How To Cope With Pain Blog

A recent study in the journal Surgical Neurology recommended that MRI’s be done while the patient is in the position that causes symptoms. This is helpful advice. MRI’s are usually done while the patient is lying down. Lying down takes stress off the spine and changes the positions of spinal structures, sometime making things look normal when there’s really a problem.

The authors of this study cite an example of a woman with complaints of pain in her neck and down her right arm, as well as numbness and tingling in some of her fingers. These symptoms occurred when she turned her head to the right or leaned her head back. She had tried anti-inflammatory medication, muscle relaxants, opiates, and physical therapy, all without benefit.

When she had an MRI sitting up, she had no symptoms and the MRI was normal. However, when she had another MRI with her head back and turned to the right – the positions that caused her symptoms – the MRI showed a disc bulge in her neck. She went on to have an epidural injection, which relieved her pain, and she was able to continue to work.

So this is information worth remembering!

(The study was done by Dr. John W. Gilbert, et. al., and appears in Surgical Neurology, 2008, Vol 69, page 463-465.)

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A reader, Heidi, recently asked about time management and pain. I invited Jeisea of CRPS-RSD A Better Life to share her thoughts about this topic.

Getting the right balance between doing pain management therapy and family, work or social activities is almost like walking a tightrope for people with chronic pain. One of the hardest things is accepting our situation and sometimes letting go of our pre-pain identity. (I found that really difficult.) Often the reality is that we can’t do all that we managed to do before. We need to define what “the new normal” is for us. Pushing on when our body is telling us we’ve done enough can set us back in the long term, so that we “pay for it” later. Above all, I think that we need to believe that we deserve to give ourselves the time to work at helping ourselves.

Although sometimes the direction life takes us derails our best laid plans, our basic survival plan should be pacing and keeping stress to a minimum. It’s easy for me to say ‘pace,’ but in a practical sense, how do you do this? I believe the secret lies in How to Cope with Pain’s articles on changing a habit.

Here’s what works for me. I had to get in the habit of doing this by practicing every day. I divide the day into the number of therapy sessions I can manage. At present I do five a day.

Before I get out of bed, I breathe in for a count of 4 and out for a count of 6-8, with a pause in between. I do 12 sets of in/out breaths, which is about 3 minutes in total. I increase the time by one set occasionally. I then stretch whilst lying down, and finally do some exercises sitting on the bed.
About morning tea time, I do breathing again followed by some different exercises (usually either with weights or a band).
Before lunch, I breathe again and do a different exercise.
Again in the afternoon.
And last, in bed at night, I do muscle relaxation and breathe again.

My exercises don’t take long, and I vary what I do each time. The breathing is calming and is mindful if you focus on what is happening as you breathe. Here, here and here are some good posts on “mindfulness.” Allow yourself time to practice, and develop a routine whether at home or at work. (It’s in your employer’s best interest to allow you time for therapy and rest at work.)

The other things I do are to notice and correct my posture if I’m in more pain or tired, and to try to move “normally.” The more we move normally, the more we reinforce the “OK” message in the brain.

Be guided by your therapists, and remember to be realistic and keep it simple and do-able.

Thanks to Jeisea for her comments on this topic. Readers, what are your thoughts?

This week’s Grand Rounds, a collection of medical blogging, is up at Suture for a Living.

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Today’s our first Monday Chat! The topic:

Your Biggest Challenge and How You Cope with It

Today from 12 noon - 1pm (Eastern US time), I’ll moderate these chats in real-time – comment, and get a comment back right away. For the rest of the day today, I’ll check in to see your comments as often as my non-blogging life allows :) and respond to what you say. Stop back frequently to join the conversation!

You’re also invited to send in topics/questions for future Monday Chats. As well, if you’re interested in being a moderator yourself one week – that is, being “present” 12-1 on a Monday - let me know.

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Welcome to April’s Pain-Blog Carnival… the best posts of this month. Bloggers were busy this month writing excellent posts. Enjoy!

Somebody Heal Me writes about being Weary of So Many Daily Medications.

Laurie at A Chronic Dose explores Summer Camp, Sick Style. (Laurie’s new book is coming out soon!)

The Sassy Lime shares Tips and Tricks I’ve Learned From 3 1/2 Years with Migraines.

The Migraine Girl looks at Missing Out on All the Fun. “It’s frustrating, it’s sad, it’s annoying - but sometimes you have to say ‘no’ to what you really want to do, so you can take care of yourself.

Psychology of Pain shares a story by former BBC Iraq correspondent, Andrew North, whose personal journey with pain led him through, “Why me? Why is this happening? Will it ever end?,” to discovering how his own experiences are reflected in other people’s lives.

Working with Chronic Illness shares some suggestions for paying attention to your body’s signals in When It’s Time to Take Charge of Your Body and Your Schedule.

Health Skills discusses a research study about Reducing Pain-Related Fear in CRPS.

Living with Fibromyalgia shares a wonderful list of 50 Ways to Help a Chronically Ill Friend, inspired by Lisa Copen’s National Invisible Chronic Illness Awareness Week website.

Going Down Swinging: A RSD Blog writes about the Dangers of “Should.”

Coming up on May 12 is International CFS Awareness Day. Fighting Fatigue shares What You Can Do.

