Functional Restoration and the Pain Patient
by Twinkle Wood-VanFleet
We all seek pain relief. Aside from a cure, maintaining our pain levels to a tolerable degree is the next best thing. Medications assist and can cause addictional problems. After awhile we can become immune needing a higher and higher dose just to get the same relief as when we started. If a medication isn’t working, there is no benefit to taking it and one should discontinue. Medication should only be used if it actually eases and manages the pain.
There are several other things we can do to minimize our pain and lessen the intensity for as long as a pain pill might. And maybe even feel much better doing it.
Biofeedback, breathing, meditation, relaxation, yoga, pacing, changing the way we think, self-talk. pacing activities, shifting focus, visual imagery, expressing emotions, practicing appreciation, nutritian, having a flare-up protocol (duraction, frequency, intensity), exercise, modalities, distraction, coping beliefs, desensitization, yoga, mirror therapy and more.
Choose a “directional goal” for the day.
Choose a “physical goal” for the day.
Choose a “memory goal” for the day.
Record both Physical and emotional responses to pain (0-10)
When setting a goal, never say “I’ll try”, but instead, “I will”
Don’t say “I’ll try to do the dishes”, instead, I will do the dishes”.
Thinking positive keeps us in a positive state of mind.
When we learn to get our emotional responses to our pain down it will decrease our physical response. Stress, fatigue and depression adds to our pain. We can learn to alter the way we feel.
Crucial to a CRPS patient is the ability to pace oneself throughout the day. It’s not good for a CRPS patient to have a mindset of “I use to spend an hour at the gym 3 times a week. If I do the same now, I’ll get better. This type of thinking is asking for a flare up. Instead, set your mind at “I will practice serveral routines for small times but over the course of the day”. This will help prevent flare ups.
We can’t dwell on who we use to be, all those things we use to do. Many of us remain locked in the bubble of our past. We feel we lost everything, nothing is the same, our lives are over.
We can learn to live a fullfilling life despite the pain. We have to learn to embrace our new selves and find happiness. Focus on the good and let go of the bad. Continuing to remain focused on all that was is stressful. Stress invites additonal pain.
Due to our beliefs we develop a pattern of “automatic thoughts” which often occur outside our consious awareness. The only way we know “why we are thinking what we are thinking” is to develop awareness about our cognitive (thinking) process.
Research has shown that people are more successful at comping with chronic pain when they have clear goals and direct there attention and efforts toward “what to do” or “what is possible” instead of “what not to do” or “what is possible”. This does not suggest a person should be in denial about one’s limitations. Good awarenss and the development of realitic and measurable goals are critical to success.
Appreciation- Recognition of the quality, value, significance, or magnitude of people and things.
Optimism– Tendency to expect the best possible outcome or dwell on the mot hopeful aspects of the situation. Optimism has been associated with an enhanced immune system. A pessimistic attitude has been associated with depression and generally poor health. Pessimists tend to niew events that happens to them as stable (this always happens to me). Optimists view events a temporal (just because it happened nce does not mean it will happen again), specific (I am having problems learning to pace myself) and external (other people are responsible for their behaviors, I’m responsible for mine).
Pain—>Guarding or Protecting: Pattern/Less Use—>Fewer Normal movement signals to spinal cord and brain—>Tusues begin to redesign themselves including: muscle wasting/shortening, out of control swelling, increased sensitivity of local temperature and touch receptors—>Decreaed movement/use, decreased socialization, decreased psychological coping.
This pattern created several changes to the body that ultimately serves to make the disease worse, in a never ending cycle of pain.
Experience reflects our Beliefs, our beliefs reflect our Thoughts, our thoughts reflect our Emotions and our emotions reflect our Behavior.
Changing the way we think (if negative) is imperative to becoming survivors, rather than sufferers.
Exercise and Physical Therapy- This doesn’t need to be a workout, again pacing is our friend. We will not hurt ourselves worse. CRPS patients have to exercise. Unless there is other damage unrelated to CRPS, we will not damage ourselves further.
Example- If someone has guarded their ankle to the point of losing use, attempting 3 ankle raises is good for us. If CRPS is in our fingers, wiggling them is okay. Same with our toes or any other part of the body. This is not to say it isn’t going to hurt. We have to move it or lose it.
Basic Yoga positions can help and bring a calm and peaceful state of mind at the same time.
Having a routine is important. It takes 3 weeks to make or break a habit.
Pain patients often have a terrible time sleeping. Sleeping days, and awake nights, no pattern. Our internal clocks stop working. It can be reset by waking at sunrise and settling down to sleep with the sunset.
Don’t isolate, be around other’s as much as possible. We all need our quiet time, yet let it be just that. Our bedroom’s are for sleep. If we spend all day in our room it can cause us sleeping problems even if we already have them.
Some of us wait and wait for a cure and then look back 10 years to find it hasn’t come yet just to realize 10 years has past them by.
Frustrations, Worker’s Compensation, insurance companies, denials and delays, lack of answers, the feeling of an uncertain future all cause our emotions to be unsettling.
We have to take primary responsibility for our own pain. We have to want to break the cycles that keep us from moving forward. Happiness is found in accomplishment. Success come from commitment.
All things are possible.