Notes from the pain management workshop, week 2

This week was a lot more comprehensive than the first week, and it feels like a lot more happened in about the same amount of time.

The major areas of focus were: problem-solving, dealing with difficult emotions (especially useful for me right now), physical activity, relaxation techniques, and dealing with fatigue.

Problem-solving

The problem-solving bit was pretty straightforward and obvious stuff, but the sort of obvious where “everyone knows” it but nobody actually goes through with it.

  1. Identify the problem (which means looking at the surface issue and then digging down into the root causes until you can no longer find an underlying cause for the problem)

    For example, if the problem is “poor performance at work,” you might consider that that this in turn is due to fatigue and depression, which in turn are due to pain management issues

  2. List possible solutions

  3. Test one

  4. Evaluate its efficacy

  5. If it didn’t work, go back to step 3

  6. If nothing seems to work, find other resources

  7. Accept that not all problems can be solved right now with the resources available

Dealing with difficult emotions

A recap was to show the symptom cycle (with the caveat that it isn’t necessarily a cycle as any of these things can feed into any of the others):

  • Poor sleep
  • Tense muscles
  • Restricted movement
  • Ineffective breathing
  • Stress and anxiety
  • Difficult emotions
  • Depression
  • Fatigue

Difficult emotions are ones that get in the way of having a satisfying life or getting things done. They have a feedback effect with chronic pain issues, due to being part of the symptom cycle. To break out, first you need to identify the causes of the emotions, rather than the emotions themselves.

(For example, in my daily life right now I am feeling stressed about what’s going on at my drawing group, which leads me to not enjoy going, which leads me to feel negative while I’m there, which leads me to not enjoy my time there, which leads me to be stressed about what’s going on at my drawing group.)

Some healthy ways of handling emotions:

  • Cry
  • Laugh
  • Discuss with people who are core to the situation/emotion/frustration/etc.
  • Do volunteer work
  • Do something nice for yourself
  • Find a bigger perspective
  • Find positives to focus on, e.g. one good thing every day or a thing you’re grateful for
  • Spend time with pets
  • Watch a comedy movie or show
  • Journaling
  • Self-care
  • Therapy (professional or talking to sympathetic friends)

They made a specific point about journaling that the act of writing out your thoughts on a thing is a great way for the brain to process it; even if the journal stays private forever, or even if you shred/delete/burn it right afterward, there’s still a positive effect to be had by journaling about the things that are causing problems in your life.

Physical activity

Nothing particularly special here; typical recap of the positive effects of exercise (endorphines, improved range of motion, better cardiovascular health, reducing fatigue, etc.), and then a suggestion of setting aside time and being consistent with it.

Their recommended regimen (keeping in mind that the subject matter mostly targets elderly folks or those who have had massive bodily injuries):

  • Flexibility: goal is to do stretches daily, go for 10 minutes without stopping

  • Strength training: goal is to do 8-10 strength-training exercises at least 2-3 days a week.

    Special note: Don’t do strength training every day – always have a day off between sessions, to give your muscles time to heal! Otherwise you might end up causing injuries which then lead to another chronic pain cycle.

  • Endurance: Do 30-40 minutes of endurance-type exercises (intense walking, running, bicycling, dancing, etc.) 3-5 days per week

Chapters 7-9 of the book focus on different exercises for different parts of the above regimen.

There was also some discussion about the ways that we end up not doing our exercise even though we know we need to. I didn’t write that part down (since that’s not something I’ve struggled with) but the big takeaway for most people is that it’s easy to decide you don’t have time to do it, and there are solutions for that like establishing a schedule and setting reminders for yourself in your phone or whatever.

Relaxation techniques

First, focus on better breathing. Inhale slowly from the diaphragm (your belly should move out a bit, your chest shouldn’t move much at all), through the nose if possible, then hold it for a little bit and then exhale slowly through the mouth through pursed lips. The exhale should take about twice as long as the inhale.

Pace yourself in your activities. Don’t try to “race” against the pain to get things done before the pain happens; that only makes the pain come quicker.

When there is pain, do a mindfulness body scan. The book has a decent script for one, but there are plenty of these on Youtube and the like (I’m a fan of Michael Sealey’s but there are many shorter 10-minute ones out there).

Fatigue

Some identified causes:

  • Depression
  • Incorrect medication
  • Boredom
  • Overcast skies/seasonal changes
  • Pain
  • Lack of sleep
  • Stress
  • Anger and difficult emotions
  • Malnutrition
  • Body deconditioning
  • Illness
  • Overexertion
  • Inflammation
  • Muscle tension
  • Ineffective breathing
  • Dehydration
  • Hormonal imbalance

Solutions:

  • Pace yourself
  • Drink more water
  • Eat better
  • Sleep better
  • Update your medications (working with medical practitioners of course)
  • Fitness
  • Breathing exercises
  • Get your hormone levels checked and work with your doctor to correct any identified imbalances
  • Remember to rest!
  • Also don’t lose track of your social activities
  • And also establish boundaries especially with the people who would suck you dry

Homework for next week

  • Bring something to make a big decision about
  • My action plan for the next week (in addition to last week’s sleep cycle adjustment, which I kinda-sorta did okay at) is to do 10 minutes of yoga at 10 AM four times in the next week (I am planning on Friday, Sunday, Monday, and Wednesday and have set an alarm in my phone accordingly).

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