My Ultimate Pain Coping Skills Part 2: Relaxation

This is part 2 of my 4-part series on my favourite coping skills for chronic pain. These are all things that I use and find helpful. Additionally, they all have scientific evidence supporting them as being helpful. This week we’re going to talk about relaxation: how it can be beneficial and some ideas for incorporating relaxation into our daily lives.

Time to get our relaxation on.

Let’s start with what the research says is helpful about incorporating relaxation into our “treatment” for chronic pain. Relaxation enhances our ability to tolerate pain. But how does it do this? First, it increases our brain’s ability to respond to endorphins, which are our body’s natural pain relievers. Second, it reduces inflammation, which is often a cause of pain. Third, it allows our muscles to relax, and tense muscles tend to cause more painful sensations than relaxed muscles. Fourth, it reduces hypervigilance and desensitizes our central pain pathways, meaning that it helps to decrease our sensitivity to painful sensations. Fifth, it improves our mood and makes us less emotionally reactive to our pain, and since we know the mind-body connection is a thing, this makes sense. I also want to point out that the research states that mindfulness skills are more effective than relaxation skills. However, I think having both is important, and the research seems to support that as well.

I want to be as relaxed as this dude.

So, let’s talk about a few different relaxation skills we can access, learn, and some other ones that I use that aren’t necessarily research based but are helpful for me.

  • Progressive Muscle Relaxation: in this practice we tense each muscle group, one at a time, and then release the tension allowing for relaxation. I love this one and feel very relaxed afterwards. There’s been a lot of research on it, and it’s one we can do on our own as there are a ton of guided versions. Here’s a guided version I made from my YouTube channel.
  • Guided imagery is another practice we can do on our own. I personally like “safe place” imagery, which I haven’t made for my YouTube channel yet but any guided imagery that uses peaceful, soothing or symbolically therapeutic mental images has evidence that it enhances relaxation from physical and emotional pain.
  • Yoga is another practice that I normally associate with mindfulness, though I will admit that I find it relaxing as well. Yoga emphasizes a number of processes including acceptance, attention, mediation and relaxation, which is likely why many people find it effective. Here’s an interview I did with MS Warrior and Yoga Instructor, Clarissa, on the podcast.
  • Hypnosis in an intervention that I haven’t tried, however there is growing research that it shows promise as being helpful for chronic pain. It alters our perception and cognitive patterns that occur in chronic pain syndromes through the use of relaxation. Here’s an interview I did with physical therapist, Sam, who uses hypnosis with his patients.
  • Biofeedback is another intervention I haven’t tried but has a lot of research support it’s use and was discussed at the World Pain Summit I attended last fall. It increases our physical awareness and induces relaxation through the use of markers of the stress response. I definitely think it’s worth looking into.
  • Pick any activity you find relaxing! Okay so this doesn’t have specific scientific evidence but if it induces relaxation then it can’t be bad. For me, that is taking a bubble bath (or epsom salt bath) and reading a book. I find it incredibly relaxing and definitely helpful for me.
Summertime, outdoor yoga definitely relaxed me.

As a therapist, I’m always surprised how many of my clients don’t have a lot of relaxation skills, which makes me wonder how many people actually actively use relaxation skills in general. So, I hope this gives you some helpful options, and I encourage you to try to make some time each day to actively do something relaxing. Keep making the most of it!

References:

Mind-body therapies Use in chronic pain management
Mindfulness-Based Meditation Versus Progressive Relaxation Meditation: Impact on Chronic Pain in Older Female Patients With Diabetic Neuropathy
Hypnotic Approaches for Chronic Pain Management

The Meaning of Yoga and How it Can Help Chronic Pain

For those of you who are against yoga, because some random person said to you once, “But have you tried yoga?” when you were telling them about your pain or illness, just stay with me for a second. No one likes unsolicited advice, but I’m guessing that if you’re here, reading this blog post or looking at this blog at all, it’s not really considered unsolicited. There is actually a lot of evidence that yoga can be helpful for pain, and I have personally found a huge difference after beginning to practice restorative yoga at the beginning of the pandemic (circa April 2020 is when I began).

