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On this page,
practical strategies for managing pain are discussed, such as learning to
relax, managing
sleep, and the practical benefits of exercise.
learning
to relax
The
ability to relax is absolutely essential in managing pain, as in essence
- relaxation and pain are at opposite ends of the wellness spectrum.
It
is generally accepted that there is a direct relationship between
pain and anxiety. Anxiety can easily increase the severity and
intensity of the levels of pain experienced, as well as also causing physical tension, which
in itself can generate pain. As a result, 'relaxation
therapy' is among the most commonly prescribed psychological
treatment methods for chronic pain sufferers.
Although
it can be very hard to relax when faced with chronic pain, with practice it
becomes easier and more effective. Being able to let go of tension
can often produce a sense of wellbeing, which can reduce the level
of pain intensity. One easy and practical way to reduce
levels of tension is by practicing deep breathing exercises.
In
essence breathing is related to the body's panic alarm, and whenever
air intake becomes slightly restricted, heightened levels of anxiety
soon follow. Heart rate and blood pressure subsequently
increase, which if left unabated can lead to a state of extreme
agitation or panic. Conversely if attention is paid to taking slow,
deep controlled breaths, a calming effect will occur on the body.
Most
people do not breathe effectively so that the body 'relaxes' with
each breath. It is normal for the body to draw in air from two
areas of your lungs, however if a stressful situation exists, short
gulps of air from the upper part of the lung are drawn in.
These short breaths stimulate the bodies 'fight or flight',
adrenaline response, which increases the heart rate in preparation
for any forthcoming stress.
Concentrated,
slow and deep breathing from the diaphragm or abdominal area causes
a lowering of the blood pressure and slows down the heart. By
making a conscious effort to breathe both from the upper then from
the lower part of the lungs, a higher state of relaxation can be
achieved.
Deep
breathing is part of a behavioral approach to treating chronic pain.
Chronic pain sufferers must accept the fact that the pain has
changed their life forever, and that they need to make personal
changes along with it. Denying these changes is counter
productive and can easily result not only in more pain, but a lower
quality of life for the sufferer and their family.
The
use of relaxation tapes has proved to be beneficial for chronic pain
sufferers. For details of how to purchase recommended
Amazon.co.uk music, please click here.
Research
as shown those practice relaxation exercises at least 5 times per
week do show long-term benefit in both physical and psychological
wellbeing. Combining frequent use of relaxation techniques
with other pain management strategies can allow chronic pain
sufferers to gradually achieve reductions in the medication they take.
Back
to the top
Exercise
Not
too long ago, it was common practice for people with chronic pain to
be told by medical staff to avoid physical activity because of the
concern that it could damage joints, muscles and increase levels of
discomfort. Thankfully
research has shown that exercise can actually help reduce pain and
improve health.
When
people become inactive, they lose muscle tone and strength, and
subsequently their cardiovascular system works less efficiently. This inactivity increases the risk factors of heart attack
and stroke due to high blood pressure and high levels of
cholesterol.
Exercise
can have a beneficial effect on any structural problem in the body
which is causing pain.
In cases of lower back pain, regular exercise and strength
training can help build up the Erector spinae muscles, which will
provide a natural brace for the back and therefore potentially
reduce stress on bones and can contribute to pain reduction.
Exercise
can also have an effect on the actual experience of pain.
During physical activity the body releases endorphins that
can block pain signals from reaching the brain. The
more endorphins that are produced by the body, the less the need to
rely on external forms of pain management, such as
medications.
Participating
in a regular exercise programme can provide benefits of:
- Increased
levels of energy.
- Potential
improvement in the quality of sleep.
- Weight
loss and reduced stress on joints.
- Potential
increase in bone mass and the potential risk of injury.
- Reduction
in levels of stress.
The
key to achieving many of these benefits is to include flexibility,
strengthening and aerobic (cardio-vascular) exercises into the
regular exercise programme.
Flexibility.
Flexibility
exercises include simple stretching movements. Such exercises keep
joints moving through their full range of motion. They also
prevent muscles from shortening and tightening, which can increase
the risk of injury.
Strengthening.
Strength
training helps in the development of stronger muscles. Stronger
muscles make it easier to carry out life's daily activities.
Strength
exercises also help to preserve and increase lean muscle mass, which
helps to burn more calories and therefore is beneficial in weight
loss and in reducing stress on joints.
Aerobic.
