Mend Physical Therapy Blog and Injury Information

5 Easy Ways To Reduce Chronic Pain

October 17, 2022

Chronic or persistent pain is defined by pain that extends beyond 12 weeks or the normal healing time for a given injury/diagnosis despite treatment. Our medical system does a great job treating new or acute pain, but has struggled to be as effective with patients dealing with chronic pain. It is estimated 1 in 4 to 1 in 3 adults will experience chronic pain after an acute pain episode. Authors estimate the prevalence of chronic pain in the United States to be between 20% to 35% of adults. The costs associated with chronic pain are in the hundreds of billions between time off of work, reduced productivity, and health care expenses.

Effective treatment for patients with chronic pain must be directed at the sources of the current symptoms. In the majority of cases pain is derived from both the tissues (low back pain, knee pain, shoulder pain, neck pain, etc.) as well as the nervous system including the nerves, spinal cord, and brain. For reasons not yet determined the nervous system in some individuals becomes hyper vigilant in this patient population creating painful experiences from non painful stimulation and movement, as well as, exaggerated responses to painful stimulation. The brain and nervous system become as important, and in some cases more important, than the injured tissue(s) for targeted treatments. Chronic pain is a multifactorial process which requires a multi disciplinary team including physicians and Physical Therapists, but here are 5 easy tips used in our Boulder Physical Therapy and Lafayette Physical Therapy practices to ease symptoms.

  1. Education – this is the key step of the 5. Do you truly understand your diagnosis and symptoms? What if the information you have learned from prior clinicians and the university of the internet is not completely true and may be perpetuating your symptoms? If you are unsure, find a physician and Boulder or Lafayette Physical Therapist that can explain your symptoms and their persistence despite treatment. There are so many great pain resources online, including our boulder physical therapy website links, to find researchers and clinicians who not only study chronic pain but can also explain it well to any patient. Some of the most successful treatments for chronic pain have included patient education, understanding, and brain based interventions.

  2. Control your thoughts – without the brain there is no pain. The brain is final step in the processing of information including touch, movement, temperature, and painful stimulus and makes the final decision on whether or not information is processed as painful. For example, for some people deep tissue massage is therapeutic but in others the same pressure is painful and threatening. Another example, includes music levels. If the music is to your liking the higher volume is enjoyable but if you hate the music the same level becomes irritating and threatening. Cue Dads across America asking for their kids to turn it down as they rock out to their favorite music or TV show.

    In the event of an irritating, painful, or threatening stimulus our brain’s fight or flight response is activated and a continuous feedback loop begins, hyper vigilance to the stimulus, increased sensation from this area more pain processing in the brain. Our thoughts regarding this stimulation drive further pain processing. Negative thoughts can drive associations to other negative thoughts which begin to ruminate in the brain. For example, my back hurts at work, I begin to think about the negatives of my job, and ruminate about each one in a downward spiral. Controlling these stress responses can make a huge impact each day.

    The key is to step back from this spiral and stop these associative dominos from falling. Try to regain perspective by first asking is this truly a painful experience or am I processing a normal stimulus (sitting, standing, walking, bending, etc.) as painful? Changing the interpretation of this stimulus (ex. great music or a great deep tissue massage) can change the processing of information in the brain. In addition, instead of zooming in on the pain, zoom out to the entire sensations of your body. Give equal focus to areas that don’t hurt to gain the full body experience. In addition, how does this sensation feel as we zoom out to 30,000 feet and look down on our body, family, neighborhood, city, and state or the world. Placing sensations in perspective and managing your thoughts can be the most effective ways at reducing pain.

  3. Sleep – the average adult needs between 7-9 hours of sleep per night. Many authors have described the restorative benefits of sleep, but these hours can be reduced or become less effective in patients with chronic pain. Seek out information on improving your sleep hygiene including managing your smart phone and devices. Remember these electronics were designed by the best minds with drawing our attention to gain longer utilization in mind. Our notifications are loud, colored red, and persistent. Aim to put your device down when you complete an active task vs. passively scrolling and displaying a pavlovian response to each notification. Constant notifications are associated with fight or flight responses which reinforce the cycles described above.

  4. Nutrition – we are going to eat everyday regardless of what happens in our lives so make these moments count with healthy, well balanced nutrition. Aim for nutritious meals and snacks that improve how you feel mentally, emotionally, and physically. Avoid the quick fix of our cheap, quick, and easy society by choosing the least processed form of foods you can find. Processed diets have been linked to numerous conditions and diagnoses that can impair how our brain and bodies function each day.

  5. Exercise – one of the most effective treatments for chronic pain is often avoided by people suffering from symptoms because of previous negative experiences. Aerobic, flexibility, and strength training have tremendous benefits that cannot be replaced by medications, surgeries, or other passive interventions. The key is the proper prescription of what type, how much, and why the exercise can help your specific condition. Seek out a knowledgable, well educated and trained Physical Therapist who has the time to find the most effective treatment for your symptoms.

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