Be mindful of what works best (when, how, etc.) for your chronic pain while you are trying many approaches. For example, for some, applying heat followed by cold to the painful area works best. Other people do better with just heat or cold alone. For still others, usually those with neuropathic or nerve pain, their pain is aggravated by the application of either heat or cold. Some things work as soon as you do them, like acupuncture and massage. Others may initially make your discomfort worse, like physical therapy or movement modalities, but if you continue to do them they will result in real, lasting improvement. Choosing Practitioners and Techniques It is important when pursuing therapies to choose qualified and knowledgeable practitioners to ensure you are receiving the best care. We also recommend informing your doctor of any therapies you are considering. Be careful not to exceed your capabilities and injure yourself, though you may be able to gently “push yourself” through difficult exercise. Just keep in mind a common saying in some twelve-step programs: “Easy does it.” We have listed some basic information on several modalities that have been shown to be beneficial for chronic pain. As you will see, many of these modalities are about balancing your mind, body, emotions, and spirit. Exercise When you experience chronic pain, you may feel inclined to rest and avoid exercise; however, exercise is one of the best things you can do to ultimately reduce your chronic pain. The danger of inactivity is that your body becomes deconditioned, which can add substantially to your perception and experience of chronic pain. Studies have shown that regular and sustained physical activity is beneficial to virtually every system in the body. During exercise your body releases chemicals called endorphins, which naturally relieve pain and also help to lessen anxiety and depression. The four major types of exercise are cardiovascular, strength training, balance, and stretching. Some other benefits of regular exercise include:
- Helping you maintain a healthy weight. Dropping extra pounds can lessen the stress you place on your joints, which is one way to ease bone pain.
- Increasing flexibility. As your body gains flexibility, you are less likely to strain muscles and joints, which can add substantially to chronic pain. Helping you build strength. The stronger you are, the better your muscles can take the load off joints and bones. The healthier the muscle, the less chronic pain you feel.
- Increasing serotonin level. Serotonin improves your mood and fights pain by blocking the perception of pain in the brain. It is a natural sleep regulator, and sleep also helps you fight the perception of chronic pain.
- Protecting and strengthening the heart and circulatory system. Exercise helps decrease the risk of stroke, heart attack, and diabetes. It also reduces high blood pressure.
- Increasing dopamine levels, which results in improved moods and increased energy. Regular exercise can boost your dopamine level and add strength to all the systems your body needs and uses to fight chronic pain, which may have been depleted by chronic drug use.
Before beginning any exercise program, you should consult with your doctor to be sure the exercises are appropriate and helpful for your specific situation. Foods and Nutrition: What we eat every day has a profound effect on how we feel. Our foods play a major role in our health and well-being. According to Dr. Neal Barnard, author of Foods That Fight Pain, foods fight chronic pain in four distinct ways:
- They can reduce damage at the site of an injury.
- They work inside the brain to reduce chronic pain sensitivity.
- They act as painkillers on nerves.
- They help our bodies fight inflammation.
A healthy diet can extend our lives and help us fight many chronic diseases that often lead to chronic pain or make it worse. Without a doubt, being and feeling healthy helps us fight pain sensations. Physical Therapy Physical therapy (PT) is the treatment, prevention, and management of movement disorders arising from conditions and diseases. A good PT program with a qualified therapist can help you reduce discomfort, increase flexibility, and improve function. PT may encompass techniques such as manipulation, traction, massage, therapeutic exercise, functional training, education, and counseling about movement and healthy body mechanics. Physical therapists use ice, heat, electrical currents, and a variety of newer techniques to relieve adhesions (e.g., Graston technique, active release techniques) and to decrease sympathetic tone (e.g., Primal Reflex Release Technique). Because each individual is different, physical therapists design programs specifically for each person. These programs usually also include goal-setting and monitoring of progress. Achieving goals helps boost your confidence and reinforce your sense of self-efficacy, factors that are closely linked to positive outcomes in chronic pain treatment. Pilates Pilates is an innovative system of mind-body exercise developed by Joseph Pilates in the early 1900s. It was designed to build strength and improve flexibility without adding bulk. The Pilates method, as well as the specially-designed apparatus used with the exercises, focuses on core postural muscles that keep the body balanced and are essential to support the spine. Pilates teaches awareness of neutral spine alignment and strengthens the muscles that support this alignment. The alignment helps treat and prevent back pain and reduces the potential for injury. Controlled breathing and concentration are also an essential element of Pilates, making it a mind-body workout and an effective way to reduce stress and promote relaxation. TENS TENS means transcutaneous electrical nerve stimulation. TENS units are small, battery-powered devices that produce a vibration or signal intended to interrupt pain transmissions from nerves before they reach the brain. TENS units (or electrical stimulators) can be implanted and operated with small controls that send signals through the skin into the muscles. TENS is considered to be the electrical equivalent of portable acupuncture or acupressure. TENS falls into a treatment category called “hyperstimulation analgesia.” These treatments include vibration, acupressure, acupuncture, and massage. There are two theories practitioners use to explain how TENS works. The first is the gate theory that says nerves can carry only one signal at a time, and the TENS signal overrides the pain signal, in effect closing the gate on pain transmissions before they can reach the brain. The second theory is the endorphin theory that claims TENS stimulates the body’s production of natural painkillers, giving users relief. This blog post is an excerpt from Pain Recovery – How to Find Balance and Reduce Suffering from Chronic Pain by Mel Pohl, MD, FASAM, Frank Szabo, LADC, Daniel Shiode, PhD, Robert Hunter, PhD; Published by Central Recovery Press (CRP).