Self Help Strategies for Pain Relief

It’s a sad thing when a person is in pain and there is no one around to help them deal with it.  I know a number of doctors and therapists but they can’t always be there like a phone app.  If you are one of those people – I would like to show you some things that have been helpful for me and those I have treated.

The first thing to do is to have some basic knowledge about what pain is.  Just that knowledge can help to make it less frightening and calm the nervous system down a notch or 2 (sometimes just the knowledge does the trick).  Moment by moment our brain is active.  The nervous system has danger receptors in the body that are constantly active.  Even during sleep our brain is processing that incoming information.  Now comes the point – it’s not pain until the brain says it is!

I’ve mentioned this before but it bears repeating.  The brain takes in the input from our nervous system – and this includes the brain.  It is part of the nervous system.  It houses our deepest emotions, our thoughts, and it processes the input from the periphery and analyzes it in terms of what it already thinks it knows and what it expects.

If I step on a nail or fall off of a roof there are chances that I might really have an injury.  We know that these injuries heal with scar tissue over a period of a couple months or so.  If pain from an injury goes longer than that we can usually safely assume that we now have sensitized nerves as opposed to an injury.  This is good news – because we can do something about sensitized nerves!

That’s right – here are a few things you can do right now to calm down irritated nerves

·       Breathing

·       Slapping

·       Fidgeting/Squirming

·       Roll Down

That’s 4 – count em 4 things you can do right now!

Breathing

I always enjoy watching a show where someone is having something horrible happening and another character reminds them to breath.  Most of our moms probably do that.  You have probably told others to breath.

It’s time to take that advice.  Slowing our breathing down has been shown to calm us down.  It activates the Rest and Digest part of our nervous system.  That calms down the Freeze, Fight, or Flight part of our nervous system.

I don’t recall where I got this format from but for years I have used a simple formula that others have tried with success.  Here it is:

Breath in for a count of 4

Hold the Breath for a count of 1

Exhale for a count of 6-10

Perform for 3 minutes

This has been effective for many.  I hope it is for you as well.

Slapping

I bet you are really wondering about this one!  The Breath work we just looked at was to calm down the nervous system.  The brain tends to either become hyper irritable or to become accustomed to ramped up neurological input.  This ramping up is called accommodation.  The brain just stops paying attention.  In the body this often means that the soft tissues tighten up and get less blood flow.  Blood flow is how oxygen is applied to the skin, nerves, and muscles in the periphery.  In the absence of oxygen we often have pain.

Slapping all over our body brings attention to these areas.  It also increases blood flow for a period of time.  This gives us the ability to move.  In this proprioceptive slapping video you can see how it is done.  I recommend that you twist from side to side before and after to see how we can even increase our flexibility by slapping.

I love this because, just like breath work, it requires no extra equipment.  It can be done almost anywhere.  You can even watch some martial artists and Olympic athletes doing this.  If you insist on spending money you can practice skin brushing.  It will do the same thing! Focusing on what you feel and slowing down as you towel off after a bath our shower is very similar.

Fidgeting/Squirming

This one is just plain fun.  If you are like me, this got you into trouble in school.  I always tell teachers about this technique.  It’s actually not a real technique.  It’s just a part of being human.

When a part of our body is not getting enough oxygen because of a lack of blood flow we instinctively move to allow blood to flow back into the area.  This stops the discomfort.  Until we need to move again.

The problem arises when we inhibit this instinctive movement.  Often we stop this type of movement when we are concerned that others might be watching.  We might be criticized.  Worse yet, people might think badly of us.  We sit still and allow the discomfort to progress toward pain.  We really need to get over this.  Maybe I need to create the next best-selling video called “Fidgeting for Fun and Pain Relief " - Oh wait  I did make this video here called "Fidget, Wiggle, and Squirm for Pain Relief"!”

Pelvic Tilt

One of the most effective ways of calming down the nervous system is to utilize gentle movement of the spine.  I often teach the movement in this Pelvic Tilt Instruction Video to people as I work on them.  People regularly let me know how much this particular movement helps them. 

I began doing this type of movement in 1990.  I’ve probably taught it to hundreds.  The video makes it seem easy but some times it needs to be done in steps.  Many people need to just start with the breath work in this position.  Then they add the chin tuck.  The movements often need to stay small in order to be useful.  If you the entire movement too fast can be irritating - so go slow. Slow is fast.  Do it right.  Pay back is sweet.

I hope that these 4 self help techniques will be of use.  They may help you get by until you can get in for an appointment and they will certainly help you to stay better longer.

Am I Strong Yet?

My Roots

We all have to start somewhere.  My earliest experiences with strength training had to do with high school and was often connected to my love of wrestling.  Strength was a key element of the training and we worked really hard.  I was on a team in one school where almost the entire team consisted of state champions – no,  I was not one of them.

What was evident to me was that people who were stronger seemed to do better.  They were no pinned as easily and could often break holds.  I could see it’s importance but it was not something I particularly worked at unless the coach was making me do something like push-ups or sit-ups.  I do have to admit a more than passing interest in Charles Atlas and his dynamic tension.  I just never made enough money to buy his product.  It still sells for about $50!

And Then Came the Army…

I joined the Army to study Physical Therapy.  In my mind it is still one of the most important things that I have done.  I learned a good deal about the body and specifically about how therapy is done.  I was expecting to learn massage and exercise.  

