Alternative Strategies for Managing Chronic Pain
Friday, May 5, 2017
Written by: Cora Tomowich
Hello all and welcome back to my discussion about pain! Earlier on, I wrote a blog about 8 New Ways to Think About Pain, which touched on some of the physiology behind how our brains experience, interpret, and express bodily pain. We also looked at the role of our emotions and circumstances in ramping up the nervous system and ultimately worsening the pain experience. I later wrote another blog titled: Name that Pain: Understanding Chronic Pelvic Conditions, which spoke about some of the most common pelvic pain conditions that I see in clinic.
As I continue along this pain train, I want to talk about treatment. How do we even begin to treat the vast complexity that is chronic or persistent pain? Well, here are some of the coolest, evidence-based methods that we can use to help:
Laughter is an incredibly amazing tool to help manage chronic pain. Research proves that laughter helps to lower blood pressure, increase blood oxygenation, improve cholesterol levels, reduce inflammation, and improve the immune system response. It is also a highly beneficial exercise for it stimulates heart, diaphragm, and other deep core muscle activity, while decreasing excessive tension in the large muscles of the neck, back, and limbs. The motion of the diaphragm and pelvic floor during hearty laughter can help regulate intra-abdominal pressure and improve functioning of the genitourinary, lymphatic, circulatory, and digestive systems.
Laughter has also been found to promote pain-free sleep and emotional health. Laughter also decreases systemic cortisol levels that cause us to experience stress and anxiety, while promoting the release of endorphins that promote positive affect and healing.
So, go ahead and choose to build laughter into each day – Watch funny movies and shows, read funny stories, and cultivate relationships with people who make you laugh! For your viewing pleasure, here is one of my current favourite laughables:
For some patients, knowing more about why we feel pain can be a therapy in itself. I find that simple education helps to reduce the fears and anxieties around chronic pain, which otherwise make things worse. Research shows that basic knowledge helps to decrease the sensation of pain, perceived disability, catastrophization, and improve overall physical performance.
Many of us have been told that when we hurt, we should rest and avoid movement. We have been led to believe that pain means tissue damage and movement only increases that damage. But new evidence-based knowledge tells us that avoiding movement can actually make things worse and engaging in the right kind of movement can help heal damaged tissues and eliminate our chronic pain! See what I mean… knowledge is indeed a powerful ally.
Pain-Free Touch and Movement
In cases of chronic or persistent pain, the brain changes its cortical mapping in an attempt to ignore the areas of the body that are affected by pain – essentially blurring the lines and confusing sensory input. These changes ultimately lead to the development of poor balance, kinesiophobia (fear of movement), and global muscular tension. It’s almost as if the brain tries to mask the pain experience by putting everything on high-alert.
Fortunately, there is a solution to this problem. Techniques like light-touch massage, Yoga, Qi Gong, and Tai Chi have all been found to be pain-free touch and/or movement techniques that help to calm a ramped-up brain and nervous system in the face of chronic pain. Since these techniques do not involve rapid, uncontrollable activity or additional input of pain, they can remind the brain that the body can be touched and moved without it being hurt. And since the brain really likes the lack of painful input into the system, it responds by decreasing its high-alertness and expression of pain. It’s as if the brain were a screaming baby and these gentle touch/movement techniques were the soft, hush tones that help to calm the baby down.
Research has found that Qi Gong helps to facilitate deep abdominal breathing, loosen thoracic spinal tension, help with symptoms of depression, and decrease overall fatigue. Additionally, Yoga has been found to increase body awareness and sensation, improve functioning, and decrease pain. So move right and move lots!
That’s right folks, meditation is not just for Yogis, Monks, and Gurus; it’s for all of us! Traditional definitions of meditation have described it as a mental training practice that is designed to habituate or familiarize oneself with specific types of mental processes of the mind. Since I am not exactly sure what that means, I have come to define meditation as a practice whereby the entirety of our being (body, mind, and soul) is brought into a conscious state of relaxation, or what some have termed a “wakeful sleep” or “relaxed alertness”. Maybe you have your own definition of meditation, which is totally cool; it’s all relative anyways. There are many different forms of meditation such as mindfulness, chakra, walking, working, transcendental, etc. For the purposes of this discussion, I will speak more about mindfulness and its role in managing chronic pain.
The research behind mindfulness meditation as a strategy for managing pain has been incredible. Studies have repeatedly found mindfulness practices to reduce the high negative emotions and stress that we often have during chronic or persistent pain experiences. In 2015, Zeidan et al found that 20 minutes of daily, guided mindfulness meditation demonstrated increased attention and cognitive control, as well as, a decreased activation of the brain’s thalamus – a structure in the brain that reminds us of pain and its severity. Other studies have consistently found mindfulness to significantly improve immune system functioning, reduce anxiety and symptoms of depression, and increase the activity of certain brain centres that cause us to experience positive emotions. Please note that these studies were done on people like you and me… not Yogis, Monks, and Gurus.
In my practice, I always recommend that patients with chronic pain practice daily meditation as part of their home treatment program. Personally, I very much enjoy the meditations from Deepak Chopra, Davidji, and the Innapeace Brainwave Institute; but to each his or her own!
Of course, as always, there is much more than meets the eye when it comes to chronic pain management. If you have any questions about your specific needs, please feel free to reach out… I’d love to hear from you!
- Pelvic Health Solutions [Course – Levels 2 and 3]
- Search Inside Yourself [Book] by Chade-Meng Tan (2012)
- Zeidan F. et al (2015). Mindfulness Meditation-Based Pain Relief Employs Different Neural Mechanisms Than Placebo and Sham Mindfulness Meditation-Induced Analgesia. J of Neurosci. 2015, 35(48):15307-15325
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