Coping with Pain
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/ Categories: WELLNESS, 2022

Coping with Pain

The Journal of the International Association for the Study of Pain estimates as many as 18 million Americans suffer from chronic pain on most days. It can be caused by headache, surgery, cancer, trauma, arthritis, nerve damage, and neck or back injury. Sometimes the cause is unknown or continues long after the initial cause of the pain has healed. The pain can go on for months or years and can lead to anxiety, depression, fatigue, insomnia, mood swings, irritability, and other difficult psychological conditions.

Once you have worked with your primary care provider and specialists to identify and treat the cause of the pain, you can try these options for coping with the pain in any order that makes the best sense to you and your provider.

Medical Approaches

Each of the many medications used to help with pain come with side effects. 

  • Acetaminophen can harm the liver if used excessively or improperly.
  • Ibuprofen and other nonsteroidal anti-inflammatory drugs (NSAIDs) can cause kidney damage in certain patients.
  • Muscle relaxers can provide relief in some cases, but they may cause drowsiness, dizziness, headache, and other side effects.
  • It’s best to develop a system that includes these medications when needed.
  • Antidepressants are being prescribed for those with chronic pain. Often, the benefits outweigh the side effects.

SPECIAL NOTE:

A few of the drugs often turned to for pain come with major concerns and should only be used with careful supervision from a medical provider.

  • Opioids come with a great risk of addiction, tolerance, dependence, and a paradoxical increase in pain. This factor alone makes them undesirable for many patients, even for short-term use.
  • Cannabis is not approved by the Food and Drug Administration. It is associated with acute adverse effects including anxiety, nausea, panic, disorientation, impaired attention, short-term memory, and driving performance.

Physical and occupational therapy can be a great drug-free way to cope with chronic pain. Movement can help restore strength and confidence. Often, the symptoms of chronic pain are reduced. Therapy is a safe, even fun, way to navigate pain.

Similarly, mental health counseling can help patients think more positively, process past events, and implement helpful changes. Through talk therapy people often come to understand how unconscious forces contribute to their pain.

Pain Management Programs combine imaging and anesthesiology technologies to target the source of pain and relieve it.  Services offered include joint injections, nerve blocks, spinal cord stimulation, and others.

Do-it-Yourself Ideas

Many people find that concentrating on improving their overall health is a great way to make progress against chronic pain.

Many people find it beneficial to focus on relaxation.

  • Don’t try to do too much. Create a daily schedule that includes a few priorities and time for rest and self-care.
  • Create the conditions for good sleep.
  • Learn stress management techniques that work for you, including deep breathing, yoga, meditation, listening to music, walking in nature, playing with kids or pets, and others.
  • Getting interested in a new hobby can also be beneficial. More than a distraction, hobbies and interests get us thinking positively about the future.
  • Strong relationships help us cope with pain too. Meet up with friends and family or join a pain management support group.

Complementary Medicine

Complementary medicine can be as simple as treating the site of your pain with heat or cold or enjoying a cup of restorative tea. If you are receptive, you can also try massage, reiki, acupuncture, biofeedback, guided imagery, or hypnosis. Each has been shown to be an all-natural method for achieving pain relief.

It is unlikely that any one of the tips above will resolve your pain entirely. A personalized system of pain-management habits you do on a routine basis will be most powerful in helping you live a healthy and fulfilling life.

Joshua Tobe, MD, is an anesthesiologist and interventional pain management specialist at SVMC Anesthesiology, part of Southwestern Vermont Medical Center and Southwestern Vermont Health Care in Bennington.

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Home Office How To

Did you know that many sources of chronic pain start in a poorly arranged office? Carpal tunnel, pinched nerves, overuse injuries can often be traced to chairs being positioned improperly or important tools being positioned outside easy reach. While reaching or straining once or twice wouldn't hurt us at all, doing so repeatedly day after day can cause painful and lasting injuries.

As an occupational health physician at Southwestern Vermont Medical Center, one of my responsibilities is to help employees of SVMC and other companies who have workplace injuries and recommend the adjustments they should make.

During a spike in work-from-home arrangements, I have heard about friends’ and family members' work-from-home set-ups. Some are working from laptops on their couches. Others are set up at kitchen tables. We know that their cats walk across their keyboards and their kids interrupt. Especially since Governor Scott has just indicated that remote workers will likely be the last to return to the traditional workplace, it's time to get our home office arrangements figured out.

That's why I would like to share the important details you need to arrange a healthful workspace and encourage all to invest the time (and sometimes a little bit of money) needed to implement them. Learning these points is key to avoiding injuries, as continued work-from-home policies, where feasible, will help maintain appropriate distancing needed to decrease the spread of COVID-19.

An adjustable chair is the first and most important component of an office set-up. Office chairs include crucial lumbar support and encourage good posture. When your forearms are resting on your desk or table, adjust the chair height up or down until your arms form a right angle. This is an important step in avoiding wrist pain and carpal tunnel, two of the most common office injuries. If, when your arms are in the correct position, your feet are not touching the floor, employ a footstool.

Position your monitor an arm’s length away. (If you can't see the screen from this distance, better go get an eye exam!) And raise the screen so that the top of the screen is eye level. This, too, will encourage good posture.

If you use two monitors, positioning them properly depends on how you use them. If you use them equally, the dividing line between them should be right in front of you. If you use one primarily and the other secondarily, position the more dominant screen directly in front of you. If you use a laptop, consider investing in a riser and an additional keyboard needed to raise the screen to eye level.

Put all of your other tools, including your mouse and phone, within easy reach. If you use the phone a lot, consider investing in a headset.

The only other recommendation I make is to stretch every 15 – 20 minutes. A list of helpful office-oriented stretches is available here. And every hour, be sure to get up and take a short walk or standing stretch.

If you follow these recommendations at home, you will be much more comfortable and are likely to be more productive, too, all while maintaining the social distance we need to keep COVID-19 infections low throughout this next phase of the pandemic. Most importantly, you will save yourself the pain and discomfort of office injury no matter where you're working.

Mark Zimpfer, MD, is a physician at Southwestern Vermont Medical Center's Occupational Health practice. 

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