4 Tips for Managing Chronic Pain

Have you had pain for what seems like a long time? Does the specific pain you have seem to be turning into pain not just at the site of an initial injury…but everywhere? You may be suffering from chronic pain.

Chronic pain is defined as pain that has been ongoing for more than six months, or pain that may continue even after the injury or illness that caused it has healed. It may be affecting your relationships, affecting your ability to perform work or household duties, or causing depression and anxiety.

It is important to note that pain is a product of the brain and nervous system, not the body, and is not always triggered by injury or degenerative changes. Pain is like a jig-saw puzzle and all the pieces have to be put together the right way to complete the picture.

Let’s take a look at why you still may have pain, tips that may help, and unique pain management resources available at Penn Medicine Lancaster General Health.

Why You Still May Have Pain

Most tissue (bones, muscles, etc.) in our bodies heals within three to six months. Pain that continues after this period typically points to a hypersensitive nervous system. In other words, the body’s “alarm system” stays in alarm mode even after healing has taken place. 

Hypersensitivity increases the signals in your nerves and changes the way your brain functions. This results in feeling pain easier and quicker than before the injury. While initially, the goal was to allow healing to take place, the focus now turns to calming down the nervous system. Here are some tips.

Relaxation

Relaxation therapy involves learning specific techniques to assist in experiencing the relaxation response. Benefits include the production of endorphins, which create a feeling of well-being and pain relief. As the techniques are practiced, the body responds with more relaxed muscles, slower breathing and heart rate, and even lowered blood pressure. All of these things physically benefit your body, improving your overall health. 

The goal for relaxation therapy is finding something that works for you. Some find relaxation in crafts or reading a book, while others find relaxation in meditation or breathing techniques. 

Here are several examples to help you manage your pain with relaxation:

• Belly Breathing: Begin sitting in an upright position with one hand on your upper belly and your other hand on your chest. Take a deep breath in, feeling your stomach expand against your hand, then breathe out. Repeat. You should not feel any movement in your chest as you breathe.
• Progressive Muscle Relaxation: Sit in a quiet space with no distractions. Think about each body part starting with your toes and moving up your body, slowly tense up that body part for 5-10 seconds and then release the tension.
• Quiet Meditation: Start in a sitting position and focus on something (your breath, a physical object, a particular saying you like) and focus on that item to help cultivate a more peaceful state of mind. Each time you find yourself drifting or distracting return to your original item of focus.

Diet 

Poor diet and obesity contribute to the inflammatory process, which is directly related to pain. Focus on healthy options.

• Colorful whole fruits and vegetables provide vitamins and minerals, while reducing inflammation
• Healthy fats such as avocados or fish 
• Fiber, such as flax seed, promotes adequate bowel movements and adds healthy bacteria to your gut 
• Moderate amounts of organic meats such as grass-fed beef or free range chicken
• Spices and herbs such as garlic, turmeric and ginger, add an anti-inflammatory component to your diet

Exercise 

Exercise helps calm the nervous system. Find an activity you like, such as gardening, walking or running. Any physical activity that is enjoyable would be appropriate. While it would be beneficial to complete one form of physical activity each day, a brisk walk for 20 to 30 minutes, four to five times a week, is a good goal. It is okay to exercise up to the point of discomfort, but not beyond. Doing this will allow your body to improve its activity tolerance, lessening the discomfort without creating new aches or pains.

Note: When exercising use the “2-Hour” rule. If you still have pain following exercise for more than pain hours after you stopped, you may have done too much. Next time, decrease the intensity of the exercise. 

Sleep 

Sleep increases the chances that chronic pain will come to an end over time. As such, it is important to establish an evening routine in preparation for sleep.  

• Limit screen time about an hour before bed
• Do not take any naps during the day
• Do not smoke, drink alcohol, or drink caffeine a few hours prior to going to bed
• Make sure your room is dark and cool
• Use comfortable bedding and pillows
• Attempt to go to bed around the same time each night and wake about the same time each day
• If you continue to have difficulty with sleep contact your physician to talk about possible use of medications

Pain Management Program

The Pain Management team at Penn Medicine Lancaster General Health consists of physicians, anesthesiologists, a physiatrist, psychologists, physical therapists, and occupation therapists specially trained to help you manage chronic pain.

With a referral to Pain Management, you will meet with a doctor or physician assistant who will oversee your care, including any medications, injections, acupuncture, or other interventions designed to alleviate your symptoms. Every approach is tailored to a patient’s individual needs.

Physical and occupational therapy are often provided in conjunction with the medical treatment to promote improved motion, strength and function. Progressive exercise reverses deconditioning and teaches your nervous system that you can move normally again and not hurt.