Do you experience any chronic pain? Leading expert on pain and pain management Dr Deepak Ravindran reveals 5 steps that will help you transform your life and mind-set
We know that chronic pain can have an impact on your emotional well being and similarly low mood and mental health issues can make your pain worse and if that is the case, you might need help in that aspect to support you as well.
Sometimes you can work with your specialist to help build a toolkit and other times you may have online groups or your complementary therapy provider such as a physiotherapy, osteopath or therapist helping you.
low mood and mental health issues can make your pain worse
Using these 5 steps and combining it into a toolkit that is personalised for you will give you the ability and confidence to overcome most pains and have a mindset that is capable of overcoming any flare ups that you may have.
Step #1 Understand the reason for your pain
In the last two decades, new research about the pain processing systems in the brain and the spinal cord prove that the mind and body are one.
There is a significant overlap between the nerve circuits for physical pain and emotional pain so now we think of pain as both a sensation and an emotion.
The nervous and immune system are also deeply linked which means that if the immune system perceives threat and feels unsafe then it can activate the nervous system and the various pain centres in many parts of the brain.
The nervous and immune system are also deeply linked
We are also now aware of the phenomenon of neuroplasticity – the ability of the brain and the nerves to be rewire and change in a way that it can learn to overcome any pain.
This neuroplasticity can be enhanced in many different ways and these can be sometimes as powerful and longer lasting that drugs or surgeries.
Step #2 Understand the role of medications
Pain Medications are often the first port of call for any pain condition. Unfortunately the research indicates that drugs work only 30 per cent of the time in about 30 per cent of the people so a large number of people don’t get the benefit.
They work BUT only when the selection of the person is right and the condition is right.
In fact there are no such things like ‘pain killers’ and unfortunately because of the concern around opioids in the USA, we are worried about the addictive and dependence potential of these drugs so it is important to consider them but not put them as the only option.
All drugs have side effects so it is important to keep trialling them and find the right one for the patient. This often needs patience and specialist support and knowledge.
Step #3 Understand when Interventions can help in your pain
Interventions include injections like steroid shots or even infusions and surgeries that are often done to hopefully ‘cure’ or ‘eliminate’ the pain.
Again, studies have shown that most surgeries and injections don’t last for long in terms of pain relief and they can have side effects that can often be unpleasant and difficult to reverse.
For example, once a surgery is done, scarring can happen at the surgical site causing a different set of problems and worsening pain and this can be even more difficult to fix.
Repeated surgeries often don’t work and only cause significant pressures financially and emotionally on the patient and their family.
It is very important that when you are considering an intervention that you have a conversation with your provider/surgeon around the BRAN framework.
- B: make sure you understand the Benefits of the planned procedure.
- R: make sure that all the Risks have been explained in a way you can understand.
- A: make sure that all Alternatives have been considered.
- N: also ask the specialist about the option of doing Nothing. What would that mean for you and the pain?
Step #4 Understand the role of sleep
Sleep is a very powerful weapon in terms of pain control. We know that sleep and pain are now bidirectional meaning that they influence each other and sometimes sleep disturbances can occur a few months or years earlier than the start of pain issues.
About six to eight hours of sleep is now a recommended figure and research shows that when we have less than that on a consistent basis, our housekeeping cells in the brain can’t function and that leaves behind inflammatory chemicals that can sensitise the nerves and potentially predispose people to experiencing more severe pain and lead to chronic pain.
six to eight hours of sleep is now a recommended figure
These days using sleep trackers and wearables, we can understand our sleep cycles better and using physical activity and stress management and appropriate foods, we can improve our sleep pattern and potentially influence our pain.
Step #5 Understand the role of physical activity
It is better to think of activity not as exercise which may always mean something hard to do but as a form of movement. Keeping active and doing a movement that can be safe and easy to do and familiar is important.
It prevents deconditioning and a variety of movements such as Stretching, strengthening and cardiovascular routines can built in to a balanced routine so that we learn to do it everyday or in frequent intervals rather than in episodes.
New research proves that regular and routine activity changes the brain, builds new nerve circuits and enables neuroplasticity.
It is important to think of movement as a form of growth mindset. Just because you do it the first few times and you feel hurt, it does not equal harm.
Be prepared to feel an increase in pain when you start but try not to give up and aim to start low and go slow with any movement activity.
Consider doing such activity in groups and often the use of favourite music and any support you can get from friends and loved ones all help in reinforcing the safety and fun of the activity.
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