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This post has been a long time coming. As someone whose life-long dream it is to help people come off of medications, this is an important topic. There are thousands of articles, journals, books and tutorials in medicine on managing chronic pain. In fact, pain management is a whole specialty in and of itself.

Pain medications can cause tolerance, withdrawal and even CAUSE one to feel more pain, a phenomenon know as opioid-induced hyperalgesia. Patients are often forced to take higher and higher doses of pain medications as they develop tolerance for them.

Part of the problem is that pain is subjective – there is no established test that can objectively quantify and compare each person’s pain level. And it is as debilitating as it is elusive. There are many people who would rather die than be in pain, and indeed, it can make people suicidal, depressed, anxious and generally unable to function. Further complicating matters is the fact that once pain becomes chronic, neurologic connections form between the parts of our bodies that feel pain and our brains. That means that, yes, part of people’s pain is in their heads.

To me, pain is like a spider-web – interconnected, complex, and where it truly started is unclear. For the same reasons that pain has multiple causes, it needs multiple treatments and they need to act in concert with eachother. The best way is to take an inter-disciplinary approach- meaning multiple providers and treatment methods working together to put a plan of action in place. We will dedicate a series on different non-pharmacological ways to manage pain. In a previous post, we mentioned healing foods for muscle and skeletal injuries/pains. This entry focuses on lifestyle changes.

Lifestyle Adjustments

Avoid alcohol and tobacco when managing chronic pain. Alcohol can dull the senses and it can help relax people, but not only are there other ways to achieve both of those things, but the combination of alcohol and chronic pain medication can be dangerous. Always ask your doctor if it is ok to have your daily glass of wine if you start a chronic pain medication. Dependency on alcohol is not helpful in the management of chronic pain. Tobacco can cause muscle to spasm, and increases inflammation, which is linked to pain. It is also important to avoid pro-inflammatory foods-such as refined carbs, sugar and excess meat. Try to incorporate fresh fruit and vegetables, which are anti-inflammatory.

Exercise and stretches, such as yoga, are also important for decreasing pain and speeds up body’s natural healing process. Check with your instructors on different modifications you might need to accommodate your injury. Not only does exercise help to reduce pain, it also helps to get you back on your daily routine by recovering movements you have lost.

Meditation/Relaxation: The mind and body are connected, and with chronic pain, this is even more so. No chronic pain intervention is complete without a behavioral intervention that deals with pain from a psychological perspective. An important part of treating chronic pain is actually learning to decrease the sensation of pain. Relaxation techniques helps to minimize the pain sensation and focus on controlling the pain. They also help to decrease tension on muscles making for smoother and stronger movement. The idea of relaxing to help get rid of pain might feel counter-intuitive, but the research is compelling. {include a compelling study about relaxation technique efficacy here}. Bio-feedback and mindfulness based stress reduction, are probably the most studied relaxation techniques. Others methods include hypnosis and guided imagery.

-DS and NZ