Coping with Chronic Pain

Contributed by Jackie Waters

Living with chronic pain can drain you physically and emotionally. It’s normal to experience frustration when you’re unable to do the things you used to do. Aching muscles, sore joints, and fatigue are just a few of the symptoms chronic pain sufferers deal with on a daily basis. Whether you have fibromyalgia, osteoarthritis, or any other disease that causes pain, you know that such a condition transforms your life into a day-to-day battle. If you’ve recently been diagnosed with a chronic pain condition, read these tips to help you cope.

What Is Chronic Pain?

 Chronic pain is any pain that lasts more than six months. People can experience chronic pain for a number of reasons. It may be triggered by an injury or even a sickness. Often, there is no apparent cause for the pain. In the past, doctors thought pain was always the result of a disease or undiagnosed injury. As a result, doctors concentrated on treating the cause of the pain. They believed curing the cause would automatically eliminate the problem. If the patient wasn’t cured, doctors sometimes told patients that they were imagining their pain. Fortunately, today’s medical professionals realize that chronic pain is a disease and not some phantom pain inside a patient’s head.

Over-the-Counter and Prescription Painkillers

 In the past, traditional methods of treating chronic pain typically included over-the-counter and prescription painkillers. But the negatives far outweigh the positives. Using prescription painkillers can lead to liver failure and stomach ulcers. And it’s easy to become addicted to painkillers as well. Doctors now recognize that alternative treatments help reduce the symptoms associated with chronic pain. Even better, these alternative treatments don’t lead to addiction or other negative effects.

Give Your Body a Rest at Home

 It’s okay to take breaks to help relieve chronic pain. While you rest, let others help you get things done. Ask a friend or family member to run an errand for you. Another option to consider is calling a professional on occasion to take care of a home project, like doing yard work or cleaning the house. You can find a service within your budget by searching online. If you absolutely need to do your own cleaning, look for a vacuum that’s lightweight and easily maneuvered so you don’t strain yourself.

Exercise

 If you want to treat chronic pain using natural methods, incorporate exercise into your daily life. When you are physically active, the body releases natural hormones called endorphins that work as natural painkillers. Endorphins affect brain receptors, changing the way we perceive pain.

Before you begin an exercise regimen, discuss your plans with your physician. As long as your doctor says it’s okay, start a gradual exercise routine. Do easy stretches each day. If you find your joints are sore and tight, try taking a warm bath or shower before beginning your workout. Yoga, tai chi and Pilates are all gentle forms of exercise that help some chronic pain sufferers. And, of course, you can’t go wrong with good, old-fashioned walking!

Combine a Balanced Diet with Natural Supplements

 Incorporating more vegetables and whole, clean foods into your diet makes you healthier. A healthy diet can help reduce inflammation in your body, which is linked to chronic pain. Additionally, probiotic foods and supplements can help your body and mind become healthier by boosting the immune system, aiding in digestion, and increasing emotional health. Probiotics contain good strains of microbes that work in your gut, and since around 95 percent of all your microbes are in your gut, it’s especially important to take care of it. 

Acupuncture and Other Natural Therapies

Some people with chronic pain experience relief through acupuncture. It’s an ancient Chinese healing method where tiny, thin needles are inserted into specific parts of the body to relieve pain and stimulate healing. Other natural therapies may include massage or relaxation therapy. Some pain sufferers benefit from guided imagery, when a trained professional teaches you to focus your mind on specific images so you’re not concentrating on the pain you feel.

Just because you’ve recently been diagnosed with a chronic pain condition doesn’t mean you need to give up on an active lifestyle. Talk with your physician and devise a strategy to combat your chronic pain. As you incorporate lifestyle changes and investigate various therapies and treatments, you just might find the right combination that will help you alleviate your pain triggers and place you on the road to a happier, pain-free life.

New research provides hope for people living with chronic pain

September 9, 2019

Science Daily/University of Calgary

Researchers have been investigating which brain circuits are changed by injury, in order to develop targeted therapies to reset the brain to stop chronic pain.

When you experience severe pain, like breaking or shattering a bone, the pain isn't just felt at the sight of the injury. There is an entire network of receptors in your body running from the site of the injury, through your nervous system, along the spine and into the brain that reacts to tell you how much pain you are feeling. This system goes into high alert when the injury occurs, and then usually resets as you heal. However, sometimes, the system doesn't reset, and even though the injury has mended, nerve damage has caused your brain to be permanently altered. It means you still feel the pain, even though the injury has fully healed.

