by Deb Brothers-Klezmer, BSN, RN-BC, CRRN, NCTMB & Wendy Midgley, MEd, RD, CDE
“Pay attention to your body. Everyone is different. You have to figure out what works for you.” by Andrew Weil, MD
September is National Pain Awareness Month so we are writing this BLOG to help people in pain, or those who know somebody in pain, to make informed decisions regarding pain management.
Did you know that 116 million American adults suffer from pain each year? (Source: recent statistics by the NIH–National Institutes of Health.) NIH research has also shown that healthcare costs for adult pain in the USA range between $560 billion and $635 billion annually.
This does not include the $34 billion spent on Alternative Medicine–which most Americans pay for out-of-pocket. According to the CDE (Center for Disease Control), the main reason people turn to Alternative Medicine is for pain control.
Alternative Medicine (also called “Complementary Medicine”) includes a variety of therapeutic health care modalities such as: homeopathy, naturopathy, chiropractic, herbal medicine, mindfulness and stress reduction/relaxation programs, cognitive behavioral therapy, breathing exercises, biofeedback, acupuncture, acupressure, EFT (meridian tapping), massage therapy , Reiki healing and other energy healing modalities, manual therapies (ex: craniosacral therapy), distraction therapy, music therapy and visualization, and many nutritional regimens, ETC, ETC–that do not follow generally accepted medical methods and may not have scientific explanation for their effectiveness.
- PAIN CAN COME in MANY FORMS, and last for varying amounts of time.
- PAIN (even though arriving uninvited) can serve as a Wake-Up Call, or a Crucial Turning Point for MAJOR POSITIVE SHIFTS in one’s life.
The authors of this article believe that PAIN is WHATEVER the CLIENT SAYS it IS. It can be emotional, mental, physical, or spiritual or all of these. It can even be that someone has taken on the pain of someone else. And sometimes they don’t even know that they have done so!
ACUTE PAIN can be defined as pain that usually resolve in less than 1 month. Acute pain situations may be resolved by treatment, or resolve on their own.
SUBACUTE PAIN is defined as pain that lasts 1-6 months.
CHRONIC PAIN can be defined as pain that lasts for 6 or more months. Chronic pain can be a real challenge to live with as it affects so many aspects of one’s life: work and finances, relationships, ability to stay physically active plus many other aspects.
The real challenge is for those whose QUALITY of LIFE has been altered due to pain.
Even though a pain situation may be resolved, oftentimes there is post traumatic stress disorder (PTSD) to deal with–that is associated with the original pain. For example: someone may have had a bad accident or experienced a terrifying emergency situation, or was raped or attacked. And the pain still remains.
TREATMENT and THERAPY:
Pain management treatments vary from someone purchasing an on-line nutritional supplement to rhizotomy (surgical severance of spinal nerve roots for the relief of pain.)
A first step in pain management begins with a CRUCIAL CONVERSATION with your MD, physician, or other health care provider. At regular medical visits, inform your doctor, nurse practitioner, or nurse if you have pain that interferes with your ability:
- to sleep
- to get dressed
- to move around in general (e.g., walk, get in and out of a car)
- to stand for more than 5 minutes (e.g., wait in line, cook, load a dishwasher).
- to lift 10 or more pounds (e.g., bags of groceries, infants, and pets)
- to exercise
- to be social
- to enjoy hobbies and creative interests: e.g., playing a musical instrument
- to be sexually intimate
- to fulfil all required tasks of your job
A second step is Assessment of Pain–which may include one’s personal assessment as well as the healthcare provider’s input, including diagnostic evaluations such as MRI, cat scans, x-rays, ultrasound, EMG, thermography and many more.
The third step is choosing appropriate treatment(s). Treatments and therapies can be either “conventional” (for example, a referral to a physical therapist) or “alternative” or “complementary.” Conventional and alternative treatments can be combined in “an integrative approach.”
NOTE: When seeking “alternative treatments”, please contact a resourceful healthcare professional that can guide you to the most appropriate treatment.
Before starting any treatment or therapy, ask the healthcare provider the following questions:
- Does the treatment or therapy address the actual cause of my pain or just treat the signs and symptoms?
- How will the treatment or therapy reduce my pain?
- Are there any published reports or research that demonstrate the effectiveness of the treatment or therapy?
- What are the potential risks of the treatment or therapy?
- How long will it take, and approximately how much will it cost?
NOTE: Try not to do more than 2 new therapies at a time. (Example: two new therapies might be: starting to see a psychotherapist, plus one type of manual therapy.)
***HOW DOE WE TURN DOWN THE PAIN BUTTON?***
Recommendations and Suggestions for Self-Care:
Regardless of which treatments you have chosen to experience, there is no treatment that exempts one from active participation in his/her own healing. One needs to stay actively involved in calling forth healing for oneself.
- Get enough sleep and rest. Some people find relief, sleeping on a firm mattress. Or try a sheet of chipboard under your mattress.
- Move through your pain. KEEP MOVING! Do not stay in one position for too long. Move before you stiffen up. Don’t stop doing things. Just change the way you go about your day. This may require reducing your activity. If you are unable to move yourself, have somebody move you, turn you, and if possible help you stretch.