CRPS-RSD A Better Life is promoting Awareness of CRPS (RSD). A worthwhile endeavor!

Thanks to everyone for their submissions!
May’s Pain-Blog Carnival will be Wednesday, May 28
Deadline for submissions: Friday, May 23
Send in your submissions here.

Thanks to Jim-AR at Flickr for the photo. The here’s the link to this week’s Grand Rounds, a medical blog carnival.

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Our pain management series has concluded, and I’m interested in how you did!

Was it helpful?
Anything confusing?
Are you continuing to practice all the exercises?
Which ones work best for you?

Please join in, in the comments below.

Next Monday, we’ll be starting “Monday Chats.” I’m envisioning these as conversations with you, as well as a forum for readers to talk with each other. From 12 noon - 1pm on Mondays (Eastern US time), I’ll moderate these chats in real-time – comment, and get a comment back right away. For the rest of the day on Mondays, I’ll check in to see your comments as often as my non-blogging life allows :) and respond to what you say. I also invite all of you to add your own thoughts to the discussion! And of course, you’ll also be able to leave comments at anytime in addition to times on Mondays.

Next Monday’s topic will be: Your Biggest Challenge and How You Cope with It

You’re also invited to send in topics/questions you’d like to discuss with other readers or me. As well, if you’re interested in being a moderator yourself one week – that is, being “present” 12-1 on a Monday - let me know.

I’ll be interested to see how “Monday Chats” go. And all of you will be who makes it a success!

Articles in the Pain Management Class series:

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Today’s the deadline for your April Pain-Blog Carnival submission.

A reader, Lynn, writes “I would be interested in a feature related to multiple sclerosis and chronic pain. Thank you for the empowerment and humanity your website provides – as always, knowledge is power.”

Knowledge can indeed be powerful to help people understand, manage and cope with their illnesses. I’m glad you find How to Cope with Pain helpful!

Multiple sclerosis (MS) is a neurological disease that causes weakness and movement problems. The underlying process is a deterioration in the covering around nerves, which makes nerve signals slow down. A less well-known symptom is pain – which 70% of patients with MS have. And almost ½ of patients have chronic pain.

There are several different types of pain which can occur in MS. Let’s look at these:

1. Pain can occur from muscle spasms, tight and aching joints, and back or musculoskeletal pain. Anti-inflammatory medication (e.g. Motrin), massage, and physical therapy can help these symtpoms.

2. MS can have intense but brief pains, which can be Keep reading →

CRPS-RSD A Better Life recently posted a link to a discussion of mirror therapy by Dr. Eric Altschuler of UMDNJ. I recently spoke with Dr. Altschuler, who is researching mirror therapy for pain disorders, including RSD, stroke rehabilitation, and other conditions.

As I’ve said before, I think these types of approaches are one of the most promising approaches out there for pain disorders. Enjoy!

The deadline for your April Pain-Blog Carnival submission is 4/25. This week’s Grand Rounds is great - posted at Dr. Val and the Voice of Reason.

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Last week we looked at why people with pain disorders have trouble sleeping. Today we’ll look at how you can improve your sleep.

9 ways to get better sleep

Next week will be the last post in this series. We’ll have a discussion next Monday about how you did with this series. Was it helpful? Anything confusing? Are you continuing to practice all the exercises? Which ones work best for you? Please join in!

After the end of this series, I’m going to introduce “Monday Chats.” I’m envisioning these as conversations with you, as well as a forum for readers to talk with each other. For a few hours each Monday, these chats will be moderated in real-time – comment, and get a comment back right away. (Of course, you’ll also be able to leave comments at anytime, but the real-time conversation will only be for a few hours.)

Each Monday for Monday Chats, you’ll be invited to comment on a topic or specific question. You’re welcome at this point to send in topics/questions you’d like to discuss with other readers. As well, if you’re interested in being a moderator yourself one week, let me know.

I’ll be interested to see how “Monday Chats” go. And you will be what makes it a success!

The deadline for your April Pain-Blog Carnival submission is 4/25.

Other articles in the Pain Management Class series:

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A recent study showed that mindfulness exercises can significantly help low back pain in older adults.

8 sessions of training in mindfulness, which is “awareness that emerges through paying attention on purpose, in the present moment and non-judgmentally, to the unfolding of experience moment by moment,” were given to older adults with chronic low back pain. Participants in the study meditated an average of 4.3 days a week and 31.6 minutes per day.

3 techniques of mindfulness meditation were taught. These techniques take regular activities such as sitting, walking and lying down, and transform them into a meditation through directed breathing and mindful awareness of thoughts and sensations. Several attitudes that support mindfulness meditation were emphasized throughout the 8 classes, including patience, non-judging, “beginner’s mind”, acceptance, letting go, non-striving and trust. Letting go of struggle and accepting one’s condition without judgment are critical concepts in mindfulness-based programs.

Significant improvements were seen in 1) acceptance of pain, and 2) physical functioning. The majority of participants continued to meditate at the 3-month follow-up, suggesting they found enough benefit in meditation to continue it on their own. Nearly 1/2 of the participants reported reduction in pain and sleep medications 3 months after completing the study.

Have you tried mindfulness for pain? What’s been your experience?