Dr. Gerald Zamponi, PhD, and a team with the Cumming School of Medicine's Hotchkiss Brain Institute (HBI) and researchers at Stanford University, California, have been investigating which brain circuits are changed by injury, in order to develop targeted therapies to reset the brain to stop chronic pain.

"It's a terrible situation for many people living with chronic pain, because there is often very little that works for them to control their pain," says Zamponi, senior associate dean (research) and a professor in the departments of Physiology & Pharmacology and Cell Biology & Anatomy at the CSM. "This doesn't just impact people who have experienced peripheral nerve damage. There are cases of people having a stroke and are experiencing severe pain afterward in another part of their body. It may also explain why some people who have lost a limb can still feel pain in the limb even though it's no longer there."

Working closely with Dr. Junting Huang, PhD, and Dr. Vinicius Gadotti, PhD, co-first authors on the study, along with Dr. Zizhen Zhang, PhD, the team utilized optogenetics to study the neuron connections in the brains of mice. Optogenetics allow scientists to use light to target and control individual neurons in the brain. With this tool, researchers are able to map a pathway showing which neurons are communicating with each other to process a pain signal and then communicate this information all the way back through the spine where painful stimuli are first processed.

"We've known that certain parts of the brain are important for pain, but now we've been able to identify a long range circuit in the brain that carries the message and we've been able to show how it is altered during chronic pain states," says Zamponi who is also a member of the CSM's Alberta Children's Hospital Research Institute.

Much of the research for chronic pain has been focused on the spinal cord and targeting nerve fibres where the pain response is processed. Treatment with current pain relief medications is often ineffective and can have serious side effects. This new understanding of the pain signaling circuit may allow scientists to develop new drug therapies and targeted brain stimulation treatments to address chronic nerve pain, and hopefully provide relief for pain sufferers. Working with mice, Zamponi's lab has proven that targeting certain pathways in the brain can interfere with the pain signal and stop pain sensation.

"If you understand how the brain rewires itself, you can interfere with that and you can restore it. That's important," says Zamponi. "If you think about it, there are some drugs you don't want to give to kids who have chronic pain. What if you could non-invasively stimulate certain brain regions or inhibit them, and bring pain relief that way? I think it would be a tremendous, alternative approach to taking drugs."

Zamponi expects the results the lab has seen in mice will be comparable in humans. While the human brain is very complex, the communication network is similar in the animal brain. Findings are published in Nature Neuroscience.

The Zamponi lab is already applying this research to investigate how this brain circuit interacts with other parts of the brain involved in more complex behaviours like the interaction between pain pathways and addiction, depression, and anxiety.

https://www.sciencedaily.com/releases/2019/09/190909113027.htm

Yoga boosts stress-busting hormone, reduces pain

July 27, 2011

Science Daily/York University

A new study finds that practicing yoga reduces the physical and psychological symptoms of chronic pain in women with fibromyalgia. The study is the first to look at the effects of yoga on cortisol levels in women with fibromyalgia. Participants' saliva revealed elevated levels of total cortisol following a program of 75 minutes of hatha yoga twice weekly over the course of eight weeks.

The study is the first to look at the effects of yoga on cortisol levels in women with fibromyalgia. The condition, which predominantly affects women, is characterized by chronic pain and fatigue; common symptoms include muscle stiffness, sleep disturbances, gastrointestinal discomfort, anxiety and depression.

Previous research has found that women with fibromyalgia have lower-than-average cortisol levels, which contribute to pain, fatigue and stress sensitivity. According to the study, participants' saliva revealed elevated levels of total cortisol following a program of 75 minutes of hatha yoga twice weekly over the course of eight weeks.

"Ideally, our cortisol levels peak about 30-40 minutes after we get up in the morning and decline throughout the day until we're ready to go to sleep," says the study's lead author, Kathryn Curtis, a PhD student in York's Department of Psychology, Faculty of Health. "The secretion of the hormone, cortisol, is dysregulated in women with fibromyalgia" she says.

Cortisol is a steroid hormone that is produced and released by the adrenal gland and functions as a component of the hypothalamic-pituitary-adrenal (HPA) axis in response to stress.

