*Pain Management-a few thoughts*
By: angellight
18 May 2006

It would be the rare individual who has not felt pain in their lifetime. We are exposed to many different types of pain as we age and yet not everyone will be exposed to the same types of pain. Some will never have a broken bone, have labor pains, or migraines. But many will experience pain from strains, bruises, sprains, pulled muscles and tendons, wrenched backs and a maraud of other types of pain caused by overwork, underutilization of muscles, poor execution of motion and on and on.

Pain is not necessarily a bad thing. It tells us when we should "stop" doing something, which is akin to the flight response, or if we have been doing something that has caused a chronic condition, which may also be from the onset of age or poor nutrition. Acute pain is usually telling us of a new and or serious problem. Chronic is usually more of a throbbing pounding nature left over from an old injury or health condition.

Acute pain is usually felt directly through the motorway of the spinal column. This is the fastest way because usually this type of pain needs to be dealt with immediately. (Pull your hand from the hot stove)

Chronic pain flows along the side roads of the spinal column. With chronic pain we are not in any immediate danger but the throbbing and discomfort can be debilitating. It may also be laced with acute pain.

It is actually electrical impulses that flow between the injured or hurting part of the body and the brain that tells you pain is present and needs to be dealt with. Since this electrical impulse flows into the brain with this message of pain the brain can also produce an electrical impulse along the pathway blocking the next pain response. This is a brief description of the Pain Gate Theory. Our saving grace is the word "Gate", because a gate can be opened and a gate can be shut.

The Gate Control Theory OF Pain basically says that by manipulating our bodies and or environment we may be able to close the gate to chronic pain. It was discovered in 1965 by Dr Ronald Melzack & Dr Patrick Wall and written up in their book The Challenge of Pain in 1966.

There are many books, papers, theories and hypotheses written about the control of pain. Hopefully by sharing the ones I have personally used someone may find help with their situation. I cannot assert that these will work for everyone or that each is suitable for everyone. Common sense, your doctor and your past medical history will need to be considered before trying these.

Obviously over-the-counter drugs are useful in countering many of our everyday knocks and bruises, headaches and stress-related problems. Pale Horse has written a good article on the best way to choose the drug that will help you for certain problems.

Hot and cold compresses: if there is swelling or inflammation cold compresses are usually recommended. If there is no swelling or inflammation and the pain is caused by overuse and/or spasm of a muscle then heat may be applied. I have found that if I am tending to an old condition that sometimes hot will stop the pain and at other times cold will do it. This is also something we found in our patients. The therapist agrees that in this case either is suitable.

TENS unit: - "transcutaneous electrical nerve stimulation" - involves the use of two electrodes, attached to the skin over the painful areas, and a small black box (a small, battery-powered pulse generator).

The electrodes have a cloth covering on one side and a jelly type feel on the other, this is the side that is placed against the skin. If sealed correctly when stored these can be reused for well over 20 sessions. The idea is to feel a tingling sensation that is not painful. Even though no mechanism of action can be proven for their use, TENS units often provide considerable relief of chronic, non-responsive pain and seem to close the gate

These units can be purchased for as little as $50 on up to high-grade medical units for $500. If this is prescribed by a physician many insurances is will cover the cost. I have found that both units work well the higher-priced unit has more bells and whistles but the $50 one will also do the trick. It has enough settings to be effective and has dials instead of a digital display. Both have timers and a selection of pulse settings.

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Do not use if you have any metal implants or a pacemaker. Never place them directly over your spine, major arteries, temples, and eyes. Do read the directions.

Rubbing/massage: rubbing is a natural instinct and one that shuts the gate by stimulating surrounding nerve endings confusing the signal sent to the brain. Learning basic massage techniques can help with pain in the extremities. Massage works best for me on the feet.

(Deep massage is not for everyone and is not recommended if there is inflammation, a chance that there may be a clot, or medication such as a cortisone shot has been recently given.)

Breathing: sometimes by concentrating on your breathing and increasing or decreasing the lengths of breath mechanically pain responses can be diverted from the brain. This works best for me with back pain or with acute pain I use the LaMas method to shut the gate.

Visualization: sometimes all you need is to get the pain in an area to stop for a little while and it will not restart. I have found that if I give the pain I'm experiencing and image or color and picture it moving to another part of my body I can find relief. The pain will actually be as if it is coming from the part of the body I have now moved it to. Often once I release the image to pain does not spring back to the original place. I have found this to be beneficial in headaches and toothaches. (It can also be used with breathing in acute situations of pain but does require some practice ahead of time. This can be done by practicing breathing techniques for relaxation and then include some visualization to get the hang of it)

Herbs: can be useful as rubs, inhalants, teas and taken orally. A good herb book or teacher should be utilized for this as some herbs have strong medicinal properties. I have found them to be helpful with arthritis and other immune related pains.

Exercise: can relieve pain through the release of endorphins but caution must be used as to not aggravate the condition or create a new condition because of surrounding weakness or exertion to an unaffected part.

Here is a list of questions you can ask yourself when trying to formulate a plan to take care of your pain:

Where is the pain felt?

When does it occur?

How does it feel e.g., aching, stabbing, shooting, etc.

How severe is the pain on a scale of 0-10?

(0 - being no pain and 10 - being the worst pain imaginable.)

How often is the pain felt e.g., every couple of minutes/hours, constant?

How long does the pain last, e.g. minutes/hours?

Does anything seem to trigger it or make it worse e.g. eating/temperature, specific foods, stress, movement?

Does anything make it better e.g. resting, heat/cold, bathing, medication, particular drinks or foods?

What impact does it have on your life, e.g. restricts physical movement, depression, etc.

What you have tried to relieve it, e.g. painkillers, complementary therapy, etc.?

What haven't you tried that is noninvasive and not harmful?

Here is a list of some things that can trigger pain: Overdoing things,

Fear

Tension

Concentrating on the pain

Poor diet

Depression

Indecision

Stress

Tiredness

Anxiety

Poor posture

Here is a list of some things that can release endorphins to help close the gate by breaking the electrical impulses to the brain: Laughing,

Massage

Exercise

Hypnosis

Pacing your activities

Being enthusiastic

Rubbing the area that hurts

Meditation

Visualisation

Feeling joyful

Good posture

Relaxation

Distracting your attention from the pain

Having a positive attitude

Tens machine

Applying heat or cold to the area that hurts

Gentle movement (qi gong, tai chi)

Deep breathing

Music

Faith & prayer

A meaningful lifestyle including helping others

Commonsense must be used in dealing with pain. It can play havoc with our lifestyles and our relationships. A "grin and bear it" philosophy usually benefits no one and reducing pain can only enhance your life. If you are in pain and you find nothing to help you here please keep looking to you find your solution.
angellight



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