The War on Pain has begun! But in order to defeat this enemy, we first have to understand it.Many people simply mask pain by avoiding activity and taking increasing amounts of medication like opioids. However, there is a growing body of evidence that suggests having increased knowledge of pain can help the recovery process.
At Activcore, we want to share some of our thoughts on pain management. We hope that, with this new arsenal of information, you can conquer your pain and return to whatever it is that you love to do.
Section 1: Introduction (prevalence, incidence, societal impact of pain)
So what is pain? And how big of a problem is it?
The International Association for the Study of Pain (IASP) defines pain as “an unpleasant sensory and emotional experience associated with actual or potential tissue damage, or described in terms of such damage.”
Pain is a very real experience, and every person’s perception of pain is much different. For many people around the world, pain directly impacts their everyday life.
Important Facts about pain:
- Over 1.5 billion people worldwide suffer from chronic pain. Pain affects more Americans than diabetes, heart disease and cancer combined.
- Pain is cited as the most common reason Americans access the health care system. It is a leading cause of disability and it is a major contributor to health care costs, approximately $560-635 billion each year; that’s $2,000 for every person in the US!
- Total incremental cost of healthcare due to pain from ranging between $297-$336 billion due to lost productivity (based on days of work missed, hours of work lost, and lower wages).
- According to the National Center for Health Statistics, approximately 76.2 million, one in every four Americans, have suffered from pain that lasts longer than 24 hours and millions more suffer from acute pain.
- Chronic pain is the most common cause of long-term disability.
- Pain can be a chronic disease, a barrier to cancer treatment, and can occur alongside other diseases and conditions (e.g. depression, post-traumatic stress disorder, traumatic brain injury).
Section 2: Treating Pain (Acute)
Our therapists at Activcore put together the following tips in order to better understand your pain, how to treat it, and help you achieve your goals!
RICE is a strategy used by many health professionals for early treatment of recent injuries.
- Rest: Reduce or stop using the injured area for 48 hours. If you have a leg injury, you may need to stay off of it completely.
- Ice: Put an ice pack on the injured area for 20 minutes at a time, 4 to 8 times per day. Use a cold pack, ice bag, or a plastic bag filled with crushed ice that has been wrapped in a towel.
- Compression: Compress the injured area, such as an injured ankle, knee, or wrist to help reduce the swelling. This includes bandages such as elastic wraps, special boots, air casts and splints. Ask your therapist or doctor which is best for you.
- Elevation: Keep the injured area elevated above the level of the heart. This will also help to reduce the amount of swelling to the injured area. You can use a pillow to help elevate an injured limb.
*RICE becomes PRICE when you add:
- Protection: If you have sustained a more serious injury and have any type of buckling, giving way or instability in your joint or injured area, you may want to protect the injured area with a brace. You should see a doctor immediately if you feel any of these symptoms, or if your symptoms have not resolved within 7-10 days.
RICE or PRICE for at least 48 hours. As you start to feel better, you can slowly return to normal activities. Just be sure to stop whenever you feel pain.
Section 3: Stages of healing
No matter what or where your injury is, your body goes through a typical cycle of healing, with 3 main stages: Inflammatory, Proliferation and Remodeling.
- Inflammatory: This happens right after injury. Starts from the moment the injury occurred and typically peaks within 48 hours, but can last up to 7 days or longer. So if your knee still hurts after your pick-up game last week, it’s ok! What you are feeling is perfectly normal (albeit unpleasant). This is the optimum time for RICE!
- Proliferation: Typically lasts 7-21 days. You will be able to increase your activity levels but still may have varying levels of pain. It is important during this time period to return to normal activity as much as tolerated.
- Remodeling: Typically begins about 21 days after your injury. You injury is now healed with scar tissue and pain will gradually subside if it has not already. However, now is the time to slowly but steadily increase your activity and try to return to your prior level of function. This will help to ensure that you keep healing the injured area and strengthen it to a level where you can return to the activities you love.