"Hatha yoga promotes physical relaxation by decreasing activity of the sympathetic nervous system, which lowers heart rate and increases breath volume. We believe this in turn has a positive effect on the HPA axis," says Curtis.

http://www.sciencedaily.com/releases/2011/07/110727131421.htm

Pain: What Zen meditators don't think about won't hurt them

December 8, 2010

Science Daily/University of Montreal

Zen meditation has many health benefits, including a reduced sensitivity to pain. According to new research meditators do feel pain but they simply don't dwell on it as much. These findings may have implications for chronic pain sufferers, such as those with arthritis, back pain or cancer.

"Our previous research found that Zen meditators have lower pain sensitivity. The aim of the current study was to determine how they are achieving this," says senior author Pierre Rainville, researcher at the Université de Montréal and the Institut universitaire de gériatrie de Montréal. "Using functional magnetic resonance imaging, we demonstrated that although the meditators were aware of the pain, this sensation wasn't processed in the part of their brains responsible for appraisal, reasoning or memory formation. We think that they feel the sensations, but cut the process short, refraining from interpretation or labelling of the stimuli as painful."

"Our findings lead to new insights into mind/brain function," says first author, Joshua Grant, a doctoral student at the Université de Montréal. "These results challenge current concepts of mental control, which is thought to be achieved by increasing cognitive activity or effort. Instead, we suggest it is possible to self-regulate in a more passive manner, by 'turning off' certain areas of the brain, which in this case are normally involved in processing pain."

"The results suggest that Zen meditators may have a training-related ability to disengage some higher-order brain processes, while still experiencing the stimulus," says Rainville. "Such an ability could have widespread and profound implications for pain and emotion regulation and cognitive control. This behaviour is consistent with the mindset of Zen and with the notion of mindfulness."

http://www.sciencedaily.com/releases/2010/12/101208130054.htm

Meditation reduces the emotional impact of pain

June 2, 2010

Science Daily/University of Manchester

People who meditate regularly find pain less unpleasant because their brains anticipate the pain less, a new study has found.

Scientists from The University of Manchester recruited individuals into the study who had a diverse range of experience with meditation, spanning anything from months to decades. It was only the more advanced meditators whose anticipation and experience of pain differed from non-meditators.

The type of meditation practised also varied across individuals, but all included 'mindfulness meditation' practices, such as those that form the basis of Mindfulness-Based Cognitive Therapy (MBCT), recommended for recurrent depression by the National Institute for Health and Clinical Excellence (NICE) in 2004.

"Meditation is becoming increasingly popular as a way to treat chronic illness such as the pain caused by arthritis," said Dr Christopher Brown, who conducted the research. "Recently, a mental health charity called for meditation to be routinely available on the NHS to treat depression, which occurs in up to 50% of people with chronic pain. However, scientists have only just started to look into how meditation might reduce the emotional impact of pain."

The study, to be published in the journal Pain, found that particular areas of the brain were less active as meditators anticipated pain, as induced by a laser device. Those with longer meditation experience (up to 35 years) showed the least anticipation of the laser pain.

He said: "The results of the study confirm how we suspected meditation might affect the brain. Meditation trains the brain to be more present-focused and therefore to spend less time anticipating future negative events. This may be why meditation is effective at reducing the recurrence of depression, which makes chronic pain considerably worse."

Dr Brown said the findings should encourage further research into how the brain is changed by meditation practice. He said: "Although we found that meditators anticipate pain less and find pain less unpleasant, it's not clear precisely how meditation changes brain function over time to produce these effects.

"However, the importance of developing new treatments for chronic pain is clear: 40% of people who suffer from chronic pain report inadequate management of their pain problem."

http://www.sciencedaily.com/releases/2010/06/100602091315.htm

Millennials prefer healthy habits, less likely to choose opioids to manage pain

Survey finds millennials regret opioid use, lack knowledge on proper disposal

August 30, 2017

Science Daily/American Society of Anesthesiologists

Often spending their days hunched over phones, tablets or computers and their free time at spin class or playing sports, millennials are the next generation poised to experience chronic pain. Even at their young age, millennials say acute and chronic pain are already interfering with their quality of life.

Their preferred method to manage pain? Lifestyle changes such as exercising, eating right, quitting smoking and losing weight, according to a nationwide survey commissioned by the American Society of Anesthesiologists (ASA) in conjunction with September's Pain Awareness Month.

The survey also found millennials were half as likely as baby boomers to have turned to opioids to manage pain, and 1 in 5 millennials regret that they used the highly addictive painkillers.

