Massage
Along
with mind/body therapies to de-stress, massage helps to relieve
depression and anxiety, an increase in the number of natural “killer
cells” in the immune system, lower levels of the stress hormone
Cortisol, and reduced difficulty in getting to sleep. For those who
have neck or back pain, massage therapy can help relax sore muscles and
increase mobility. This form of drug-less therapy has also been shown
to increase circulation, give relief from musculoskeletal pain and
tension, act as a mind/body form of stress release, increase
flexibility, and increase mobility.
Biofeedback
There
is good evidence that biofeedback might help to relieve many types of
pain, including tension and migraine headaches, according to a
consensus statement from the National Institutes of Health. This
therapy is based on the idea that when people are given information
about their body’s internal processes, they can use this information to
learn to control those processes. In one study by researchers at the
University of South Alabama, 80 percent of children who suffered with
migraines were symptom-free after receiving intensive biofeedback
training. In other research, some headache patients who were able to
increase hand temperature using thermal biofeedback, also experienced
fewer and less intense migraine headaches.
With
biofeedback, you are connected to a machine that informs you and your
therapist when you are physically relaxing your body. Using sensors
placed over specific muscle sites, the therapist will read the tension
in your muscles, heart rate, breathing pattern, and the amount of sweat
produced or body temperature. Any one or all these readings can let the
trained biofeedback therapist know if you are learning to relax.
Over
time, the ultimate goal of biofeedback is to learn to relax outside the
therapist’s office when you are facing real stressors. If learned
successfully, electronic biofeedback can help you learn how to control
your heart rate, blood pressure, breathing patterns, and muscle tension
when you face pain or stress—even when you are not hooked up to the machine.
Meditation
Meditation
involves sitting still in a quiet place while placing your ultimate
focus on the moment. During this time of personal solitude, you let all
the day’s worries leave your attention and only experience the moment.
Meditation is believed to result in a completely “free” mind while
affording you a chance to recover from the day’s pain, interruptions,
and stress. Because pain is a complex interaction between sensations,
thoughts, and emotions, meditation can help self-regulate the pain you
feel and increase your ability to handle stress.
Meditative
techniques are a key element in the Arthritis Self-Help Course at
Stanford University. More than 100,000 people with arthritis have taken
this course and learned meditation-style relaxation exercises.
Graduates report a 15 to 20 percent reduction in pain.
To
learn to meditate, find a quiet place indoors or outdoors with no
distractions. While sitting in a comfortable position, close your eyes
and focus on your breathing, keeping it very slow and intentional. You
should notice the sensation of air passing in and out of your nostrils
during this moment of solitude. It’s difficult to reach the stage of
complete “mindfulness,” where your thoughts are focused entirely on the
moment instead of your past or future. But as you practice this
repeatedly, you will learn how to focus on your breath, which will keep
your mind from wandering. After 10 to 15 minutes, stop the meditation
and return to your normal activity.
Yoga
I
have many patients who are interested in yoga for exercise purposes and
also for managing their daily stress. This ancient discipline
originated in India more than four thousand years ago, and is quite
popular in the United States. Hatha yoga, the most commonly practiced
branch used in the West, emphasizes specific postures, active and
relaxation poses, breath control, concentration, and meditation.
If
practiced regularly, yoga can relieve muscular tension or pain by
improving range of motion, relaxing tense muscles, and increasing
muscle strength. Practicing yoga when you are feeling anxious may help
to reduce stress when you are on the job or at home. In fact, findings
show that, for some, just three months of weekly yoga training results
in an increase in physical well-being, significant improvements in
perceived stress, and a marked reduction of headache and back pain.
Yoga also reduces blood levels of Cortisol, which is important for reducing inflammation, as discussed on page 4.
There have been several recent studies on yoga and pain, and the findings are all encouraging:
In
one study, researchers concluded that yoga was effective at improving
function and reducing back pain and the benefits persisted for at least
several months.
Another study revealed that yoga improved carpal tunnel syndrome after just three weeks of practice.
A
revealing study of patients with rheumatoid arthritis found that hand
grip strength of both hands increased in patients following yoga
practice.
Perhaps
the most intriguing findings are on the effect of yoga on body weight,
blood pressure, and insulin resistance. In one study, just 8 weeks of
yoga practice resulted in 1.5 to 13.6 percent reduction in body weight,
while even relatively short-term practice of yoga was found to reduce
blood pressure. More than ten studies that evaluated the effects of
yoga on markers of insulin resistance show significant improvements.
Of
course, there are dozens of other studies, but the point is that
alternative therapies like yoga can be extremely healing for pain
sufferers.
Practicing a simple pose known as
corpse pose is an easy and relaxing way to meditate. The more you
practice meditation in this pose, the easier it will become to quiet
your mind. With time, the practice of meditation becomes more calming
and you will feel more rejuvenated.
1. Lie
on your back on a comfortable surface, and stretch your arms and legs
out straight. Keep your arms down by your sides, and extend your legs
straight from the hips. Your feet should be about 12 inches apart, with
both feet turned out slightly to keep the feet, ankles, and legs
relaxed.
2. With
palms facing upward, keep your arms 8 to 10 inches from the body.
Lengthen your back on the floor and feel all your muscles stretching
and releasing.
3. Notice your
shoulder blades and hips, and adjust the body until you feel balanced
on both the left and right sides of your body. Scan your body and
consciously relax every muscle group, including your throat, face, and
eye muscles. Continue this scanning as you he down and relax, and
become aware of areas in which you might hold chronic tension.
4. As you he there, feel the breath take you into a deeper relaxed state.
Figure 1—The Corpse Pose
Increase Your Social Network
Having
intimate relationships with family and friends helps us to feel
accepted and maintain optimism and aids in stress management. All of
these emotional benefits lead to stronger immunity, which is vital to
staying well and functioning optimally. In fact, it is well documented
that people who are happily married and/or have large networks of
friends not only have a greater life expectancy compared with those
people who do not, but they also have fewer incidences of just about
all types of disease.
Support groups such as
those sponsored by the Arthritis Foundation are geared toward meeting
the unique needs of those who suffer with pain. Although support groups
are not psychotherapy groups, they do provide patients with a safe and
accepting environment to vent their frustrations, share their personal
stories, and receive comfort and encouragement from one another. In
many such groups, the latest medications are discussed and coping
suggestions are shared among members. Assurance is given that someone
else knows what you are going through as people share their struggles
in living with pain. After joining a support
group, you may realize that the best experts on treating pain are those
men and women who live with it daily, although it still remains
critically important to talk your doctor before trying any treatment
suggested by other patients in the group.
I
have listed support organizations for individuals with different types
of pain on pages 262 to 265.You can call or write to these
organizations for literature, or check out their Internet sites. These
groups are focused on educating consumers about pain-related disorders,
along with giving the latest methods to diagnose, treat, and prevent
pain.
On a different note, social support
does not have to be just with other people. You might form emotional
attachments with your animals. I have many patients who live alone yet
find comfort and camaraderie with a pet—an attachment that is every bit
as strong as that between a parent and a child. There are countless
papers published in the area of animal-human bonding revealing the
health benefits of this type of interaction.
Interestingly,
even having a plant can be beneficial. In a study at Yale University,
researchers found that when people had a plant present in their room
they had speedier recoveries compared with people who did not. I have
patients who live alone yet are positive and optimistic about their
lives because of a connection to their gardens. These patients find
meaning and purpose from being outdoors and enjoy the healing benefits
of nature.
