About 100 million Americans suffer from chronic pain. Lasting longer than six months, such pain can be mild or excruciating, episodic or continuous, inconvenient or totally incapacitating.
For too many, chronic pain is an invisible and debilitating condition. Often employers and even spouses can’t quite appreciate the impact of a migraine or the limitations imposed by back pain. As such, those who suffer often report feeling isolated in addition to feeling depressed, worried about levels of medication and anxious about a future of no relief from pain.
Scientifically Proven Non-Medication Strategies
The good news is that in addition to ever expanding medication options, there are an increasing number of scientifically proven non-medication approaches to reduce chronic pain, increase the effectiveness of medication, address flare-ups, and in some cases reduce need for medication.
Identified by experts, some of these include: Diaphragmatic Breathing, Guided Imagery, Progressive Muscle Relaxation (PMR), Cognitive Behavioral Therapy, and Meditation.
Why don’t more people use and benefit by these?
My experience both personally and professionally is that while many have read or heard of these strategies from doctors, physical therapists, mental health professionals, etc. people tend not to use them because no one has answered these questions: Why do they work? How can we be sure we are using them in the most effective way?
In a recent episode of “Psych Up” on Cosozo Radio, entitled ” Living Well: Strategies for Managing Chronic Pain and Health” my guest Dr. Dawn Buse, nationally recognized expert in migraine and chronic pain and Director of Behavioral Medicine at the Montefiore Headache Center in New York, offers us answers. Here is a brief synopsis of two important answers to the two questions above.
The reason that non-medication approaches have proven to reduce chronic pain is that they have the capacity to move us out of The Stress Response by activating The Relaxation Response.
The Stress Response
- We are wired to survive. Our Stress Response of Fight/Fight/Freeze is a body-mind response triggered when we perceive danger.
- Whether we see a tiger in our path or we realize we are going to be fired, information is sent to the amygdala, the part of the brain that deals with emotional processing. When danger is perceived it instantly sends a message to the hypothalamus, which in turn trips the sympathetic nervous system to provide a burst of energy for fight/flight or sometimes freeze in order to survive.
- If we were wired to a computer for biofeedback, you would see increased heart rate, increased blood pressure as blood is pumped to the major organs away from the limbs, slow down of digestion, and shallow breathing due to dilation or constriction of key blood vessels and small airways in the lungs called bronchioles.
What is crucial to understand and clear if you were using a computer for biofeedback is that our mind-body connection does not differentiate between a tiger in our path, an argument with a co-worker, or chronic pain. All activate The Stress Response and the body reactions that go with it.
The problem with chronic pain is that the Stress Response works at cross-purposes to pain reduction.
- The racing heart and shallow breathing does not allow for relaxing which lowers pain.
- The slowing down of digestion can interfere with digestion and effectiveness of medication.
- Flow of blood away from the extremities does not increase circulation or reduce pain in those areas.
- Hyperarousal needed for survival does not facilitate sleep, which is restorative to pain and healing.
- The fear and loss of control which pain triggers exacerbate stress response activation.
The Relaxation Response
We can stop the vicious cycle of pain, stress response, and more pain by using proven strategies to activate the parasympathetic nervous system, which acts like a brake. It promotes The Relaxation Response–the “rest and digest” response that calms the body down after the danger has passed.
In her clear and detailed descriptions, Dr. Dawn Buse tells us that if we were using biofeedback we would see that by initiating diaphragmatic breathing at times of stress, we would begin to see changes and reduction of the bodily correlates of The Stress Response within 10 seconds!!
Effectively Using Scientifically Proven Strategies to Reduce Chronic
Many of us have heard of Diaphragmatic or Abdominal Breathing to initiate the Relaxation Response—but do we really know how to do this? If not, it is unlikely that you will automatically draw upon it as a strategy to deal with pain and stress.
Hearing Dr. Buse describe this valuable breathing technique on Psych Up and hearing her invitation to listen to her online (dawnbuse.com) or to use any of the many apps or websites now available to guide you in using strategies like Diaphragmatic Breathing, Guided Imagery, Progressive Muscle Relaxation or Meditation (PRM), etc. opens up a new world of possibility for chronic pain reduction by effective use of strategies.
- Listening to someone walk you through reassures you of correct technique.
- It frees the listener from the burden of thinking. You are being guided, for example, through the steps of Progressive Muscle Relaxation (PMR)–all you need to do is relax.
One young man describes putting on his headphones to ease his back with a quick nap when his babies (twins) are sleeping. He reports being asleep before he has even heard the steps for the final muscle group!
- One of the problems when suffering from chronic pain is the feeling of being alone, not because people are not trying to be helpful, but because pain puts you in a different place than those who are not suffering. Having someone (a therapist, a soothing voice on an app, a tape, etc.) walk you out of pain into pain reduction is a valuable connection.
Once you understand why these strategies work and feel a sense of competence when drawing upon them frequently, you are not only likely to feel less pain; your ability to feel a sense of well-being may belong to you again.