Coping with Chronic Pain

Transcription

1 Coping with Chronic Pain

2 Why do we feel pain? Pain is normally a signal that your body has been damaged, or that something is wrong. It stops us from doing things, which has two effects: In the case of physical injury it stops us from making the problem worse e.g. walking on a broken ankle. It forces us to rest, giving our bodies a chance to heal themselves. Why? We feel pain when the nerves in our body send electrical impulses to our brain. The brain then interprets these signals as pain. Thus you could say that all pain comes from the brain. The brain controls not only whether or not we feel pain, but: The quality of that pain The way that we experience it. Pain is an opinion Vilayanur Ramachandran - Neuroscientist

3 Acute or Chronic? Acute or Chronic? Acute Pain Acute pain normally begins suddenly and has a clearly defined cause e.g. an injury or infection. Acute pain might be mild and last just a moment, or it might be severe and last for weeks or even months, disappearing once the cause of the pain has healed. Chronic pain Chronic pain is pain that, has lasted for more than 6 months and either: - Persists after the initial injury has healed OR - Is the result of a disease with no known cure e.g. arthritis Sometimes chronic pain has no known cause, which can be particularly difficult to manage because of the uncertainty associated with the condition. Chronic pain can last months, or even years, and will have both physical and psychological effects.

4 Side effects of Chronic Pain For many chronic pain suffers the pain itself is not the biggest problem. It s living with the pain. The constant physical and mental toll that living with pain takes. Side Effects Chronic pain often affects every aspect of the sufferer s life. Things that used to be simple to do become almost impossible. Things that used to be pleasurable are now dreaded. Chronic pain results in: Fatigue Forgetfulness An inability to focus Depression, anxiety and anger These things then often take their toll in all the areas of the sufferers life: relationships, work, leisure. So much so that people suffering from chronic pain can often find themselves lonely and isolated with very little to look forward to.

5 What works for you Factors that affect pain There are a variety of factors that affect pain. Some are common to all and some are unique to you. 1. Diet The better you eat, the healthier you will be and the more able to cope with pain. Weight reduction can also significantly improve certain types of chronic pain. 2. Alcohol and Cigarettes Both alcohol and smoking affect your brain chemistry making it more difficult to cope with and manage pain. 3. Exercise This can be especially difficult if you are in pain, but the effort it may take to find a suitable activity that works for you will be more than rewarded, as the exercise boosts the natural pain-killing chemicals that your body produces. 4. Sleep Sleeping well is crucial to stress management, and hence to our ability to cope with pain. 5. Pacing Constant pain is exhausting. It s important to learn your limits and how to manage the things you want to do in a way that allows you to feel productive without exhausting yourself.

6 Understanding Pain Rubbing it better The Pain Gate Theory If you then rub your foot, this activates sensory nerve fibres. Signals in sensory fibres travel much faster than those in pain fibres. Signals in sensory fibres cause the pain gates to close. If there are only a small number of pain signals the gate can be shut completely, and the pain disappears. If there are lots of pain signals then the gate can be shut partially, which eases the pain. It is believed this is why therapies such as massage, acupuncture and TENS can be so effective is helping to manage pain. They activate the sensory fibres and close the pain gate. FACTORS THAT OPEN THE GATE: Stress and tension Lack of activity Focusing on the pain FAST PAIN FIBRES (33 MPH) OPEN SLOW PAIN FIBRES (3 MPH) FACTORS THAT SHUT THE GATE: Relaxation Hypnosis, inc. self hypnosis Physical Activity Focusing on things you enjoy Medication CLOSE SENSORY FIBRES (89 MPH)

7 Understanding Pain It s all in the mind Because pain is your brain s interpretation of a series of electrical impulses, your mind can have a huge impact on how your experience pain. Opening the Pain Gates 1. Stress and Tension Feeling depressed, anxious and / or angry and the accompanying stress and tension cause the pain gates to open and the signals to be amplified. Because your brain is trying to protect you it makes the pain worse to try and make sure you don t do more damage. 2. Thought Patterns One of the most effective ways of opening the gates is to focus on the pain. When you are constantly in pain, it can be hard not to think about it. Unfortunately though thinking about it makes the gates open wider. For this reason boredom can also lead to the pain gates opening. Closing the Pain Gates 1. Relaxation and Contentment Thinking positively, focusing on the good and feeling relaxed has been found to help to close the pain gates 2. Thought Patterns Focusing on things you enjoy can be tremendously useful in easing pain because: The distraction helps to close the gates. Thinking positively causes the brain to produce pain-killing chemicals that work to close the gates. 3. Self - hypnosis Because of the powerful influence your brain has on your body, self hypnosis can be a highly effective way of managing pain.

