Brain / Pain management strategies

Brain Science:

          Chronic pain is complex; it can take some time to find the best pain relief that works. There are many options to try, such as hot and cold therapy, yoga, or drug treatments. Chronic pain is defined by health professionals as pain that lasts longer than 3 months, or beyond the normal healing time for the underlying condition or injury

Brain Facts:

·         According to the Centers for Disease Control and Prevention around 20% of adults in the United States had chronic pain in 2016. While 8% had high impact chronic pain.

·         Pain management refers to the techniques to reduce and control the amount of pain.

·          As mentioned previously, chronic pain is complex so the treatment of pain is also complex. Not everything works for everyone and a lot of time can be spent finding what works for whom.

·         Below we are just going to list several strategies, hoping those who suffer from chronic pain will by trial and error find what is appropriate to their particular situation.

§         Physical techniques: Hot and cold therapy. Heat relaxes muscles and dilates the blood vessels. It can also promote healing after an injury. Cold therapy reduces blood flow and reduces inflammation that causes pain. Generally people who have arthritis find relief from cold therapy.

§         Massage: Massage is soft tissue manipulation. People may benefit from this technique when used with other pain management treatments. Studies show that lower back pain is, in some cases positively affected by massage. The jury is still out on other areas of pain.

§         Physical therapy involves techniques to strengthen and stretch the muscles and joints. Therapeutic exercise can have long- term benefits for chronic pain, including helping people cope. There is a technique called dry point needling that is fairly new that has shown promise, especially with regard to trigger points.

§         Acupuncture: it involves a practitioner applying thin needles to the skin at precise points in body. Evidence suggests that acupuncture helps with short term relief from pain in lower back, neck, knee, and osteoarthritis. However, there is little evidence to suggest it is effective over a long term.

§         Mind/body techniques such as cognitive behavioral therapy. A 2013 review of psychological pain technique concludes that CBT is effective at reducing pain immediately after treatment. The technique is useful for reducing anxiety around pain and for improving quality of life.

§         Yoga: aims to relax, strengthen, and keep the body flexible. A 2010 study into yoga’s effects on chronic pain concluded it did not decrease participants pain, but did help them cope, and control how their pain affected their everyday life.

§         Relaxation techniques: Relaxation techniques can help ease muscle tension, muscle spasms, aches, and pains. They can also release endorphins, which are the natural pain killers. (We may at a later date go further into these techniques whether you have pain or not.)

§         Drug therapy: There is a whole world of pain kellers both on the market and by prescription. We can’t go into all of these, but new drugs are coming out every year. Meloxicam is the latest, Gabapentin before that. Both are nonsteroidal anti-inflammatory drugs . Needless to say prescription drugs (vs. over the counter), with the exception of opoids, are preferred and have better regulation than some commercially available. Most over the counter over promise and under perform.

§         Surgery: Only your doctor knows (or your surgeon). There is a whole world of lucrative practices based on surgery to correct back pain etc. Surgery is amazingly effective but not always. Both types of arthritis are especially difficult to treat with surgery. There are limits and surgery can sometimes facilitate bone spurs in arthritis patients.

§         Chiropractic treatments: my sources do not list this but my surgeon suggests that it is a viable and useful technique to relieve pain. He in fact prescribes chiropractic treatments. I have had personal experiences with pain relief. However, the pain relief can be temporary and at some point a more aggressive strategy will be necessary.     

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So What:

Most of the above relates to self management of pain. My conclusion over the years has been that each individual has to find what works for them. Surgery or drugs alone most of the time does not do it. Depending on a surgeon for total relief would be nice but most of the time multiple approaches are necessary. Listening to your doctor helps but not all there is to it.

 Sue recently had rotator cuff surgery. (4 weeks ago) As an air traffic person she was used to following procedures to the “T”. She followed the instructions on the use of a cyro cuff with ice. We changed the ice every 4 hours for 4 weeks! To this date she has had no pain whatsoever. She did her exercises faithfully. The surgery was supposed to be one of the bad ones. It hasn’t been for her so far. The point being that if anything is going to work on pain it has to be worked at. Self management is just that self management. If you are in pain take charge and do something about it. Your brain will thank you.