Top 10 Tools for Managing Chronic Pain – Louisiana Pain Specialists

The Toolbox Strategy

By Dr. Mark Skellie, Psy. D.

If you’ve seen my previous articles, I’m committed to people living with chronic pain to develop a toolbox strategy for coping. The toolbox strategy is really simple: If you have a range of different ways to cope with pain, stress, or other types of emotional distress when one tool does not work, you can go back to the toolbox and find another. Individuals who develop a variety of intentional coping strategies, have a way to face any problem through trial and error. Like they say, if you only have a hammer you tend to see every problem as a nail…

For this article, I’ve developed a Top 10 List of great psychological strategies that work to improve the quality of life for those individuals living with chronic pain. Obviously, this list is not meant to be a summary of all of the possible strategies for managing chronic pain and I would love to hear from you about things that I have not included but are part of your toolbox. The list is also not in any specific order, but as a psychologist I’m obviously biased towards number 10.

Lean on your doc. Ask questions and look for answers.

1. LEAN ON YOUR DOC. Your relationship with your physician and the rest of your pain management team can make a dramatic difference in living well with chronic pain. If you are unsure about something, ask for more information or where to find good information online. Your pain management team is your ally in living well, so make sure to tell them about major changes in your life that affect your pain management or your current treatments.

It is important for you to understand the medicines you’re taking, what they can do for you, and their potential side effects. Then educate yourself about additive or alternative treatment options. Your goal should be to have a normal mood and activity level – if you don’t, then a different medicine might be better for you. Be proactive, to ask questions, and look for answers. A great strategy is to write down questions you want to research and discuss with your pain management team.

Journal. Keeping a pain journal can be a great way to help your pain management team understand and more effectively treat your chronic pain. At the end of each day, record an average daily pain rating between 1 and 10, where 10 indicates the worst pain possible. Then note what you did that day, and how these activities made you feel. The next time you see the doctor, bring the journal and discuss your findings.

2 HYDRATE. According to the Mayo Clinic, dehydration may aggravate the symptoms of some chronic conditions, like headaches and back pain. Although it may be tempting to load up on coffee, soda, or juice, their diuretic effect makes them poor sources for hydration. Water keeps you hydrated without the extra calories, sodium, or caffeine. The recommendation that adults need to drink an 8-ounce glass of water 8 times per day may not be accurate for all people and simply drinking when thirsty may be a better goal. It should be noted that summer increases our need for water due to the extreme heat, so 8 glasses a day is still a smart goal when it is hot. Also, you should try to maintain the 8 glass habit when you are having increased perspiration, high body temperature (or fever), nausea or vomiting, or diarrhea, which magnify your fluid needs.

3 EAT CLEAN. If you’re living with chronic pain, you want to do everything you can to help your body, not hinder it. One way to keep your body strong is to eat a well-balanced diet and reduce your consumption of highly processed food (e.g. fast food, frozen dinners, hot dogs, snack foods, etc). Eating right improves blood sugar, helps maintain weight, reduces heart disease risk, and aids digestion. Aim for a diet rich in whole grains, fresh produce, and low-fat proteins. A diet free from processed foods can alleviate inflammation. Foods that may alleviate inflammation that leads to pain include leafy greens, foods high in omega-3 fatty acids, asparagus, low-sugar fruits and soy products.

Get Spicy. Turmeric is known for its anti-inflammatory properties. This spice is a beneficial treatment for chronic pain. It contains curcumin, which provides a natural way to reduce inflammation in the body, without harming the liver or kidneys. The National Center for Complementary and Alternative Medicine explains that turmeric increases ligament flexibility and boosts the immune system. Add it to meals, or sprinkle it in your tea. Another spice, Paprika, has capsaicin, a natural pain and inflammation fighter. You can also get capsaicin from chili peppers, red peppers, and cayenne pepper. Ginger and garlic may also lower inflammation.

Low-sugar fruits such as pineapple are great anti-inflammatory foods that may alleviate pain.

4 PUT OUT THE FIRE. Inflammation is a process by which the body’s white blood cells and substances they produce protect us from infection with foreign organisms, such as bacteria and viruses. However, in some diseases, like arthritis, the body’s defense system — the immune system — triggers an inflammatory response when there are no foreign invaders to fight off. In these diseases, called autoimmune diseases, the body’s normally protective immune system causes damage to its own tissues. The body responds as if normal tissues are infected or somehow abnormal. Inflammation is a common cause of pain, and certain chemicals in foods may exacerbate it.

