ANU KULKARNI has been happily married for more than 30 years, has a beautiful daughter and a son, a dog, and loves throwing parties.
But, like 2.2 million Australians, she has osteoarthritis, where her knee and foot joints are painfully inflamed.
“I’m in pain every single day,” Anu says, having spent the better part of three decades dealing with chronic pain.
ILLUSTRATION: Aaron Blanco Tejedor. Unsplash.
“Medication is what keeps me going. If I wasn’t to take the painkillers, I might be struggling to walk.”
Anu also has depression and anxiety, and for a two-year period, was unable to leave her house.
Anu, along with her husband Narendra, wants to enjoy the years to come with the best health possible.
So, they signed up for an eight-week Catalyst experiment to make some changes to their lifestyle with the help of GP Preeya Alexander and a team of experts.
Navigating chronic pain is complex, and there are a number of factors to consider, Dr Alexander says.
“Things like chronic pain, stress and anxiety are tricky to manage,” she says.
“Over the years I’ve found that not all prescriptions come in the form of a pill.
“Of course, if you need a medicine, I’ll write you a prescription.
“But I also prescribe treatments from another growing speciality: lifestyle medicine.
“Things like exercise, meditation, or even diet changes.”
So, what is chronic pain?
Chronic pain is typically defined by how long pain has lasted — anything over three months is usually considered chronic.
A number of conditions can fit under chronic pain, from back pain to endometriosis to headaches.
It’s “incredibly complex” — and that’s a good thing, according to neuroscientist Tasha Stanton.
Dr Stanton believes if we can change how we understand pain and what contributes to it, we can reduce our experience of it.
“We’re feeling pain because our brain is determining whether or not we need to be protected,” Dr Stanton says.
“What we often see in people with chronic pain, is that the pain system itself is over-protective — it’s doing too good of a job.”
For someone with osteoarthritis, pain is “a whole-body process”.
“It’s systemic, which means body-wide, low levels of inflammation, that actually change the way that many of the systems of the body are working,” Dr Stanton says.
Dr Stanton says changes to systems such as the brain and the gut “can influence inflammation and how sensitive our pain systems are”.
“There are numerous different contributors to chronic pain, but that means there are numerous different targets — things that we can actually try to treat.”
Can lifestyle interventions really help manage pain?
Lifestyle interventions are “surprisingly more effective than most people think,” Dr Stanton says.
“I guess what we understand from the available evidence is that the things that really help are the things that are ultimately lifestyle changes,” she says.
“So they’re things like making an effort every day to move more, making an effort to get enough sleep, [and] really thinking about diet, because diet can play a huge role in how much inflammation we have within our body.
“All of those things they might not seem like much, but when you add them all together and when you individualise them to that person, that can be an enormous contribution.”