Aerobic
exercises works the heart, lungs and muscles, by increasing the
heart rate, blood pressure and need for oxygen. Such exercise
helps the body work more efficiently and can reduce the risk of
cardiovascular disease, including heart attack, high blood pressure
and high cholesterol. Aerobic activity also increases stamina so
that fatigue is lessened during daily activities.
If
you decide to begin an exercise programme:- It
is easy to do more harm than good by over exercising or by poorly
exercising. Join a reputable gym, which provides induction,
exercise programmes and regular reviews.
Before
you get started
It would be a sensible
precaution for any chronic pain sufferer to talk with their GP
before starting any type of physical activity program.
It is particularly
important to see your GP if you:
- Have
high blood pressure
- Have
diabetes or heart, lung or kidney disease
- Are
a man age 40 years or older or a women age 50 or older and
haven't had a recent physical examination
- Have
a family history of heart-related problems before age 55
- Are
unsure of your health status
- Have previously experienced
chest discomfort, shortness of breath, dizziness or loss of
consciousness during exercise or strenuous activity
If
you are starting an exercise programme, these tips may help:
-
Set
simple and achievable goals.
People who can stay physically active for 6 months usually end
up making exercise a regular habit.
-
Pace
yourself. Initially,
do a little bit at a time and then rest. When you first
start you may experience DOMS (delayed onset muscle soreness)
from exercising muscles that are not used to exercise. But
after a few days muscle strength and joint flexibility improve
and chronic pain may begin to lessen in severity.
-
Add
variety to prevent boredom..
For example, try alternating walking with swimming. On
days when the weather is pleasant, perform stretching exercises
outside.
-
Exercise
with others. Performing
activities with people who have similar fitness levels can make
exercise more rewarding and enjoyable.
-
Be
flexible. If
you're especially busy on a certain day then adapt exercise to
accommodate your schedule.
-
Track
your progress. Record
what you do each time you exercise, how long you do it and how
you feel during and after exercising. This can remind you
that you're making progress.
-
Reward
yourself. Work
on developing an internal reward that comes from feelings of
accomplishment. After each activity session, take 2 to 5
minutes to sit down, relax and savour the beneficial feelings
that exercise provides.
Reference-
Edward
Laskowski, M.D., a physical medicine and rehabilitation specialist
and co-director of the Sports Medicine Center at Mayo Clinic,
Rochester, Minn.
Problems
with sleep are a common feature of chronic pain.
Often sleep problems or difficulties can be aided
by using a diary to effectively manage sleep. Therefore a journal tool has been provided, which can be
pasted and printed out. This
should be kept for 7 days.
However, to be effective this needs to be accurately
completed, as this information can help in evaluating sleep habits
and to begin to appreciate how they may be related to chronic pain.
Sleep journal
- please paste and print in any word processor.
Did you consume any alcohol, caffeine or medication yesterday?
If so, what was it? How
much? and when did you take
it? (Please note) The later
you consume alcohol or stimulants the likelier you are to find
your body over stimulated and less likely you are to sleep..............
......................
.........
...
..
Did you take a nap yesterday? If
so, how long did you spend asleep?
How long did it take for you to drop off?
(Please note) The closer you nap to bedtime, the likelier nighttime
sleep will be disturbed...
.................
...........
How many drinks did you have after 6pm
(Please note) The greater the volume, the
more likely sleep will be
disturbed!.
.................
..
How would you describe your mood yesterday and how well did you
cope? (Please note)
There is a direct correlation between sleeping badly and
depressive thoughts and feelings.....
..
...........
..
..........
..
How long did it take you to fall asleep
last night?
.........
..........
.
How long did it take to fall asleep last night?
..................
..........
.
How many times did you wake up during last night?
....................
...........
For how many hours did you sleep last night
overall?
...................
..........
.
What time did you wake up this morning?
...............
..........
.
How did you feel when you woke up this morning?
...................
..........
.
There are several minor remedies which can potentially alleviate
some problems relating to sleep.
- Refrain
from consuming alcohol, nicotine or caffeine after 2pm.
- Try
to use the bed solely for the purpose of sleep and sex.
- Reduce
fluid intake close to bedtime.
- Go
to bed at the same time each night.
- Get
up in the morning at the same reasonable time in the morning.
- Attempt
to follow relaxation exercises and breathing exercises when you
are in bed.
- If you need to take a nap during the day, do so, but not so
late that it might interfere with nighttime sleeping.
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