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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How to Become a Mask Wearer

Long before COVID-19, online chat groups for people with pulmonary fibrosis (PF) were filled with posts about how uncomfortable it is to wear a mask in public: not physically uncomfortable, a fact that was barely mentioned, but psychologically uncomfortable. For people with this condition or the lung transplant used to cure it, catching a cold or the flu could be deadly. They need to wear masks in public to help protect themselves from getting ill.

The participants discussed how awkward it is riding the bus in a mask, going to the grocery store in a mask, or boarding a plane while wearing one. They were mostly self-conscious that others would think they were ill or weak. Many would rather suffer the risk of getting fatally sick than put a mask on in a department store.

Now, we've all been directed to wear masks in public. Both Bennington and Wilmington's Select Boards have passed local mandates requiring masks in public places. This—along with distancing and handwashing—are crucial parts of returning to a more normal way of life. Suddenly, we are all feeling the psychological discomfort PF patients have felt for many years.

People usually have an interest in blending in. And, just like doing anything out of the ordinary, wearing a mask for the first time definitely feels like putting yourself out there. If we want to return to a somewhat normal way of life, masks are crucially important, along with frequent, thorough handwashing and keeping a distance from others.

Here are a few tips for making the leap from being someone nervous about wearing a mask to being a person who wears one regularly.

Do it for others. We know that people can spread COVID-19 as many as a few days before they get sick. Even if you feel fine, you could have COVID-19 right now without knowing it. At the same time, masks are far better at keeping sick people from spreading germs than they are at keeping people from getting sick. So wearing a mask isn't a sign of weakness; it's a sign of altruism. It's like saying, "I am not certain that I am not sick, so I want to pay those around me the consideration of limiting the likelihood I will infect them." Think of it as a badge of kindness.

Get a mask that fits. We know that masks are not completely comfortable physically. Getting the right fit makes a big difference in their "wearability." Cloth masks are readily available online and from local groups. The Green Mountain Mask Makers have excellent information and resources. If you can, purchase a few types in a few sizes to see which you like best. Buy enough of that type to allow washing between trips out in public.

Get a mask that you like. Once you have found a mask source and as long as you have a choice, pick one that you like. You can choose colors that match your wardrobe or that represent your interests, like camouflage. There are even masks that look like fashionable scarves when they hang around your neck. The sooner we start thinking of masks as part of our outfits, as essential and unremarkable as shoes or a belt, the healthier we will all be.

Try to quit caring about what others think. This one is hard. But one wise PF patient wrote, "I just don't give a darn!" Essentially, he shared that if people want to judge him for wearing a mask, so be it. Their opinions don't have a single thing to do with him. Many in the chat group applauded his confidence and vowed to adopt his attitude.

If we all do our best, soon the cultural scale will tip. Wearing a mask or not wearing one will cease to be a political statement. It will be normal. And thankfully, if wearing a mask in public, handwashing and sanitizing, and keeping our distance are all normal, going out into public again can be safe and normal too.

Donna Barron, RN, is the infection preventionist at Southwestern Vermont Medical Center.

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