What I actually learned was about 3 hours of massage and exercises for particular issues that are regularly seen in a military setting.  It was a very good foundation but it only emphasized the shortening aspect of exercise.  We specifically focused on strengthening muscles for the purpose of returning a soldier to duty in the shortest amount of time.  We were considered miracle workers by many due to the way we were able to get people out of the hospital so quickly.

One of the things that is burned into my mind is the amount of pain often experienced with our approach.  Many people told me that they really dreaded coming in for their treatment.  PT was said to stand for Physical Torture.  No Pain – No Gain was our slogan.

What I Learned as a Trigger Point Therapist

 I went to school to study Trigger Point Therapy.  It was not like today where one goes and learns to incorporate treating trigger points into a massage session.  This was actually studying Trigger Point Therapy as an actual discipline.  There are not many who actually do that.

One of my favorite memories is of a teach asking us periodically in class – with no time to think about an answer – How we were similar to and different from other specific disciplines.  She asked me about Physical Therapy.  My reply – PT sees a person in pain and asks, “How can I teach that person to exercise and increase their strength to get out of pain.”  A Trigger Point Therapist would ask, “How can I lengthen that person’s muscles to get them out of pain.”

Those 2 perspectives differ greatly.  In my experience I saw more people respond positively to pressing “Trigger Points” than I did to “Strengthening” muscles.  In fact, the strengthening approach often increased the pain so much that people often quit therapy before it was over.  The other really interesting thing is that I found people had more strength after the lengthening process and that it was an instantaneous improvement.  The patient did not have to exercise for weeks or moths to see the improvement!

The strengthening approach has grown in recent years into a movement in PT  Athletic Training that is called Core Strengthening.  It seems to make sense that if we strengthen the muscles most responsible for maintaining posture that we should be able to help more people.  The story about posture is pretty well debunked in my post, “Confessions of a Recovering Posture King.” There are numerous studies that actually show that core strengthening is now really effective at all and was implemented by good marketing instead of by good science.

 I really liked, taught, and used the lengthening approach for many years.  Now I think differently.  It’s time for the rest of the story.

The Rest of the Story

When a person is experiencing pain they learn to avoid it by not using the area.  Our brain, for some reason, has decided that it is safer to shut down and avoid movement in order to protect itself.  In long term pain we learn to guard or hold ourselves long after the injured tissue has actually healed.

This lack of activating the muscle shows up as weakness and we assume – often incorrectly that the body’s defense is actually a defect. This defect must be corrected by strengthening or lengthening – depending on the view adopted by your therapist.  

But……What happens if we simply remove the sense of threat?  What if we could convince the brain that there is nothing wrong with the tissue and that nothing bad is going to happen when we move it?  This is what modern pain science is indicating that we should actually do.

The there are those pesky 95 lb. weaklings with zero pain. They don’t need strengthening to avoid pain.  They may need help opening a ketchup bottle though!

You Can’t Replace Something with Nothing!

If the brain is experiencing a sense of threat when there is no actual threat – What can we do?  There are a number of specific things that we can do.  Here we are simply going to mention a few of them.

We can show the brain that it is safe.  This can be done in a number of ways.  I often do this by passively moving a joint to show the person that it is safe to do so.  I then explain that pain does not necessarily indicate damage to tissue.  If there is redness warmth and swelling – indicators of actual inflammation – there may well be a problem requiring actual medical intervention.  If it is an acute injury it is usually a good idea to have the injury checked out – just to be safe.

You can also move the area where you feel pain.  I encourage people to move the area to the edge of pain and to practice doing that.  With practice – the initial point of pain is passed and greater movement is accomplished.  This is illustrated here by a PT.  He calls it Edge Work.

I often touch the painful area and then stay there as I distract the skin from another location.  This actually fires of stretch receptors in the skin and tells the brain that it is sage.  You can do that with a medical tape such as kinesio tape that is sold in drug stores.

These things commonly lead to strength increases without exercise and without pain. They are things that you can do for yourself.  There is almost always something you can do to help pain.

Christian Pain Management Blog - Pittsburgh: Pain Specialist?

Christian Pain Management Blog - Pittsburgh: Pain Specialist?: A pain specialist is just what it sounds like.  Is your pain new or old?  Does it keep you from doing things at work or with kids or grandkids.  We have an approach for that.  The approach is simple.

·        Calm down the nervous system and begin moving.

·        Look for the things that keep the nervous system on alert.

·        Start to move in non painful ways. 

This is what your body needs and wants.

Don’t look for or expect a specific technique.  That is not what pain treatment is about.  Your nervous system gets to decide what works and there is no one size fits all technique.  Instead – I listen to your story.  That helps me decide what approach I might take.  My technique varies based on your response.  This is all about what your nervous system needs.

Why this approach?  This approach is taken because of how modern pain science tells us your body reacts.  When your brain senses that danger is afoot it often creates pain.  This is a message that your body uses tell you to Withdraw from the pain.  This is like hitting your thumb with a hammer.  Your response is immediate.  You just can’t help it.  You pull your thumb away.  Then you Protect it.  You hold it to keep it safe.  This is where most people are at when they come in for treatment.  Their muscles pull them into a protective cocoon.  This tightening up protects us but tends to keep the blood that carries important “stuff” like oxygen and food to your nerves. Therapy aims to take you toward Resolution.  In this phase you begin to move, the nerves get their nutrients, oxygen and other needed chemicals.  Most importantly, your brain doesn’t sense a threat and tells the body to relax.  It stops – you get relief.

I recommend wearing a tee shirt and running shorts to treatment.  This gives me access to skin if I need it.  Most importantly – you get to be comfortable!