Self Help

Most doctors and pain organisations will be right behind us when we say that drugs and medical techniques are only part of the story when it comes to relieving pain, and that other treatments and your own practices are extremely important. The self-help and complimentary options for chronic pain can be absolutely life-changing. There are those of us who give thanks every day for the life-changing discoveries we made because of pain, and the richer lives we lead as a result. At the same time we stay emphatic that sufficient and appropriate pain medication should be available to chronic pain sufferers. Let’s not make a virtue of unnecessary suffering. It isn’t one or the other with Chronic Pain. It’s both. As much pain control as possible and as much enriching our lives and discovery as we can get from working with the pain.

The importance of psychological support for people in pain should not be underestimated. We would add that spiritual support can also be most profound and effective. The often quoted “Man’s extremity is God’s opportunity” may be deeply relevant and important if you are that way inclined. Whether you are or not, you can also try the Shollond Trust  for a fast, simple but profound non-denominational meditation technique. See our Complementary Techniques and Therapies Guide for a wealth of further options.

painSupport is full of good advice and approaches to combining medical help with self help. We’ll concentrate on their advice here because we really like their content and style.

You’ll read on the painSupport website that they are often asked what the difference is between pain clinics and pain management programmes. and what each can offer. They explain that:

Pain clinics offer a wide range of treatment including drug therapy, nerve blocks, manipulation, exercise, electrical methods, some complementary therapies and pain management programmes to teach you self-help skills to control and relieve your pain.

Remember, it’s your choice and your body, you don’t have to have anything anyone suggests to you without finding out everything about it first of all. Discuss with the consultant what the treatment will involve, what the likely benefits will be and also whether there are any risks or side effects involved.

On a Pain Management Programme you will learn how to control your pain yourself, through careful pacing of activities, learning about correct breathing and relaxation, positive thinking skills, exercise and many of the other skills that can be found on the painSupport website.

You could talk to your GP and ask what kinds of treatment you are likely to be offered at the Pain Clinic. You could also discuss with your doctor if it would be a good idea to ask your Consultant if you could be referred on to a Pain Management Course as well as, or instead of, the Pain Clinic.

painSupport has a really excellent menu to explore the techniques for pain relief which you can use to change your life. They are enormously encouraging that you can change your situation, and we know their techniques well enough to agree. We offer a digest of some of their information below. This is just to summarise and be sure that you catch their drift. Do go to the original source. They say the good news is that you already have the power within you to reduce your pain. Those of us who have tried know this to be true. Whether you go to painSupport or one of the other excellent organisations we’ve listed offering similar advice, you’ll find that self help techniques can be amazingly effective for pain control. What’s more they can make life far more interesting and quality of life far better than you may have thought possible.

Pain levels vary from time to time throughout each day. The Gate Control Theory of Pain does much to explain why this happens. The theory uses the idea of a gate, which can be open to allow pain messages through, or shut to stop pain messages being passed to the brain. The gate also opens and closes in response to messages sent from the brain.

The following advice is about how to avoid opening the Pain Gate and to close it as much as possible. We are summarising, so let’s start by picking out a few tasty bits of overall gate-closing advice we really like, including:

• Feeling joyful [easier said than done, but true and look for opportunities]
• Good posture
• Being enthusiastic
• Rubbing the area that hurts
• Laughing

painSupport goes on with much more, and explains quite practically how and why pain management techniques work. We just liked the above for openers. Their management approach includes, mostly in their words:

A Daily Plan
Pain Relief techniques will enable you to get back in control of your life, and encourage the body’s natural healing processes to be maximised. All of the methods suggested can be used alongside conventional medicine. They will enhance the effect of any treatment you may be having. When you help yourself, you empower yourself. You feel that you’re in control of the situation, not the pain. You may not like it, but, for the moment, the pain is here and part of your life. Try to accept it as such and do what is best for it.

Don’t let the days just drift – by giving your days some shape you remain in control and you are more likely to keep pain levels down. Make a daily plan, so as to be sure that essentials, such as relaxation and pacing, are definitely included in your day’s activities.

Pacing – Don’t keep going until the pain forces you to stop. Make sure you space out activities, breaking them up into smaller sections, if necessary. Vary your activities and the posture needed for them. Plan your meal for the day, especially if you’re the cook and the meal needs to be prepared in sections throughout the day.

Exercise – Plan to take some exercise, whether it is walking, swimming or some other activity. Perform a set of exercises that are appropriate to you and your pain. Do them in a relaxed, meditative state. Take advice on which exercises are best for you from an expert, such as a physiotherapist, chiropractor or osteopath. [See our Complementary Techniques and Thearpies Guide and Health Information we Trust list for techniques and opportunities].

