Below are five classifications of nonpharmacological (non-medication) ways that people have learned to implement in order to manage their chronic pain.  You may already be implementing some of the examples listed below.  The important thing to remember is you can always improve your ability to intervene in a way that helps you obtain effective pain management.  Sometimes the intervention does need to include pain medication or medical procedures, but changing your medication protocols should only be done with your healthcare provider’s knowledge and permission. 

1. Relaxation: When you are in chronic pain your body’s automatic response often includes a reflexive tensing response. This problem leads to your being unable to relax the locus of the pain problems, which leads to increased muscle tension in these areas. You need to practice to consciously relax the affected muscles, enabling them to modulate your pain levels and bring the pain under your control without needing to increase your medication.
2. Increasing Activity and Fitness: Many people experiencing chronic pain become very sedentary, with strong avoidance tendencies for many types of activities. The two primary reasons for this are the pain itself, and your own predictions regarding the negative impact of activity. Therefore, it is crucial to return to more normal levels of activities and slowly increase your stamina for physical activities. The goal is to extinguish conditioned avoidance patterns.
3. Reducing Emotional Over-Reactivity: When you are experiencing intense uncomfortable emotions—especially about being in pain—your pain levels actually intensify. Your emotions become like an amplifier circuit that increases the “volume” of your pain.  You need to practice specific methods of reducing this automatic process that occurs in the face of stressful triggers. You need to realize that you may not be able to eliminate these problematic emotional triggers but what you can learn are different methods of reacting and managing your feelings.
4.  External Focusing/Distracting: The more you focus on your pain the more you actually intensify your experience of the pain. You need to learn to shift and manipulate your focus of attention in a positive way, which will minimize your experience of the pain. This can be accomplished by changing how you think and feel about your pain. You can then find pleasant activities or tasks to take your focus off of your pain. 
5. Using Anything That Works: There are numerous interventions that you can attempt to help manage your chronic pain. In addition to those listed above you can use breathing, muscle relaxation, visual imagery, music, cold/heat, stretching, massage therapy, stress management, acupuncture, acupressure,  TENS Unit, journaling, hydrotherapy, etc.

If you want to learn more about non-medication management of chronic pain please go to our website at www.addiction-free.com or go right to our Publications page to check out my APM Module Three: Understanding and Developing Effective Pain Management.  You can also check out our Ariticles page to download any of my free articles.

I believe and important part of developing an effective pain management plan includes having an understanding of each person’s lifetime history with pain and pain management going back to early childhood if possible.  What people experience as children when they have pain does impact their perceptions about pain and what to do about being in pain.
 
I’ve seen a very wide spectrum of family history where on one end of the spectrum people learn that when they have pain they are to “tough it out” and not “complain and cry.”  They learn that it’s a sign of weakness to show pain.  Now on the other extreme end of this spectrum is where someone learns that when they’re in pain they get nurtured, extra attention, and pain is quickly medicated—and sometimes over-medicated. 

I’ve seen significant research over the years about how pain in childhood does impact how people are able to effectively manage their pain and also are more likely to experience chronic pain as an adult.  I was looking at a new website today—www.massagemag.com—and on their research page I found the research posting that I’ve copied below.

Childhood Pain Patterns: Research 5/19/2008

Pain experienced during childhood can lead to chronic pain in adulthood, according to recent research.  The mid-May annual meeting of the American Pain Society featured research showing that children who complained of multiple symptoms in childhood, including abdominal pain and headache, were three times more likely to have chronic pain problems as adults than children who infrequently complained about pain.
 
Another childhood-adulthood link reported by Gary Macfarlane, M.D., professor of epidemiology at University of Aberdeen, Scotland, School of Medicine, is that babies who were treated in intensive care units and had invasive procedures showed reduced sensitivity to pain as children.

“Around age 10, individuals treated in ICUs as babies scored higher on pain threshold tests using heat as the pain stimulus, demonstrating that early pain experiences might influence how you perceive pain later” he said.

Macfarlane’s research focused on 17,000 British children who were born in 1958 and who have been studied to adulthood. The American Pain Society is a multidisciplinary community of scientists, clinicians and other professionals working to increase the knowledge of pain and transform public policy and clinical practice to reduce pain-related suffering.

If you want to learn more about chronic pain management please check out our website at www.addiction-free.com and go to our Ariticles page for more information and download my free article Treating People in Chronic Pain.

One trend I’ve seen over the past 25 year of working with people with chronic pain is how challenging it can be for them to describe what they’re going through.  I also know this from a position of living with my own chronic pain for the past 27 years.  I can still remember early in my pain recovery when I couldn’t find a way to articulate what I was going through.

Over the years I have helped many patients develop what I call a pain vocabulary and gain a more effective way to communicate with their healthcare providers and significant other how they’re really doing with their pain management.  In addition to a pain vocabulary some people find the using artistic interpreations of their pain can assist their healing and/or pain management process.
 
I still remember about fifteen years ago I asked one of my patients to make an artistic interpretation of her pain on a bad pain day to bring to our next sesssion.  She came back with the most ferocious and scary black and red dragon that I had ever seen.  It had long claws and fangs with blood dripping from them.  On our final session she brought me a gift.  She was a very good artist and what she brought me was a picture she made of her relationsihp to her pain as a result of all her hard work and healing.  I still keep this in my office.  It was a picure of a cartoon-like friendly dragon with a silly grin who was playing with a little boy who had a toy wooden sword.  The caption on the drawing showed the dragon touching the tip of the sword and saying “Och! That’s sharp.”  What a transition.

Unfortunately, not all of my patients have been able to make such a dramatic change in their relationship with their pain but the more successful ones all have made peace (friends) with their pain.  One thing that really helps is when people are able to separate out the physical components from the psychological components of their pain.  Two of my publications have an exercise that assists people to do just that.  It’s also a very good pain vocabulary building tool.  If you want to read more please go to our website www.addiction-free.com and go to the Publications page and check out APM Module One or the Addiction-Free Pain Management® Workbook.

If you want to learn more about the psychological component of chronic pain management please check out our website at www.addiction-free.com and go to our Ariticles page to check out all of my articles and obtain a free download of my article The Psychological Components of Pain.