Jill Clark, Rehabilitation Assistant
Adapted from Dr. Bahram Jam, Registered Physiotherapist “The Pain Truth and Nothing But!” Advanced Physical Therapy Persistent Pain Certification Program
Pain has a way of overtaking the brain, and at times you may feel it is all you can think about. Your pain might be so unbearable that it makes a simple task, such as folding laundry, seem daunting. With persistent pain, we need a balance between challenging the nervous system (i.e. exercise or activities of daily living), resting the nervous system (i.e. watching TV) and calming the nervous system (actively using strategies to bring the nervous system back down). Many people in pain tend to fluctuate between challenging the nervous system (and flaring up the pain) then resting
the nervous system when the pain becomes too much. Strategies that calm the nervous system down can be effective for helping to manage pain; therefore, it is important to add those activities into your daily regime. This may be achieved by recognizing what brings you joy and incorporating that into your life. By paying attention to the things that make you feel good, you may learn to do more with the pain. Below are a few strategies that may be helpful in actively calming the nervous system.
It is important to notice the little things that you accomplish in your day to day life that bring you joy. The smaller and simpler the goal, the easier it is to gradually build off of. Starting with smaller and achievable goals that you enjoy, instead of focusing on goals that you feel like you should do, can be calming for the nervous system. When we experience pleasure, happy hormones, such as Dopamine and Endorphins, are released in the brain that can have a positive effect on pain.
Small things that you should pay attention to
- Mindfully breathing for 1-minute
- Reading one page of a book that you love
- Eating your favourite fruit and paying attention to how it tastes
- Taking a bubble bath
- Walking for 10 minutes
Magnesium (Mg) may help for the following symptoms associated with persistent pain:
- Muscle aches and cramps (calves & lower back)
- Poor quality of sleep/difficulty falling asleep
- Frequent urination
- High stress, low mood, decreased concentration
- Heart palpitations
- Decreased concentration
Magnesium rich foods
- Almonds, pepita seeds, spinach, broccoli, avocado, brown rice
A vitamin D deficiency may affect both physical and mental health. In addition to spending time in the sun, you may also take a supplement and incorporate vitamin D into your diet (Dogru et al 2017).
Vitamin D rich foods
- Spinach, kale, okra, collards, soybeans, white beans, salmon, oatmeal
Emotions can become part of the pain experience. Aromatherapy is thought to work by stimulating smell receptors in the nose, sending messages through the nervous system to the limbic system – the part of the brain responsible for controlling emotions. Flooding this part of the brain with positive emotions may contribute to aiding pain. What is the best scent to help sooth and calm the nervous system? Whatever one YOU enjoy the most.
Different ways to use essential oils:
- With a diffuser to scent a room
- Combine with an unscented lotion and rub onto painful areas of the body
- Sprinkle onto bed sheets
An inexpensive way to help with persistent pain, music therapy has no adverse effects and can assist in lowering stress and anxiety, thereby lowering pain. The music that is most beneficial for calming the nervous system is the type of music that YOU enjoy most.
Tips to fully benefit from music therapy
- Use headphones
- Close your eyes
- Mindfully listen for 60-90 minutes
- Repeat 1-2 times daily
Physical activity should be any activity you enjoy. Walking is a great way to mindfully move your body and do so at your own pace. Below are some tips to keep in mind:
Before you start, evaluate where your pain is on a scale from 0-10.
- Your pain will increase when you go to move, this is normal and safe. Notice how much your pain increases and if it is more than 2 points, take a break to check in.
- If your pain does come down with a short rest, continue on your walk and repeat step 1 and, if necessary, step 2
- If your pain keeps going up, take some more time and when you are ready, try to walk again.
If your pain keeps increasing or stays increased for more than 2 hours, it is a good indication that you were either walking too fast or too far. Don’t worry, you did not damage anything. It means you pushed your nervous system too far for that activity. Do not stop walking if you love it, simply modify the distance and your speed and gradually increase. You will need to find the amount you can tolerate without flaring up your pain.
Making your walk more enjoyable
- If possible, walk with a dog or a loved one
- Walk on a familiar path
- Pay attention to the colours of the trees
Our nervous system is plastic, meaning it is continually changing and adapting; our nerves learn what we practice. By incorporating calming activities into your day, you can help teach the nervous system to change thus managing your persistent pain. Neuroplasticity!
References: Dogru, Atalay, et al. “Effects of Vitamin D Therapy on Quality of Life in Patients with Fibromyalgia.” The Eurasian Journal of Medicine, The Eurasian Journal of Medicine, June 2017, www.ncbi.nlm.nih.gov/pmc/articles/PMC5469836/.
Brent A. Bauer, M.D. “Aromatherapy: Is It Worthwhile?” Mayo Clinic, Mayo Foundation for Medical Education and Research, 24 May 2017, www.mayoclinic.org/healthy-lifestyle/consumer-health/expert-answers/aromatherapy/faq-20058566.