Relaxation – Best taken after your exercise session. Let yourself go into a deep relaxation for about 15-20 minutes at least once a day. Sitting watching TV is not the equivalent of relaxation. You need to lie down and really let go so that you allow the production of endorphins, your natural pain relieving agents, to flow. The relaxation will leave you feeling peaceful, centred and with less, or no pain.

Social contact – Try to have close contact with at least one person during the day, family or close friend. painSupport acknowledges in their advice that this is not always possible, but if you can’t do it physically, contact a friend by phone, write a letter, use the painSupport Contact Club or Action on Pain (you can call their Pain Line) or any of the other support organisations we list.

Leisure activity – First thing in the morning, before you get up, ask yourself, “What am I going to do to enjoy myself to-day?” Decide on at least one thing, then make sure you do it.

Work – It doesn’t matter whether the work is voluntary, paid or studying, try to do some every day if you can. It improves your self-esteem and keeps you in touch with the ‘real’ world. Voluntary work can be most rewarding. Find some to do at home if you can’t go out.

Fun – Laugh and smile – the best therapy of all! Pain relieving endorphins are released with every smile. You will look and feel better for having some fun in your life. Not always easy, and if it doesn’t come naturally, you need to plan to have laughter in your life. There are plenty of videos, books and tapes which are guaranteed to make you smile or even laugh out aloud. There is also a meditation/relaxation technique which combines breathing and smiling so that you keep a smile on your lips, which makes you feel calmer and happier – and, yes, it really does work! [see the painSupport website]

Flare-up plan: At flare-up time you need a plan of action already in place so you will know what to do. If you haven’t already started learning some Survival Skills, such as diaphragmatic breathing or relaxation, etc. – check them out and begin today [see painSupport and our Complementary Techniques and Therapies Guide].

Daily review: This is vital. In the early evening, note any problem areas and unfinished tasks and write down the next action to be taken – there’s no need to write everything down, just the next action to be taken. It is unfinished business like this that is the cause of most sleeplessness. Use this time as a dividing line between your day and your evening. If you start thinking about these items at night tell yourself you have dealt with them until tomorrow. Spend the last hour or so of the evening preparing for sleep. Keep all activities after the Daily Review very low key and undemanding so that you are in a relaxed and quiet mood when it is time for bed – but don’t become so relaxed that you fall asleep on the sofa! [Our note: we define evening as whenever you choose to start winding down for bed. If you like to function late, it’s late].

We will not repeat in detail here all the excellent advice you can easily get from painSupport, Action on Pain, Pain Concern and others. We’ll just stay with painSupport’s advice that some of what you can learn includes:

• not to panic, and to control the situation
• to stop negative thoughts and know how to cope
• living with less tension, more confidence and more joy [which is more than lots of people who are not in chronic pain manage to do]
• to acknowledge how hard things are and still turn negative thoughts into positive thoughts.
• to be patient. Stop battling. Accept the situation and allow it to take its course. Work with it.
• learning to live with bed-rest when you really need it but not a weakening habit of sleeping / giving up when you don’t.
• the use of simple heat, cold and touch techniques to make a big difference to your pain.
• staying involved in day to day household activities.
• keeping your body mobilised for better healing, strength and better spirits no matter what your condition. painSupport recommends that each day you:

Make time for one or two relaxation sessions.
Make time for your exercise programme.
Make time for at least 20 minutes of an enjoyable leisure activity.

• to go on setting goals for yourself to improve your activity levels once you have your pain more under control.
• cry or otherwise release sadness or anger effectively when you need to, while not spend too much time focused on your pain.
• focusing on what you CAN do and not on what you can’t do.
• increasing your own cheerfulness and that of other people.
• using posture, the way you move and the way you set up your physical life and surroundings to help relieve pain and increase your wellbeing.
• sleeping better at night and reducing tension during the day.

Complementary Therapies and Techniques
Pain Support advises that: Both medical and complementary therapies have their uses in reducing and coping with pain. It’s a good idea to check with your doctor or medical expert before starting a course of any therapy. Also check out the therapists’ qualifications with their professional associations.

When seeking a therapist, ask the professional association for details of one nearest to you and/or ask in your local natural health centre. Personal recommendation is one of the best ways to find a good therapist.

There are many complementary therapies available nowadays which can be used alongside conventional medicine. It’s best to regard any therapy with the attitude, ‘I’ll try it for a few weeks and see what happens.’ Not every therapy suits every person or their particular pain. So monitor your progress carefully and don’t carry on unless, after a fair trial, you continue to make progress.

