have lives to live. We cannot hide in our cave every time we have a migraine or we would be in there every day. We do have to do things with migraines. Even socialize with them. Do housework with them. Go for walks for exercise with them. Limited errands with them. Just not with pain levels at 8 or above. We are limited by our pain levels and, therefore, the lower functionality that comes with those levels.  Likewise, we can be limited by bouts of vertigo, vomiting, and diarrhea. And we can’t push those limits without risking our mental health. In the 6-7 range with have lower functionality and can do limited housework and limited errands and limited socialization. Not on the same day. But we can. It tends to make the pain worse. Aggravates things. Sometimes so much worse you have to leave early, get home as soon as possible, or immediately stop what you are doing.

Acceptable with Fibromyalgia is a lot easier. You pace, moderate and stay within your limits. Rest on flares. Self-care on flares. But the rest of time just ensure you pace, rest when you need to and never exceed you limits. You can live a well-rounded, mellow and careful life. Mind you mine has gotten worse over the years but I still follow this and it works well. Migraines, daily, on top? A lot harder process. Pacing means nothing to migraines. They come on regardless if you pace. Pacing doesn’t prevent the pain from being worse or better. It just is.

So we can have acceptance and try to live our lives within the capcity we have. It is just limited capacity.


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