Diabetes Self-Management Blog

Last week I wrote about all the different medicines available to treat chronic pain. But there are many nondrug approaches as well. Here are a few:

You can do physical things at the point of pain. Massage is good, and it doesn’t have to be professional. Any kind of caring touch may distract from pain sensations and help tissues heal. Self-massage helps, too.

Topical creams like something that includes capsaicin or Arnica reduce pain for a lot of people.

Ice or heat can help healing and reduce pain. It doesn’t seem to matter which — some people like cold and others like heat, or you can alternate them. Heat and cold both compete with pain signals and so reduce pain sensations. So does gentle touch.

Exercise — stretching, strengthening, and conditioning — can reduce pain. An interesting study showed that being sedentary increased sensations of pain in mice. (They could tell by observing the mouse’s behaviors — they didn’t ask the mice to rate pain on a scale of 1–10.)

Of course, it’s hard to exercise when you’re hurting. It’s important to start slow and keep it gentle. A good physical therapist can help.

Anodyne Therapy is treatment with an infrared light. It seems effective for peripheral neuropathy, which can cause pain in the arms, legs, feet, and hands. You can read about Anodyne Therapy here.

Electrical stimulation to the nerves can be done through the skin and can block pain signals. Ask your doctor about a “transcutaneous electrical nerve stimulation” (TENS) unit.

As I wrote last week, there are many medicines approved for treating pain. Ask for them, whether they are narcotics or not. As reader Gary commented, many doctors refuse to prescribe narcotics, because they are afraid of “drug seeking” or “addiction.” They seem to think those are worse than pain. But they’re not. Here’s an article about addiction in chronic pain and why it’s not a major risk if medicines are used right.

See my blog entry from last week for other categories of medicines that can help with pain.

Laughter is great pain medicine. It’s very difficult to feel pain when you are laughing. Watch comedies or watch children playing, or just laugh for no reason. Studies actually show that laughter, even forced laughter, reduces pain. It also reduces inflammation and improves circulation, so it can heal the causes of some kinds of pain.

Sex causes your body to release oxytocin and endorphins, both of which make you feel better. Of course, both sex and laughter can be difficult when you are in pain. You can take some of your medicine to make it easier to relax and have fun.

Being aware of how eating affects pain levels makes a difference for many people. It may be that some foods increase your pain, while others make you feel better. Pay attention and keep records, and you may notice patterns that help you. Then eat the things that make you feel good.

Poor sleep is pain’s twin. If you can improve sleep, your pain will almost certainly decrease. Get checked for sleep apnea. Learn sleep hygiene techniques here. Have your medicines evaluated for their affect on sleep (all medicines, not just your pain medicines.)

Many times, painful thoughts add greatly to physical pain. As I wrote two weeks ago, chronic pain is physical, emotional, and mental, a whole body experience. So getting some psychological help with changing painful thoughts (such as “I can’t stand this”) to more balanced thoughts, like “I can barely stand this” make a big difference.

Distraction makes it easier to forget pain for a while. Hobbies, volunteering — especially helping others — puzzles and games, guided imagery, or remembering pleasant times (looking at pictures, etc.) can all take your mind off pain. So can working on some project that is important to you. It doesn’t have to be important to anybody else.

Relaxation, meditation, and prayer all improve pain conditions. Learning to step back and observe your body and its sufferings with your “higher self,” or letting pain go to your “higher power,” takes a lot of pressure off. Just the act of sitting peacefully and breathing will relax muscles. Accepting what is and realizing that it won’t last forever may give comfort and help you go on.

Pain specialist Dr. Karen Burt-Amira talks of “developing a witness within,” a part of you that sees what your mind and body are going through, but does not identify as the one who is suffering. This practice helps to “open up a bigger sense of who you are” so you see that pain is only part of your experience.

I’ve listed 13 categories of treatments for chronic pain. I wrote about more here, including acupuncture and changing painful living or work situations.

But just as important as any of them is finding support and connection. People need to talk with someone who understands. They need the support and understanding of families. They need a sense of connection to the world, which can be difficult when pain makes it hard to participate.

Pain specialists have a saying: “The group is the medicine.” It’s true. We’re group animals; we feel better with support. Find yourself a support group, even if it’s only one other person. And please let us know what your experience is going forward.

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