- Pay attention to your posture.
- Breathe through your pain. Learn therapeutic breathing techniques.
- Limit your “pain talk.” (talking to others, or just yourself) to 10-15 minutes each day.
- Take all medications in the way they are prescribed. If you need painkillers before going to sleep–take them one hour before going to sleep. Don’t be a martyr and skip a prescribed medication if you really DO need it. If you feel you need a change in medication regimens, do not hesitate to speak to your healthcare provider.
- Stay well hydrated, 6-8 glasses water per day.
- Avoid sugar, excess alcohol, excess salt, excess starch, and highly processed foods. SOME THOUGHTS on ALCOHOL: Small amounts of alcohol (1 alcoholic drink per day = to 5 oz wine or 1.5 oz. liquor or 12 oz beer) can be relaxing and help decrease the anxiety associated with pain. However, a high intake of alcohol is associated with sedative, hypnotic effects and often with INCREASED anxiety, INCREASED depression and INCREASED PAIN. If you are sensitive, allergic to, or taking any medications that alcohol may interfere with— AVOID alcohol as well as any herbal tinctures that may contain alcohol.
- Minimize gluten intake. (Gluten is a component of wheat, rye, barley, malt, beer and is found in many baked products, also some candies.) Try other grains and starchy vegetables instead, for example: brown rice, wild rice, quinoa, buckwheat (not a gluten), and millet, starchy beans like black beans, chickpeas and lentils. Also, sweet potatoes and yams.
- Take probiotics if your gut is out of balance.
- Include 60-70 grams of protein per day. (from animal proteins, dairy, eggs, nuts, seeds, tofu and other soy products.
- Eat plenty of anti-inflammatory foods (for example: lots of green vegetables).
- Include anti-inflammatory herbs such as: ginger, cinnamon, capsaicin, cilantro, rosemary, parsley, turmeric, marjoram, thyme, milk thistle, and green tea.
- Take anti-inflammatory nutritional supplements such as 1000-2000 mg fish oil/day. Fish oil should include both EPA and DHA types of omega 3 fatty acids: with a ratio of 300/200 EPA/DHA.
- Make sure your blood level of Vitamin D is adequate. An optimum blood level is 50-70 ng/ml. A safe supplemental level of Vitamin D is 1000-2000 IU Vitamin D per day, taken in Vitamin D3 form.
- Massage yourself or have somebody close to you learn from a skilled professional how to appropriately massage your effected area.
- Find peace with where you are at right now—so that you can move forward. You can find support groups: both live and on-line.
- CONNECT DAILY to your SOURCE (if applicable) and feel the comfort in knowing you are never alone.
18. Do not read every last Internet article about whatever it is that ails you!
19. Distract yourself from pain with hobbies, interests, or even simple tasks that need to be done.
- Remember: If you focus too much on pain, you will be more acutely aware of it.
20. Go beyond ordinary distractions. Do something fulfilling–and maybe even extraordinary!!
21. Find a variety of self-soothing strategies, for example: have a manicure or pedicure, use aromatherapy and light candles while in the bath, listen to soothing music.
22. Smile every day in the mirror. If you have difficulty smiling at yourself, think about something or someone who brings a smile to your face.
- LAUGHTER is the best medicine. Find something to laugh about every day, even if you have to “fake it until you make it.”
23. Raise your vibrations: What we mean by vibrations is higher level thought processes and functioning. Align yourself with the positive, with what is possible, with what is inspirational.
24. If you suffer from persistent anxiety and depression associated with pain—despite the suggested interventions-consult your physician and/or your therapist for assistance.
- Thought Therapies such as Cognitive Behavioral Therapy and DBT (Dialectical Behavioral Therapy) can help us “reframe” our experiences with pain–so that COPING is somewhat easier. When we feel we are coping better, the suffering associated with pain is lessened.
STRATEGIES to EMPLOY EACH DAY:
- Energy Conservation: Save your body some effort doing routine tasks. For example: sit on a stool or bench in the shower vs stand.
- Work Simplification: Make daily tasks easier. For example: buy wrinkle-free clothing–no need to use the iron!!
- Joint Protection: Prevent unnecessary strain on joints. For example push a wheeled cart instead of carrying bundles OR: Use utensils with large handles for easy grasping.
What works for each person is an individual matter. Don’t be afraid to try new approaches if the benefits outweigh the risks. As Andrew Weil, MD states; “You’ve got to experiment to figure out what works.”
Even if frustrated with treatments thus far, don’t give up tring to find the treatments and ways of managing pain—that work best for you.
- Remember: COURAGE conquers all things; it even gives strength to the body.
- Acknowledge how brave you are.
And as Meditation and Stress Reduction teacher Jon Kabat Zinn’s book title reminds us: “Use the WISDOM of your Body and Mind to face stress, pain and illness.”
Our wish for you:
We wish those with pain (and those who care for those with pain) a way to minimize pain, to function at one’s highest level, and to be able to experience Joy in life.
The Wellness Shifter Ladies!!!
Deb and Wendy