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Chronic Pain - It is Possible to Get Better!

Friday, November 22, 2019

By: Scott Bloomfield PTA

Do you have chronic pain after visiting several medical professionals?

When you’re someone who has been dealing with chronic pain for a while, this can leave you feeling resigned to the fact that there are no other options. You’re not alone. Chronic (persistent) pain impacts an estimated 100 million Americans and with an estimated cost upwards of 560 billion dollars. 1 The good news is there are many ways to help yourself out of this hole and I am going to cover several strategies to help you.

1. Understanding your pain – Is this chronic pain or damaged tissues?

Step one is making sure you’ve received the proper medical care: have you been treated by a doctor that specializes in your diagnosis? If not, Connecticut Orthopedics offers a variety of locations and doctors to secure a proper diagnosis and treatment plan. Oftentimes, MRI's and X-rays show nothing "wrong". If this is the case, and your physician has ruled-out a serious condition, you may still find yourself with pain. What is causing this, and what should you do ?? 

This often leaves you with the feeling of: it still feels like I have something wrong. As medical professionals, we know most bones, muscles, and tissues will heal as well as they can within 3-6 months. So, what happens when the body has gone through the healing process, but you still have pain? 

The latest research shows that pain can occur in the body without damage to the tissues. Instead of tissue damage causing your pain, it can be a result of over-sensitivity of the nervous system. This is how the brain and nerves perceive the experiences you are having. Ever notice that your pain levels increase when you are stressed? Have you ever winced when you saw an athlete get hurt on TV? Have you ever been in the ocean and had something touch your foot and it made you jump or scream even though it didn’t hurt? These are all good examples of how everyone has sensitivities in their nervous system that can elicit a pain response without damage to your body’s tissue.

2. Understanding your own unique pain sensitivities – Identify your triggers.

If you are someone who has been dealing with chronic pain, you have probably noticed certain activities that increase your pain or find yourself avoiding certain activities altogether such as lifting a box or navigating stairs. Stressful situations such as work, or dealing with traffic, can also trigger nerve sensitivities. While these are just examples, everyone has their own unique experiences that help shape who you are, and that is how you can perceive pain. Tackling these obstacles requires being honest with yourself and your outlook of these activities , why they hurt, and your avoidance of them.

3. Tackling the problem head on – Gradual exposure

What is gradual exposure? Gradual exposure is a highly effective technique at reintroducing an activity or slowly improving your tolerance to a task you have been unable to do or have been avoiding. As the name implies, you’ll be slowly (gradually) begin testing your ability to complete certain tasks, then slowly increasing the amount, or the time of the activity. For example- maybe you have been avoiding going for walks because of the pain you experience when you complete the walk. With gradual exposure you would start off small, maybe ¼ of what you would normally do. Then, slowly start to increase your walking time. Another example would be lifting or squatting, which is a common complaint with back or knee pain. Using gradual exposure techniques, you would lift lighter items and slowly increase the weight or start with a small squat and slowly work deeper into the squat. Sometimes this can be tough to manage yourself so, if you’re having difficulty, consider consulting with a physical therapist.

4. Holistic approach – Make positive changes.

Are you not feeling ready for gradual exposure? There are other ways to make changes in your life to improve your pain. Here is a list of self-care approaches that will make you feel better.

    1. 1. Sleep Hygiene
      1. Are you getting a good night’s sleep? If you aren’t getting the recommended 7-9 hours of sleep a night, you are missing out on the critical time your body needs to heal itself. This is also will help reduce sensitivity of the nervous system. Proper sleep will allow you to start your day fresh without carrying over pain from the previous day. Think of this as starting with a full tank of gas to handle any discomfort you might face.
      2. Attention to back pain patients: How old is your mattress? If it’s been over 10 years and you have been waking up into back pain, it is most likely time to consider replacing your old mattress.
    2. 2. Diet
      1. If you are having trouble making physical changes to your daily routine, making dietary changes is an effective way to improve your pain. There are two changes that you can consider making to improving your diet.
        1. Lower caloric intake with healthier food choices. A healthy diet and eating less offers several health benefits. If you are considered overweight after consulting a physician, losing weight takes pressure off your joints. Feeling like this is too much to of a mountain to tackle? Consider this: while losing 5lbs may not seem like much; due to multiplied forces when we move, losing 5lbs of weight can equal up to 20lbs of force off your knees. So next time you step on the scale and it’s just a little bit less, you should feel good about that positive change.
        2. Consider an anti-inflammatory diet. Discuss with your doctor or physical therapist if your pain is being exacerbated by inflammation. If so, consider looking into an anti-inflammatory diet. There is considerable research supporting this option. Consider visiting Harvard Health 2 for general information on anti-inflammatory foods.
    3. 3. Change your outlook – Make internal changes
      1. Goal setting. Maybe making a goal being pain free, isn’t the best goal for you. If you grade each day on whether you had any pain, chances are you are setting yourself up for failure. Consider setting more short-term goals for yourself. Instead of looking at, I have pain when I walk -consider I have 6/10 pain when I walk for 10 minutes. Be more specific.When you begin to track your progress with your pain, you’ll have a much better idea if you’re getting better. That way in a month’s time, when your pain is less when you are walking, or you can walk farther; you will feel much better about yourself.
      2. Talk to someone. This could be your doctor, your physical therapist, or a psychologist. Most of us have so many things going on in our lives- don’t try to tackle your problems alone. If you are feeling overwhelmed either physically or mentally, the best thing you can do is talk to someone that can help you get things going in the right direction.
    4. 4. Exercise
      1. Lastly, EXERCISE! The current recommendation for adults is 150 minutes of moderate exercise or 75 minutes of vigorous exercise weekly. 3 Other than the obvious benefits of improving your endurance, your strength, and losing a few extra pounds; exercise has shown to have other important effects on the body. Just 20 minutes of moderate exercise releases endorphins which reduce pain and make you feel happier. So, if you are looking for ways to wean off pain killers, exercise is your substitute.

About the Author: Scott Bloomfield is a PTA at Connecticut Orthopaedics. Earning a BS in Kinesiology and AS in Physical Therapist Assistant, Scott has specialized in outpatient orthopedics. Scott works with clients of all age ranges, including helping those with chronic pain the past 5 yrs.

References:

  1. Gaskin, Darrell J. “The Economic Costs of Pain in the United States.” Relieving Pain in America: A Blueprint for Transforming Prevention, Care, Education, and Research., U.S. National Library of Medicine, 1 Jan. 1970, ncbi.nlm.nih.gov/books/NBK92521/.
  2. Harvard Health Publishing. “Foods That Fight Inflammation.” Harvard Healthhealth.harvard.edu/staying-healthy/foods-that-fight-inflammation.
  3. Current Guidelines, health.gov/paguidelines/second-edition/

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