- Coping
Strategies: Physical Methods of Pain Management
Heat and ice: Heat, in the form of warm
showers or hot packs, can relieve chronic pain or stiff muscles. Cold
packs or ice packs provide pain relief by numbing the pain-sensing nerves
in the affected area. Cold also helps reduce swelling and inflammation.
Depending on which feels better, apply heat or cold for 15 to 20 minutes
at a time to the area where you feel the pain. To protect your skin, place
a towel between your skin and the source of the cold or heat. Some simple
ways to make heat and ice packs are listed below:
- Warm towels or hot packs in the microwave for a quick
source of heat. (Handle carefully.)
- Make instant cold packs from frozen juice cans or bags of
frozen vegetables.
- Freeze a plastic, resealable bag filled with water to make
a good ice bag.
Transcutaneous Electrical Nerve Stimulation (TENS):
A TENS machine is a small device that sends electrical
impulses to certain parts of the body to block pain signals. Two
electrodes are placed on the body where you are experiencing pain. The
electrical current that is produced is very mild, but it can prevent pain
messages from being transmitted to the brain. Pain relief can last for
several hours. Some people may use a small, portable TENS unit that hooks
onto a belt for more continuous relief. TENS machines should only be used
under the supervision of a physician or physical therapist. They can be
purchased or rented from hospital supply or surgical supply houses;
however, a prescription is necessary for insurance reimbursement.
Braces and supports: Spinal supports or
braces reduce pain and inflammation by restricting movement. Following a
vertebral fracture, a back brace or support will relieve pain and allow
you to resume normal activities while the fracture heals. However,
continuous use of a back support can weaken back muscles. For this reason,
exercises to strengthen the muscles in the back should be started as soon
as possible.
Exercise and physical therapy: Prolonged
inactivity increases weakness and causes loss of muscle mass and strength.
A regular exercise program and physical therapy can help you regain
strength, energy, and a more positive outlook on life. Because exercise
raises the body’s level of endorphins – or natural pain killers produced
by the brain – it will relieve pain somewhat. Exercise also relieves
tension, increases flexibility, strengthens muscles, and reduces fatigue.
A physical therapist can help you reorganize your home or work environment
to avoid further injuries. Physical therapists also teach proper posture
and exercises to strengthen the back and abdominal muscles without
injuring a weakened spine. Water therapy in a pool, for example, is one of
the best exercise techniques for gently improving back muscle strength and
reducing pain.
Acupuncture and acupressure: Acupuncture is
the use of special needles that are inserted into the body at certain
points. These needles stimulate nerve endings and cause the brain to
release endorphins. It may take several acupuncture sessions before the
pain is relieved. Acupuncture has been used for centuries in China and
other parts of Asia to treat many types of pain.
Acupressure is direct pressure applied to areas that trigger pain. This
technique can be self-administered after training with an instructor.
Massage therapy: Massage therapy can be a
light, slow, circular motion with the fingertips or a deep, kneading
motion that moves from the center of the body outward toward the fingers
or toes. Massage relieves pain, relaxes stiff muscles, and smoothes out
muscle knots by increasing the blood supply to the affected area and
warming it. The person doing the massage uses oil or powder so that her or
his hands slide smoothly over the skin. Massage can also include gentle
pressure over the affected areas or hard pressure over trigger points in
muscle knots. Note: Deep muscle massage should not be done near the spine
of a person who has spinal osteoporosis. Light, circular massage with
fingers or the palm of the hand is best in this case.
Coping Strategies: Psychological Methods of Pain
Management
Relaxation training: Relaxation involves
concentration and slow, deep breathing to release tension from muscles and
relieve pain. Learning to relax takes practice, but relaxation training
can focus attention away from pain and release tension from all muscles.
Relaxation tapes are widely available to help you learn these skills.
Biofeedback: Biofeedback is taught by a
professional who uses special machines to help you learn to control bodily
functions, such as heart rate and muscle tension. As you learn to release
muscle tension, the machine immediately indicates success. Biofeedback can
be used to reinforce relaxation training. Once the technique is mastered,
it can be practiced without the use of the machine.
Visual imagery and distraction: Imagery
involves concentrating on mental pictures of pleasant scenes or events or
mentally repeating positive words or phrases to reduce pain. Tapes are
also available to help you learn visual imagery skills.
Distraction techniques focus your attention away from negative or painful
images to positive mental thoughts. This may include activities as simple
as watching television or a favorite movie, reading a book or listening to
a book on tape, listening to music, or talking to a friend.
Hypnosis: Hypnosis can be used in two ways to
reduce your perception of pain. Some people are hypnotized by a therapist
and given a post-hypnotic suggestion that reduces the pain they feel.
Others are taught self-hypnosis and can hypnotize themselves when pain
interrupts their ability to function. Self-hypnosis is a form of
relaxation training.
Individual, group, or family therapy: These forms of psychotherapy
may be useful for those whose pain has not responded to physical methods.
People who suffer from chronic pain often experience emotional stress and
depression. Therapy can help you cope with these feelings, making it
easier to manage your pain.
Coping Strategies: Medication for Pain Management
Medications are the most popular way to manage pain. Commonly used
medications include aspirin, acetaminophen, and ibuprofen. Although these
are probably the safest pain relievers available, they sometimes cause
stomach irritation and bleeding.
Narcotic drugs may be prescribed for short-term acute pain. These drugs
should not be used for long periods because they are addictive and can
affect your ability to think clearly. They also have other side effects,
such as constipation.
Many people with persistent pain that has not responded to other forms of
pain relief are treated with antidepressant medication. These drugs may
work in a different way when used for treatment of unyielding pain. The
body’s internal pain suppression system may depend upon the concentrations
of various chemicals in the brain. These concentrations are increased by
the use of antidepressants.
The above-mentioned methods of pain management are used in various
hospitals and clinics across the country. If you have chronic pain that
has not responded to treatment, you should consult your physician for a
referral to a physical therapist or a clinic specializing in pain
management.
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