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Controlling Neuropathic Pain
Tips From an Occupational Therapist

by Erica K. Jacques

In general, ice is not as soothing as heat. However, it does have the advantage of being an analgesic: It can provide a mild numbing effect, which can relieve pain. Ice is also anti-inflammatory, meaning it helps reduce swelling. This can be useful if your hands or feet are prone to edema (fluid buildup), which can increase sensations of pain. Ice may also be the key for someone whose pain does not respond to heat.

Using ice is as simple as going to your freezer: Fill a large freezer bag about halfway with ice cubes and seal it. Place a doubled-up towel over the area you are treating, then mold the bag of ice to the area and keep it in place for no more than 10 minutes. Some people prefer using bags of frozen vegetables such as peas, which are easy to shape to various body parts and can simply be thrown back into the freezer when done to reuse later. Just be sure to label your “cold pack” so that no one cooks it for dinner. You can also buy different sizes of reusable cold packs — filled with gel or pellets — at a drugstore and keep them in your freezer; having options can be helpful if you use ice frequently or for more than one area of your body.

Contrast baths
Contrast baths are a little messy, but they may offer some relief from both pain and swelling in the hands or feet. Start with two basins: one filled with ice water, the other with warm water. Starting with the ice water, submerge your hand or foot for 30 seconds — if you can tolerate it — and then immediately switch to the warm water for 2 minutes. Repeat the process about five times. If you can’t tolerate the entire 30 seconds of cold, you can cut the time for each bath in half.

Contrast baths are nice for people who get good results from ice but cannot tolerate using it for long periods of time. Like ice, contrast baths can keep edema under control. If you decide to try this method, be sure to keep several towels handy — no matter how careful you are, water tends to get everywhere.

Have you ever had a headache or some other kind of pain, then forgotten about it? Later you might realize the headache or pain has gone away or is less bothersome somehow. Sometimes you only notice the pain again when you remember that you felt it before. Did your pain actually go away and then come back? Probably not; more likely, you were just distracted.

Distraction works under the principle that pain is all in your head. It’s not that you are imagining your pain; it’s that your brain — where feelings of pain are processed — only has so much attention to give. The more it focuses on pain, the less likely it is to notice much else. The flipside, however, is that if you can direct some of that attention elsewhere, your brain will have to turn down the “noise” caused by the pain.

Anything can be grounds for distraction: music, a good book, television, calling up a friend to chat. Whatever you enjoy and can focus on, do it. Distraction can be especially helpful when your pain is holding you back from a task that needs to be done. This applies most often to physical tasks such as exercise or mundane housework — although if a mental task does not demand all of your focus, it may benefit from distraction, too.

Minimizing effort
Sometimes the pain caused by peripheral neuropathy gets worse with overuse of the affected area. Just as your body would ache after a heavy workout, your hands may ache when you demand too much of them. But how to avoid this? Can you name a household activity that doesn’t use your hands? Most likely, you have a daily routine that includes holding, lifting, and carrying objects. If you can find a way to make those tasks easier, it might lessen the burden on your hands and spare you some pain. There are two ways to approach reducing the physical burden of tasks: joint protection and work simplification.

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Also in this article:
Sources of Aids for Daily Living
Tips for Using Heat and Ice



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