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PAIN/PAIN MANAGEMENT


"All pain serves a purpose. You have to understand the protective language of your body so that you can respond appropriately. Pain is not your enemy. In fact it is one of your greates allies. Pain is nature's perfect alarm system designed to alert you that something is wrong - a message something is happening inside the body, or your body is causing you harm."
From 3 Minutes to a Pain Free Life by Joseph Weisberg & Heidi Shink

 

Pain is the body's warning system - a signal to stop and find out what is going on. The spinal cord and nerves, which are located in and beneath the skin, provide pathways for messages to travel to and from the brain and other parts of the body. Pain begins when nerve cells are pressured or injured and then send signals into your spinal cord and up to your brain.

Pain can take on many forms and can be sharp, shooting, stabbing, aching, burning, throbbing, cramping, constricting, a feeling of pressure or numbness/tingling.

Acute pain is a normal response to an injury, is usually immediate and lasts for a short period of time.

Chronic pain is a sign of more serious problems, persisting for a longer period of time. It is not a normal state and the cause is not always evident. It can be intermittent, as in ulcer-related pain, or more constant as in the case of cancer.

Pain is one of the most costly health problems in America. Approximately 8 in 10 adults experience some low back pain. More than 40 million suffer with some form of arthritis, and up to 80 million have recurring headaches.

Other conditions that cause pain are cancer, sickle cell disease, shingles, gastrointestinal conditions, as well as surgery and injuries.

TREATMENT:

Pain Medication/Analgesics

Because everyone responds differently, there is no one type or dose of medication that works for everyone. The World Health Organization has developed a "ladder" for managing pain:

1.Simple analgesics such as acetominophen, salicylates (aspirin) and non-steroidal anti- inflammatory drugs (NSAIDS) should be taken on an as-needed basis for mild pain.For more chronic pain it can be taken on a more scheduled basis to control and or prevent it from worsening.

2. More moderate pain may require higher dose analgesics, which are available by prescription.

3.If pain gets worse a narcotic is added.

The Mind-Body Connection

Pain is a complex interaction between the mind and body. Research indicates that pain causes sparks of activity in multiple areas of the brain - from the pain center to more emotional parts of the brain that can activate sadness, fear, crying, etc. Francis Keefe, PhD, associate director for research at Pain and Palliative Care Program at Duke University Medical Center says "Pain is both a sensation and an emotion. That means that what you are thinking and feeling can modify your pain and make it better - and that is great news because it substantially expands our armament for relieving
suffering." Scott M Fishman, MD, a professor and chief of the division of pain medicine at the University of California Davis, believes like Buddhist monks, meditative practices can physically rewire the brain and it is possible to develop the capacity to resist pain. "It's consistent with what the Buddhists teach: we have enormous power to control the sensations that affect us".

Research also shows that your mood has an affect on how you perceive pain - the more happy and upbeat you are, the more likely you can tolerate it. Diet, exercise and sleep also have impact as they influence your general health and mood. Therefore you can be proactive by eating right, exercising and getting a good night's sleep. This will enable your body to better cope if you are currently dealing with pain, or should something occur in the future. For ideas on how to better take care of your general health : Eat Right For Your Body, Exercise/QiGong, Food:Organic, and Sleep Well. You might also find information of interest in the article on Mind/Body Connection.

 

The July 2007 issue of Prevention Magazine (www.preventionmagazine.com) had an informative article by Richard Laliberte, Natural-Born Pain Killers - Neuroscientists are Discovering Amazing New Ways Your Brain Can Outwit Your Pain.

Findings indicate that:

  • You can intensify pain espisodes by putting a negative spin on your pain - fearing it, dreading it, considering it the worst thing in your life.
  • You can signficantly reduce your pain by recognizing and blunting such noxious thinking.
  • You can actually shut down the signals that are responsible for pain by doing relaxation exercises such as meditation, guided imagery and deep breathing. (See our article on Meditation)

This article also referenced a study conducted at Stanford University School of Medicine Pain Managment Center that had pain patients undergo MRI's, initially asking them to try to increase their level of pain through visualization. Then they were asked to think in ways that might reduce the pain, such as focusing on an area of the body that didn't have pain, or repeating affirmations such as "I am going to be okay", "This is going to get better". The results were a surprise to the researchers - the study's leader, Shan Mackery, MD, said "It was really exciting to show for the first time that were people were able to direct activity away from a specific region of the brain - in this case, the area that processes pain, and alter their perception of pain at will. It gave subjects a profound sense of empowerment and opened a window on pain in the brain that has huge implications".

Expectations about pain can be self-fulfilling: If you think it will be bad, it will be - and you might even feel worse than you should. Wake Forest University School of Medicine conducted a study and told participants they would not feel much pain (in the form of nonharmful heat), but then were stimulated more severely than expected, and they rated their discomfort 28% lower than they did when told it would hurt more. Their conclusion was that if you anticipate the worst, areas of the brain that process pain become more active even before you feel what causes it, and continues to be more active during and after the stimulus. "Your attitude affects how bad you'll feel."

