6 Fast Tips for Managing Pain

 

According to the Gate Control Theory of Pain, our central nervous system has neurological gates that open and close. Opening them makes pain worse, closing them makes pain better. It is challenging to figure out what your personal pain triggers are, but there are a few rough guidelines you can follow to keep your gates in check. To remember these guidelines, just remember the acronym DREAM.

Diet: If you had a fancy sports car, would you fill the tank with cheap fuel or the good fuel? Most people would splurge on the good fuel, and your body should be no different. While it is unlikely that pain will be managed completely with just diet, changing your eating habits can help. Specifically consider anti-inflammatory foods such as bell peppers, broccoli, avocados, blueberries and salmon. Eating anti-inflammatory foods regularly can help improve your gates.

Relaxation: This is much more than stopping to rest. Relaxation means taking active measures to schedule time to slow down, take a break and do something that re-charges your brain and body. Stress is a gate opener, relaxation is a gate closer.

Exercise: It really is the best medicine. Not only does exercise improve flexibility and strength, it also improves mood and stress. There are many benefits to exercise, so make it a priority. You may want to set goals for yourself or find an exercise buddy. Maybe you need to set up a reward system. The bottom line is that this needs to be a priority if your goal is to function more.

Activities: If you’re going to be in pain anyway, might as well be in pain doing what you love. Get out and do something that is engaging and fun for you, it will help close your gates!

Mindfulness/Meditation: Mindfulness is about staying in the present moment. We tend to worry a great deal about the past, which is out of our control, and the future, which is also out of our control. To manage this worry and stress, focus on the present moment and be aware of what is happening right now.

Sleep: When you are in pain, it might be difficult to sleep… but the less you sleep, the more your pain increases. It is important to control what you can about your sleep environment and your sleep habits.  Eliminate noise and light pollution from your room, get a comfortable bed and set a sleep schedule where you go to bed and wake up at the same time every day. Most importantly, if you can’t sleep after 15 minutes, get out of bed. You don’t want your bed to become a place of frustration.

Your pain is a moving target, but with a better understanding of your gates and triggers, you can have more control over your life.  Just remember the acronym DREAM and start taking control today!

What is Pain, Really?

Why do we need pain? One way to think about it is like an alarm system. If you imagine that your body is a house, pain is an alarm system warning you that something is wrong. In your own home or office, if an alarm goes off, you are warned to take action to protect yourself. You try to get out, call 911, etc… Pain motivates you to take care of your damaged body parts. Now imagine if your alarm system in your home or office  was malfunctioning. It went off all the time and you couldn't turn it off. How could you work or live in a place where the alarm was always going off? That’s a challenging question. If the alarm in your house or office kept going off, you might just want to have it removed or you would move yourself out of that building. It’s not so easy with chronic pain. You can't escape your body, you can’t remove the signal… but according to the Gate Control Theory of Pain, you can dull the alarm enough to live your life.

 

Pain fluctuates, you’ll have some days that are better than others. Have you ever wondered why? The Central Nervous System consists of the brain and spinal cord. According to the Gate Control Theory of Pain, put forth by Melzack and Wall in 1965, there are gates in the Central Nervous System that open and close. Opening the gates make pain more intense, closing the gates makes it less intense.

 

There are many physical, psychological and behavioral factors that can make gates open and close. Exercise tends to close the gates, improving your experience of pain. Depression and anxiety tend to open the gates, making your pain feel worse. A healthy diet and social life can make pain more tolerable, while consuming drugs and alcohol can make pain worse.  Pain Management is not about eliminating the pain altogether, but having the keys to these gates so that you have more control. When you have more control, you can go do the things that you need to do and be the person you want to be. Pain is always fluctuating, but when you understand your gates and have the keys to them, it can definitely be managed.

 

Finding the Right Chronic Pain Group

Just like other psychotherapy groups, not all chronic pain groups are the same. Some of them are led by mental health professionals, some of them are peer support groups. Some groups actually make members feel worse because they focus on the dark side of chronic pain without offering any solutions. How do you find the right chronic pain group?

First, find a facilitator who understands the Gate Control Theory of Pain. Ron Melzack and Patrick Wall (1962) proposed a new way of thinking about pain. Its not just that tissue is damaged and a pain signal is set off, but rather there are gates in the nervous system that can make the pain feel worse if they are open, and better if they are closed. For example, depression and anxiety open the gates, making pain worse.

Second, find a group that focuses on active coping strategies. Active coping strategies allow individuals with chronic pain to lower their pain levels (by controlling their pain gates) and live a fulfilling life. Active skills can be used independently and at any time.

Third, find a group facilitator who understands opioids. Often many physicians treat chronic pain as if it is acute pain, meaning that they treat it as if it will resolve within 3 months. Chronic pain many go on for years or a lifetime, and it is challenging to continue to prescribe opioids for that long. If group members are interested in reducing their opioids, they will need more active coping strategies to replace the medications.

Finally, find a group with a facilitator who understands the biopsychosocial model. This facilitator will understand the complex interplay between the patient’s injury/illness, psychological factors (such as beliefs about disability, fear, depression) and social factors (such as how their family inadvertently reinforces behavior that limits their functioning).

Just because you are living with chronic pain does not mean that your life is over.With active coping strategies, support and accurate information, a person can still lead a meaningful life with pain. The right chronic pain group can help.