Understanding the process of healing will help guide you in treating your injury and when to return to your prior activities.
Section 4: Chronic Pain
As we described above, your body goes through a typical cycle of healing in order to repair the injury you have sustained. But sometimes, this cycle is interrupted or disrupted, keeping you in a prolonged inflammatory phase and leading you down the path to chronic pain.
Chronic pain differs from acute pain in that it is not provoked by a single or specific injury, disease or condition and is not self-limited to the healing process. Chronic pain outlasts the normal healing time and stages, does not serve any purpose in the healing cycle and has no recognizable end point. Furthermore, emotions have a significant influence on chronic pain and may result in a cycle of increased emotional distress and increase pain.
Chronic pain can be debilitating to everyday life and prevent you from living the life you wish to lead. We offer the following advice on dealing with chronic pain:
1. Home and Workstation Modification
If it is difficult or painful for you to perform your activities of daily living or work related tasks, it would be beneficial to you to adjust your surroundings to reduce your pain level. This could be by avoiding stairs and adding grab bars into your home to allow you to move safely or re-arranging your workstation to make you more comfortable at work.
2. The Psychology of Pain
Acknowledging and understanding the impact that pain has on our emotional, social and psychological health is an important step in conquering your chronic pain. Pain is never fun, and being in long-term pain can have a significant affect on your mental wellbeing.
Massage, meditation, yoga, deep breathing exercises and counseling may help to cope and control stressors in your life. Removing these stressors is another way to reduce the stress in your life and may reduce your pain level. You may also wish to speak with a counselor or psychologist to help address these issues.
3. Nutrition and Pain
Nutrition has a huge impact on our health and wellbeing. New research has suggested that the food that we eat can have a direct impact in our health and recovery: Eating gluten-free and dairy free foods may help to reduce the inflammation in your body. Some foods contain properties such as antioxidants, which help to neutralize the oxidative stress in our bodies.
4. Activity Modification
Avoid movements/activities, which increase your pain.
Increase movements/activities, which decrease your pain.
Modify movements/activities that you must do but cause pain. (For example, you may have to carry fewer groceries or take multiple trips to/from the car to manage your pain).
5. Fatigue and Sleep Deprivation
Decreased sleep and increased fatigue have been shown to increase pain levels and overall stress levels. This is probably more important than you think. Make sure you consistently get a good night sleep to allow for optimal healing.
6. The Importance of Movement
Inactivity leads to degeneration. Movement and exercise helps keep joints and muscles active, flexible and strong. It also releases endorphins, which are natural pain and stress fighters.
Moving in a pain free range allows your body to relax during movement and not be shut down by the fear of pain. It will also help to boost your confidence as you realize you can move and not be in pain! Consult your local Activcore therapist if you wish to learn more about pain free movement. Quality of movement is equally important. Injury, pain, misuse and disuse, can change the way you are supposed to move, resulting in muscle imbalances.
Incorrect movements can actually lead to new or more pain, as the structures of the body are not interacting in the proper way. By moving in a more natural way, your imbalances can be fixed and movement becomes pain free.
7. Pain Free Exercise
By offloading through use of bungees, exercises can be modified and regressed as needed to eliminate pain. Activcore therapists are specially trained in the Redcord Neurac method, which strives for pain free movement. Redcord’s “weightless” environment can enable persons to start exercising at an earlier point in their progression. It offers a similar off-weighting (buoyancy) effect and relief of pain that occurs while in a swimming pool.
Some Take Home Points:
- Avoid painful movements and activities.
- Start moving as much as you can in pain free activities/movements
- If the pain starts, you stop. You will steadily be able to do more activity as you heal.
- Start moving the right way! Your local Activcore therapists are specially trained to help you move better and in a pain-free way.
- Just because you are in pain does not mean you can’t move. There are always ways to adjust the activities you love or need to do.
- Remember: you are stronger than you think and feel. Sometimes, you just need a little guidance in the right direction to start moving.
To learn more about pain and how a physical therapist can help you, click here to find an Activcore location near you.