Some of the Recommendations for Reducing Pain in the article included:

Use your imagination: Create mental images that make the brain reinterpret pain and diminish its power. Visualize yourself in a room where a healer lays soothing hands on you; picture a fire extinguisher dousing the pain's fire; watch the pain float out of your body; picture a favorite place (like the beach, mountaintop, etc) and try to recall as many sensory details as possible including colors, sounds and smells. For additional ideas see Visualization.

Practice Relaxation: Focus on slow, steady breathing; inhale as deeply as you can with your mouth closed to a count of 6, hold the air in your lungs for a count of 4, then slowly exhale for a count of 6 - repeat 3-5 times. For more ideas see our article: Relaxation Techniques.

Refocus on Right Now: The more attention you pay to pain, the more processing power your brain must devote to it, and the more you will hurt. Pay attention and give priority to other signals to create a neurological traffic jam. "The brain can only handle so many messages at once. If you switch on one part of the brain, activity in another part decreases." Robert Gatchel, PhD, University of Texas Southwestern Medical Center.

Talk Yourself Down: When you find your worries escalating, pause and try using positive affirmation to calm things down: Examples: "This is tough, but I can manage" or "I've been through this before and I know the pain will get better".

If you feel your situation is becoming too difficult to handle and your regular doctor isn't able to provide answers, consider asking for a referral to a pain management clinic. They often have doctors, which may include neurologists, anesthesiologists, rheumatologists, and psychiatrists, who are specially trained to deal with pain related issues.

WebMD also had some great tips for alternative treatments and therapies to reduce chronic pain: http://www.webmd.com/pain-management

Other Treatment Choices:

Additional treatments for chronic pain may include:

  • Physical therapy. This may include hot and cold therapy to relieve painful areas of the body. It may also include stretching and range-of-motion exercises to maintain strength, flexibility, and mobility.
  • Transcutaneous electrical nerve stimulation (TENS). TENS applies brief pulses of electricity to nerve endings in the skin to relieve chronic pain.
  • Professional counseling (such as cognitive-behavioral therapy). This treatment focuses on your mental health and conditions such as stress and depression, which can accompany chronic pain and make it worse. It is important to be healthy emotionally as well as physically, to recover from chronic pain.

Your health professional may refer you to a pain management clinic to receive these treatments. These clinics provide a setting where you can receive treatment and learn to cope with chronic pain. Treatment is usually provided by a team of health professionals who work together to address the many possible causes of your chronic pain. You may also receive these treatments from your own health professional or from specialists who treat chronic pain.

Complementary therapies

Complementary therapies may reduce pain, help you cope with stress, and improve your emotional and physical well-being. These include:

  • Acupuncture, a treatment based on traditional Chinese medicine, where very thin needles are inserted into the skin at certain points on the body to produce energy flow.
  • Aromatherapy, or essential oils therapy, which uses a plant's aroma-producing oils (essential oils) to treat disease.
  • Biofeedback, a method of consciously controlling a body function that is normally regulated automatically by the body, such as skin temperature.
  • Chiropractic therapy, a hands-on therapy based on the theory that many medical disorders (especially disorders of the nervous system) may be caused by dislocations in the spine.
  • Guided imagery, a series of thoughts and suggestions that direct a person's imagination toward a relaxed, focused state.
  • Healing touch, which influences a person's physical or emotional health without physically touching the person.
  • Homeopathy, or homeopathic medicine, which is a medical philosophy and practice based on the idea that the body has the ability to heal itself.
  • Hydrotherapy, which uses water, in any form, to treat a disease or to maintain health.
  • Hypnosis, which is a state of focused concentration during which a person becomes less aware of his or her surroundings. Some people learn to manage pain through concentrating in this special way.
  • Magnet field therapy, a treatment that uses magnets to stimulate areas of the body to try to maintain health and treat illness.
  • Massage, which is rubbing the soft tissues of the body, such as the muscles, to help reduce tension and pain, improve blood flow, and encourage relaxation.
  • Meditation, which is the practice of focusing your attention to help you feel calm and give you a clear awareness about your life.
  • Naturopathy, which promotes using organic foods and exercise; maintaining a healthy, balanced lifestyle; and applying concepts from other areas of complementary medicine (such as ayurveda, homeopathy, and herbal therapies) to try to improve health, prevent disease, and treat illness.
  • Yoga, which uses meditation and exercises to help you improve flexibility and breathing, decrease stress, and maintain health.

What To Think About

If you decide to try one or more of these complementary therapies to treat your chronic pain, find a health professional who has special training and, whenever possible, certification in the particular therapy. You may get a referral from someone you trust such as your health professional, family, or friends. Make sure all of your health professionals know every type of treatment you are using to reduce chronic pain.

Additional research I found suggested indicated there are supplements that can be helpful in reducing pain. I have no first hand knowledge that any of these really work, but may be something you can research further or discuss with your doctor.

Capsaicin - and extract of cayene pepper, may ease chronic pain when applied to the skin.

Willow Bark - believed to have been used since 1763 to decreawse pain and inflammation. It is chemically related to aspirin .

L-tryptophan - a precursor to serotonin which regulates mood and may alter responses to pain.

For additional information on natural alternatives to relieve pain check out the National Center for Complimentary and Alternative Health, a government agency that studies alternative medicine, and is a part of the National Institute of Health:http://www.nlm.nih.gov/medlineplus/pain.html

 

 

 


 

 

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