Notes from the pain management workshop, week 3
Week 3’s curriculum covered the Moving Easy Program (a simple but effective stretching and minor strength training regimen), pacing and planning, treatment evaluation, and decision making strategies (both for treatment seeking and for other aspects of life).
Last week’s action plan was to do 10 minutes of yoga in the morning, 4 times. I was mostly successful, but only did it 3 times, as today I slept in from having to work late last night (doing a final build of the iOS app for Borealis).
Throughout today’s session we also got some useful affirmations that I can put onto my affirmation board:
- Practice makes progress
- You choose
- Are you choosing pain?
Moving Easy Program
The Moving Easy Program is a simple set of range-of-motion exercises with some good stretches and some minor strength training. It’s in the form of audio prompts that follow some basic workout diagrams in the book (affiliate link).
- Focus your mind on the present
- Become aware of your posture
- Monitor your breathing
- Pay attention to your body as it moves
- Move slowly, without jerking or bouncing
- Relax, keep your shoulders soft
- Keep breathing
- Never force yourself beyond what’s comfortable
- Everyone has a range of motion; don’t force yourself past yours
- It’s not a competition
- Be sure that the exercises are okay for you to do
- Don’t do moves that you can’t or shouldn’t
- When changing position between sitting and standing, don’t tip your body backwards
For copyright reasons I won’t be reproducing the specific exercises here; unfortunately I don’t find anyone doing this particular program on YouTube or the like. Maybe I’ll record a video at some point.
Pacing and planning
This is something I always have trouble with, as anyone who knows me knows. Apparently it’s also very common with other people with chronic pain, go figure.
The temptation at the start of any chronic pain is to rest up to heal (which is something that I’ve always been encouraged to do by management and so on) but this actually causes longer-term damage, because when the body is inactive it doesn’t heal itself very well and muscles atrophy and so on. And the older you get the more damaging this becomes. Even one week of inactivity can lead to significant muscle loss.
There are two common vicious cycles which occur in people with chronic pain:
- Reduced activity
- Reduced strength
- Feeling better
- Pushing too hard
- Pain returns, but now a rush to get things done
- Total collapse
- Feeling better
(I mostly fall into the second one although sometimes my “recovery” step looks a lot like the first one.)
So, it’s important to pace yourself in order to balance activity and recovery.
Some pacing tips:
- Monitor your daily activities (the book provides an elaborate journal which basically asks for an hourly breakdown of what you did during that hour and what your pain level was during it)
- Develop an activity schedule
- Be time oriented, rather than pain oriented
- Rest before pain starts to worsen
- A change to the activity might be as good as a period of rest (e.g. replacing “this hour I will work” with “this hour I will pet my cats”)
- Set a timer for rest breaks and stick to it (this is what I use Time Out for, but sticking to it is the hard part…)
- Break down activities into smaller, more manageable parts
- Avoid rushing; slow down, plan ahead
- Don’t overschedule yourself
- Prioritize the activities you do schedule
This section was mostly about maintaining healthy skepticism regarding various medical or “alternative medicine” treatments. Namely a thought process to go through when learning about some treatment for a condition:
- Where did I learn about it?
- Were the people who got better by it like me? (i.e. similar circumstances, verifiably real people, etc.)
- Could anything else have caused their improvement?
- Is the treatment complementary (i.e. works with your existing care regimen) or does it require that you do without certain things (doctors, particular medications, important lifestyle aspects, etc.)
- Is the treatment about avoiding certain foods? (A common red flag in “miracle cures”)
- What are the possible dangers or harms that can happen by undergoing this treatment?
- Can I even afford it? (not just financially, but whatever physical cost it may have, or the emotional cost of it not working – if it’s a “last hope” it might require a bit more skepticism)
- Am I willing to go through the trouble and expense?
- Does it promise to be a cure for something that’s incurable?
Some useful online resources they provide:
- The American Chronic Pain Association
- Stanford University’s Self-Management Resource Center
- The National Institutes of Health’s chronic pain resources
It also provides a bunch of resources which are no longer online as far as I can tell. It also unfortunately spreads some very common (and dangerous) misconceptions about the ability to filter out data based on the domain name it’s on; for example, they propagate the very wrong belief that .org sites are non-profit organizations (and therefore have no commercial interest in selling you things), and that .biz sites are all advertising. (Ahem.)
Sort of a simple refresher on how to make difficult decisions.
- Identify your options
- Write the pros and cons for each option, including ones that are based on emotional state (since emotions are important!)
- Score each pro or con from 1 to 5 (the score being how important it is to you or how strongly you feel about it or whatever)
- Add up the pros' and cons' scores
- See if it matches your gut feeling about which is better; if not, maybe add more pros and/or cons until it does. Or consider some of your other options.
Also it’s helpful to seek out opinions from others who have been through similar things, or respectable experts in a field or whatever.
Action plan for next week
My action plan for the next week is to resume my upper body strength training exercises. My intention is that every other day (starting today) I will, at 5 PM, do at least 15 minutes of strength training, such as lifting dumbbells, using my chin-up bar, or using my Powerball (affiliate link).
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