But while the results reflect a positive trend, they also reveal a knowledge gap. The survey found many millennials were:

• ·      More likely to obtain opioids inappropriately. One in 10 millennials obtained opioids through another household member's prescription, compared to 3 percent of Gen Xers, 1 percent of baby boomers and none of the silent generation.
• ·      More likely to think it's OK to take an opioid without a prescription. Nearly 30 percent of millennials thought it was OK to take an opioid without a prescription, compared to 20 percent of Gen Xers, 12 percent of baby boomers and 3 percent of the silent generation.
• ·      AND less likely to dispose of leftover opioids safely. In fact, 1 in 5 millennials said they "did not know" the best way to safely dispose of opioids, and only 37 percent were aware that a collection center at a local police station, hospital pharmacy or drug store was the best method of disposal.

"It's encouraging that millennials see the value of opting for safer and often more effective methods of managing pain," said ASA President Jeffrey Plagenhoef, M.D. "But clearly they are in need of further education when it comes to opioids and chronic pain because using the drugs initially to treat pain can turn into a lifelong struggle with addiction."

Learning how to manage pain safely and effectively is vital: 75 percent of millennials say they have had acute pain (which comes on suddenly and lasts less than three months) and nearly 60 percent have experienced chronic pain (which lasts longer than three months). The source of that pain is reflective of millennials' lifestyle, including technology use (leading to eye strain, neck aches, hand or finger pain, wrist or arm pain), migraines and sports injuries.

According to the survey, millennials (ages 18-36) and members of Generation X (ages 37-52) are most likely to report pain interfered with their work responsibilities, parenting abilities and participation in family activities.

It's important to address pain before it interferes with quality of life by seeing the right specialist for pain management. Whatever the age, people in severe pain who don't find relief through lifestyle changes should see a physician who specializes in pain management, such as a physician anesthesiologist. These specialists have received four years of medical school and additional training in a medical specialty, followed by an additional year of training to become an expert in treating pain. They have the expertise to best help you manage your pain.

But engaging in lifestyle changes before chronic pain can gain a further foothold is preferable. When possible, prevention is best. "Chronic pain does not have to be an automatic response to aging," said Dr. Plagenhoef. "Healthy lifestyle changes such as exercising, proper nutrition and maintaining a healthy weight can keep millennials from dealing with some of the chronic pain their parents and grandparents are experiencing."

To help all generations effectively manage their pain, ASA offers the following tips:

• ·      Take a break from devices and gaming: Aches from smartphone, tablet, gaming and other digital device overuse is common. To avoid it, use devices at eye level instead of looking down for long periods of time, which puts strain on your neck and back. Use the talk to text feature to limit finger and wrist strain. Sit up straight while gaming and get off the couch and stretch occasionally. To avoid digital eye strain, look away from the screen every 20 seconds and position yourself so there is an appropriate distance between your eyes and the screen.
• ·      Don't be a weekend warrior. Whether you plan to hit the basketball court after many years away or do CrossFit weekly, ease into it. Warm up your muscles and stretch to avoid pain and injury. If you think you've been injured after exercise or playing sports see a pain management specialist right away to evaluate the pain.
• ·      Remember to move. Whether you're in the library studying or at a desk job, get up and move at least once an hour, if not more. Sitting and being sedentary can lead to aches and pains, especially lower back pain. Stretch your legs and back by standing and walking on a regular basis rather than sitting for long periods of time.
• ·      Get healthy. Take charge of your health now and engage in healthy lifestyle changes before chronic pain sets in. Participate in low-impact aerobic and strength training exercises regularly. Maintain a healthy weight and eat a balanced diet. Don't smoke, or if you do, talk to a physician about programs available to help you quit.
• ·      Take and dispose of opioids the right way. If a physician prescribes opioids, ask many questions about taking them appropriately. Don't continue taking opioids when your pain subsides. If you have leftover opioids, dispose of them at a collection center at a local police station, hospital pharmacy, or drugstore. This will ensure others who have not been prescribed the opioids do not have access to them.

The 10-question ORC International CARAVAN® Omnibus Survey was conducted online August 7-9, 2017 among 1,011 U.S. adults 18 years or older: 34 percent were millennials, 25 percent were Gen Xers, 35 percent were baby boomers (ages 53-71) and 6 percent were from the silent generation (ages 72-92). The demographically representative sample included 504 men and 507 women.

https://www.sciencedaily.com/releases/2017/08/170830124926.htm