Finding the one for you: We note that not all the techniques which could be helpful have professional associations regulating their teaching and practice. There are no absolutely clear dividing lines here, but:

Techniques you learn to do and practice yourself, like Tai Chi, Yoga and Meditation, can’t really be regulated to great effect. That a teacher is a member of an organisation may well be a good thing, but the best teacher for you may well not have the seal of approval of any self-appointed group. You really do have to test, trust yourself, and move on if you’re not comfortable.

Treatment techniques, where you are being treated by a therapist, usually can be and are regulated. For treatments including osteopathy, physiotherapy, hypnotherapy, psychotherapy and anything else where a practitioner is giving you any kind of therapy, professional qualification and regulation does matter. In our Health Information we Trust list you’ll find professional bodies to help you be sure you’re in qualified hands. Practices like physiotherapy, occupational therapy, counselling, psychotherapy etc are really part of your extended medical treatment, and your doctor may help with referrals.

Complementary techniques can help enormously with chronic pain. Which ones will be right for you will depend on the nature of your pain and what you feel you need. If badly done they can be worse than useless. Done well they can give absolutely direct help with causes of pain, help in closing the pain gate in a variety of ways, lift your spirits and improve your general health and sense of well-being. At best they can go far beyond helping with the pain and change your whole appreciation, enjoyment and quality of life.

We can’t fully describe all the techniques available and what they can do for you, but we can refer you to our Health Information we Trust list and our Complementary Techniques and Therapies Guide to start learning about them and getting good information.

Supplements, Snake-oils and Diets

Beware “miracle cures”. Check Medline Plus or BBC Health in our Look Here First list to learn more about any supplement, alternative medicine or diet cure which interests you. They are not prejudiced against alternative options. You will get excellent information on whatever you’re considering, with no spin.

From Merck Medicus (and others) we get some useful basic information on:

Herbal Medicine, the oldest known form of health care, uses plants to treat disease and promote health. Either a single herb or a mixture of different herbs can be used. In the case of Chinese herbal medicine, mixtures can also contain minerals and animal parts. Unlike conventional drugs, in which the active substance is extracted from the herb, herbal medicine usually makes use of the herb in its natural form. Herbal medicines are available as extracts (solutions obtained by steeping or soaking a substance, usually in water), tinctures (usually alcohol-based preparations, with the alcohol acting as a natural preservative), infusions (the most common method of internal herbal preparation, usually referred to as a tea), decoctions (similar to an infusion), pills, and powders and even in a moistened cloth applied to the skin.

We note: many herbal remedies can be powerful and surprisingly effective. Powerful also means handle with care. Obviously “natural” does not equal “safe”. Herbal remedies can interact very badly indeed with each other and with prescribed medications.

Orthomolecular Medicine: Orthomolecular medicine focuses on the use of nutritional supplements to maintain and restore health. It uses combinations of vitamins, minerals, and amino acids normally found in the body to treat specific conditions. Sometimes referred to as megavitamin therapy, orthomolecular therapy emphasizes supplementing the diet with large quantities of vitamins. Some of the more common orthomolecular treatments make use of shark cartilage to treat cancer, chelation therapy (removal of toxic materials from the bloodstream), and glucosamine or chondroitin (substances occurring naturally in the body) to treat osteoarthritis (for which there is good evidence of effectiveness).

We note that: megavitamin therapy may be effective but again, handle with care. The body can react badly to higher than normal levels of vitamins.

The BBC’s website carried a report about Which? magazine undercover research into 30 health food shops in five areas of the country, including London. They found that staff were recommending remedies which could be dangerous for people to combine with their prescription medications, offering remedies without knowing if people were seeing a doctor about their problem at all, even telling people they could stop taking their prescription and substitute a remedy. Obviously on the internet the information from people selling remedies can be even worse.

As a principle, tell your doctor about any supplement or alternative remedy you are taking. This may sound fussy and unnecessary, but we have seen too many harmful consequences from alternative self-medication. If your doctor has a negative attitude to these things check what you plan to take with a sympathetic chemist or go to one of the resources in out Look Here First list.

There are many alternative remedies offered for various types and causes of chronic pain. Some have good evidence of effectiveness, and a quick check with MedlinePlus or BBC Health will tell you if there is good effectiveness and safety evidence for a remedy. Kava is an interesting example of “useful but…” It appears to be a potentially worthwhile alternative remedy for anxiety. You might find it helpful – but if you’re on tranquillisers it could be actively harmful. Things like Bach and Homeopathic remedies may be pretty benign, but Capsaicin (the fierceness in chilli peppers – used in a number of ways for rheumatic and other pain) and cannabis demonstrate the effective power of plants and natural medicines.