Have Arthritis? On Managing Pain... (7/16/13)

posted Jul 16, 2013, 5:48 PM by Diego Arias   [ updated May 19, 2014, 7:34 AM ]
I was curious to hear the 30 min lecture/interview on "Managing Pain" that was mentioned on National Public Radio (NPR) (http://www.humanmedia.org/catalog/program.php?products_id=306) so I bought the MP3 download (only cost $5). I found it quick and very interesting to hear, especially about how to deal with pain in the last 11 minutes of the segment! (Your basic Windows Media Player on your computer will be able to let you hear this MP3 audio file.)
The public radio series "Managing Pain" explains how people who are experiencing frequent, chronic physical pain (due to arthritis) can lead lives that are productive and truly joyful. It is hard and takes time to accept that your strong, younger body is gone. And learning how to navigate around the limitations imposed by pain without over-dependence on medication, and to break through to a fulfilling life is hard to do alone. The difficulty of not being able to plan activities ahead of time because you don't know how you will feel on any specific day is frustrating to you and your family members who want to spend time with you. Depression and anxiety are the most common emotional reactions to pain, according to physician Margaret Caudill who is the author of "Managing Pain Before It Manages You" (http://www.amazon.com/Managing-Before-Manages-Third-Edition/dp/1593859821/ref=sr_1_1?ie=UTF8&qid=1373992027&sr=8-1&keywords=Margaret+Caudill+%22Managing+Pain+Before+It+Manages+You%22). She says that "after some time, pain is described by most people as making them feel unlovable or ugly, and it takes them away from their social support because they believe they're no fun to be around, so people stop calling them. Or, they don't even like to be by themselves which adds to their depression. When the pain goes on for months or years, it can be very fatiguing and anxiety provoking.
Although some patients get overwhelmed from the pain, most people can learn proven techniques that help manage the anxiety that accompanies and aggravates physical discomfort. Feeling distress is a principle of normal human psychology. The actual sensation of physical pain is one thing, while our emotional distress from being in pain is different. Medical science does not have good tools for accurately measuring how much pain sensation a person is experiencing, and people don't make the distinction between the two. Therefore, the pain experience is actually a combination of the actual physical sensation and the way the person reacts to that sensation. Increasing the dose of a medication may not necessarily relieve the pain because the patient's reaction to pain (distress) is not affected by the dosage increase. You have to exploring new skills to help you get past feelings of helplessness and isolation. Keeping a simple diary to track perceived levels of pain throughout the day may help reveal useful patterns.
For one Rheumatoid Arthritis (RA) patient, it meant having to accept her chronic condition, and that there is no miracle cure. She accepted that she will probably always have RA. But that didn't mean she couldn’t live a useful, happy life. It just meant that she had to accept her limitations. After accepting this, she was able to listen to her body and take care of herself (listen to music, take a break, or do things that help her relax like take a hot bath). She began to add some structure to her life, like preparing food over several days instead of all at once. Attending a chronic pain support group has been very helpful in her insights and finding strategies that work. People with chronic pain are usually more empathetic towards others who experience pain.
Pain is a stress on your mind, body, and spirit--so stress management & relaxation techniques are extremely helpful. Your preferred relaxation technique could be a repetitive prayer or meditation or yoga or anything that quiets and focuses the mind repetitively and elicits the relaxation response. These relaxation techniques help people deal with the stress that the pain causes them. It helps them to have a better quality of life and helps with sleep deprivation or other impacts from the pain. A helpful relaxation technique is described next. Sit quietly in a comfortable chair with your eyes open or closed. Because the mind chatters a lot, you need something to focus on. This can be a candle flame, or a word like "peace" when you breathe out, or the number "1" when you breathe out and the number "2" when you breathe in. It doesn't matter what you focus on, but it is important to focus on something. And when your mind wanders off (and it will) you just bring your mind gently back to the focus and go on with the breath control. This technique doesn't help the pain sensation, but it does help relieve the pain caused by your body's reaction to the stress (e.g. tight muscles, etc.). Imagery is described as an effective pain management tool also. For example, use your imagination to walk on the beach in your mind. This helps to relax because the more pain you feel the more tense your body gets, so learning to relax will decrease how your body reacts to pain. Learning to make changes on how we speak to ourselves will also help. The way we nurture ourselves can affect our quality of life. Someone who is facing persistent pain can "talk themselves" into feeling more miserable because that is where the mind is focused on, so relaxation techniques helps calm down the chattering mind and puts the focus away from the pain.