8 Thinking about YOUR pain Rubbing it better The influence your brain has on pain means that your experience of your pain will be completely unique. It is simply impossible to understand or navigate your pain by using someone else's experiences - even if their pain has exactly the same cause. Knowing about the Pain Gate Theory will allow you to experiment with some of the ideas above to find out what factors cause YOUR pain gates to open and close. Factors that make my pain gates open:

9 What do you think? Closing my Pain Gates Factors that make my pain gates close: As you experiment with different things you ll be able to develop comprehensive list of what works for you and what doesn t. Below I ve suggested 3 experiments that my clients have found to be particularly helpful.

10 We re all individuals Experiment 1: Breathing Over the next few pages I ve outlined a few different things that you can try to help train your brain to close your pain gates more effectively. The first is breathing. When you are in pain and your muscles are tense it can be easy to breathe badly. Spending a few minutes focusing on your breathing can really help to calm and relax you. Here are 2 of my favourite breathing techniques: Technique 1: Basic Breathing You may have to experiment a bit with the exact timings. Once you have them perfect for you, practise for a few minutes each day: Sit or stand up straight and place your hand on your tummy Breathe in slowly through your nose for about 5 seconds. Really focus on feeling your tummy inflate like a balloon. Hold your breath for about 3 seconds Breathe out slowly and gently through your mouth for a count of about 7 seconds, concentrating on feeling your tummy deflate.

11 What works for you Technique 2: Rectangle Breathing Breathing This technique is brilliant because we are almost always surrounded by rectangles. Windows, door frames, cereal boxes The technique is very simple Focus on the rectangle of your choice Breathe in as you trace the top short edge Breathe out down the long edge Breathe in along the bottom short edge Breathe out up along the other long edge. Repeat until you start to feel calm. Once you feel you ve really mastered the art of breathing you might be tempted to give meditation or mindfulness a go. If you do I have listed some resources that might be helpful at the end of this guide.

12 Experiment 2: Self Hypnosis It may seem almost unbelievable that a few minutes of self-hypnosis can significantly alter your pain levels. However the power of your brain is immense and I really urge you to try this before discounting it. Breathing Find somewhere quiet and comfortable to sit or lie down Close your eyes and spend a few minutes focusing on your breathing using one of the techniques above. When you re feeling nicely relaxed imagine, in as much detail as you can, that you are inside your brain. In front of you, you can see a door. A big heavy industrial door that is labelled Control Room Imagine opening that door and walking into a huge control room. Lining the walls are dials, gauges, knobs, and levers. As you look around you will find a bank of instruments for controlling pain. As you move closer you will see that each part of your body has it s own gauge and knob / dial / lever. Find the one for your pain e.g. Left Hip When you find it you will notice that the needle on the gauge may be quite high. It may even be in the red.

13 Experiment 2: Self Hypnosis Breathing Notice where the needle is, and then look for the knob / dial / lever that controls it. Slowly begin to turn the pain down - watching the needle as it slowly falls. As it falls you may notice other things going on in the room. The sound of steam escaping from a vent, the loosening of a spring. The more details you notice the more effective the technique will be. Continue to turn your pain down until the needle reaches a 1 or a 2 on the scale. You can now leave the room and get on with your day - knowing that you can come back at any time. It s best to experiment with this technique when you are calm and quiet. However the more you practise it, the better you will get at it, until eventually you will be able to quickly just nip into the control room and turn down your pain whenever you are and whatever you are doing. Of course no one technique is perfect for everyone, so in the resources section at the end of this guide you will find recommendations for resources with alternatives for you to try,

14 Experiment 3: Thinking Positively Focus on the Good My children are still at school, and at school when they finish a piece of work they have to complete 3 stars and a wish. They have to look back on the work they ve completed and write down three things that have gone well and 1 thing that they would like to achieve next time. This technique can be great to help train your brain into a more positive way of thinking, which will increase serotonin production and your ability to cope better. So at the end of each day, write down: 3 things that have gone well in the day / that you are grateful for 1 thing that you hope to achieve the next day. This might be something really small, but it might also be something big. If it is something big take a few minutes to try and break it down into smaller steps that are more achievable.

15 3 Stars and a Wish Date: Focus on the Good W Date: W Date: W

16 Resources Books Teach Yourself To Meditate by Eric Harrison Resources How to Meditate: A Practical Guide to Making Friends with Your Mind Hardcover by Pema Chodron Mindfulness: A practical guide to finding peace in a frantic world by Mark Williams Self-Hypnosis: The Complete Guide to Better Health and Self-change by Brian M. Alman Apps Calm - A meditation app (free and paid for) Headspace - A meditation app (free and paid for) Zen Garden - All the joy of zen gardening without the mess (free and paid for)