A smart goal is to keep food Simple, that is close to a natural state with little modern processing. It is a good idea to generally reduce these possible inflammation instigators:

• Refined Sugar
• Nightshade Vegetables
• Dairy 
• Eggs
• Citrus Fruits
• High-Fat Red Meat
• Refined starches
• Processed Foods
• Red Wine, Coffee, Tea, and Soda

5 BREATHE. It sounds so obvious, but few of us actually take the time to stop what we’re doing and calm our minds. Deep breathing, biofeedback, and meditation are all stress management techniques that relax our bodies, which helps ease pain. Slow down, close your eyes…breathe in…breathe out. It’s important to have patience. Adding new tools to your pain management toolbox can take some time before you can really make them work for you.

Stress management techniques such as deep breathing calms our minds, relaxes our bodies, and helps ease pain.

Try Yoga: Yoga promotes both strength and flexibility while calming the mind and decreasing stress. This centuries-old practice offers a method of stress reduction that can help those suffering from chronic pain, reports the Mayo Clinic. The physical postures of yoga, breathwork, and meditation are all tools in the pain-reduction kit. Stress makes muscles spasm, according to the National Institutes of Health. Because muscle spasms are a part of acute and chronic pain, practicing Yoga and other relaxation techniques helps train your body to relax.

By taking care of your emotional and physical health, you can better manage your pain. That may mean saying no to events or parties if you need the rest. Schedule regular massages or set an unbreakable dinner date with good friends to boost your spirits. How you care for you is unique to you — and it’s also up to you.

6 DISTRACT YOURSELF. You already know that focusing on pain can just make it worse. That’s why one potent prescription for relief is to keep busy with activities that take your mind off the pain. Take that cooking class you’ve had your eye on, join a garden club, go on morning walks with a friend, try a Yoga class. Even if you can’t control the pain, you can control the rest of your life. Get started!

7 PERFECT YOUR POSTURE. Never found the time to make it to a Yoga class or just don’t find the motivation to get on the mat? There are simple ways to bring the posture of yoga into your life. Whether in front of the TV or using your computer at home or at work, maintaining correct posture is essential in fighting pain.
Keep your head directly above a tall, straight spine to prevent strain on your back and neck muscles. Remember, however, that long-standing postural problems will typically take longer to address than short-lived ones, as often the joints have adapted to your long-standing poor posture. Those living with chronic pain can adopt bad posture as a way to try to avoid aches and pains. Awareness of your posture and knowing what is correct will help you correct yourself. With practice, the correct posture for standing, sitting, and lying down will gradually replace your old posture. This, in turn, will help you move toward a better and healthier body position.

• Be more conscious and aware of your posture
• Shoulders back and your stomach pulled in
• Earlobes should be in line with your shoulders
• Try not to sit in the same position for too long.

8 EXERCISE? It’s a Catch-22: You’re hurting, so you don’t exercise; but without exercise, you may lose muscle tone and strength, which can make pain worse. Fortunately, even mild exercises such as walking and yoga release endorphins, the feel-good brain chemicals that lift mood and block pain. Light house-cleaning and playing with your kids are every day activities that can reduce symptoms. Ask your doctor if you are healthy enough for aerobic, strengthening, or stretching exercises. They can give your body the boost — and relief — it needs.

9 QUIT. Some people find temporary relief from stress and pain with a quick smoke or drinking alcohol. The irony is that smoking may actually contribute to pain in the long run. It slows healing, worsens circulation, and increases the risk of degenerative disc problems, a cause of low back pain. The same is true when we rely on alcohol to help manage our pain, because increased alcohol use impacts good sleep and increases inflammation, not to mention can be very dangerous when combined with common pain medications.

If you need an incentive to quit, pain relief just may be it. Ask your doctor about programs and medicines to kick the habit.

10 DONT GO IT ALONE. Reaching out is the most important habit you can develop to help you deal with chronic pain. Tell friends and family what you’re feeling, because they won’t know otherwise. Ask for help. Learn more about your condition. Then share what you know with others.

Talk to a Pro. Talking about your pain with a behavioral health professional who understands chronic pain may help reduce its effects. Commonly utilized methods include cognitive behavioral therapy, biofeedback, and guided imagery. These techniques teach stress management and real-life coping skills. The goal for patients is to improve their quality of life by getting better sleep, and reducing stress. Psychotherapy alone may not eliminate your chronic pain, but it can be effective in managing it.

Find a Group. Most of us listen to the advice or recommendations of someone who has lived the experience. Participating in a support group for other individuals living with chronic pain can open unexpected doors in your progress towards control.

A new FREE chronic pain support group is forming. Please contact Jim Walsch at (504) 858-7933 or painnola.gmail.com for more information.