I began my meditation practice a few years before my yoga practice, but became consistent with both around the same time.

Let’s start off by reviewing some of the research as to what yoga can help with and if it actually is beneficial. Guess what? The research is overwhelming a yes, yoga is helpful for chronic pain. There are tons of studies on it but I just picked three for the purpose of this post. Tal, Unrah & Dick (2011) found that pain patients in their study were able to “reframe what it is to live with chronic pain.” What does that mean? Well, not all of there patients actually decreased in the pain itself, but most found that the pain bothered them less. In other words, it was less interfering in their daily lives. Skip ahead to 2019 where Uebelacker et al. found in their study that pain patients who did yoga saw their moods improve, decrease in their anxiety levels and decrease in their pain levels. That same year, Schmid et al. (2019), found that pain patients who engaged in yoga had better occupational performance (they could return to work, do well at work), were more engaged in their regular daily activities, and had less depressive episodes.

I normally practice at home via YouTube, but I do love having an opportunity to do an in-person class, especially if it’s outside.

This research is all well and dandy but the original intent of my post was to look at the meaning of the word “yoga” and how that in itself shows how it can be helpful to us chronic pain warriors. Yoga is derived from the Sanskrit word “yuj” which means to unite (or unity). This describes unity between the individual with the universe, person with nature, and importantly, mind with body. This is likely why we see things like mood improvements and decreases in anxiety in people who practice yoga, which is mindful movement. A yogi is someone who is self-realized and self-realization leads to freedom. Linking back to the research, freedom to work, freedom to engage in activities, and freedom from pain being “bothersome.” Finally it’s important to note that health (both physical and mental) is a natural result of practicing yoga, for all of the above reasons. Do you have to practice yoga? No. But I also don’t see the harm in trying (assuming you have consulted with your healthcare team).

I also want to mention that I always modify poses so they are safe and comfortable for me to do.

I hope this brings some insight. Keep making the most of it!

Support my content on Patreon.

Video: Daily Yoga – Supported Fish

I find yoga to be helpful for chronic pain and my mental health. This is another one of the yoga poses I really like for my upper back. Please speak to your healthcare team about any changes to your exercise routine. This content is for educational purposes only.

How resilient have you been feeling lately? Anything less than an 8/10, then check out this podcast episode on how to cultivate resilience.

Keep making the most of it!

Support my content on Patreon and get bonus content weekly.

Video: Daily Yoga – Sphinx Pose

This week we’re exploring one of my favourite yoga poses. I find it to be a great stretch for my back as well as my chest as it acts as a back bend and chest opener. Make sure to check with your healthcare team before doing any new exercise routines. The information in the video is based solely on my experiences. Stretches can be great for pain that is muscular – check out this podcast interview with Dr. Yass about muscular pain. As always, keep making the most of it!

Support my content on Patreon!

Video: Daily Yoga – Chest Openers

Chest openers are among my favourite yoga poses because I am always tight in my chest, really noticing it under the shoulders, near my armpits. And I always feel good during this stretch. Stretching is super important when managing chronic pain, and something most of us don’t do enough of, which is another reason I’ve incorporated yin yoga into my daily routine. Please consult with your healthcare team before starting any new exercise routines. I am not a professional yoga teacher, just giving your some education on what has worked well for me! Yoga is also a great way to contact the preent moment, which is the topic of this week’s podcast episode, avaiable here.

Alright everyone, for now, take care and keep making the most of it!

Support my content on Patreon!

6 Ways I’m Managing a Weather-Caused Flare (+ 5 More Ways I Could)

Long title, I know. But nonetheless I thought I’d share some of my tips with you, plus a few other evidence-based ones I found online as I’m trying to get through this. I’m writing this exactly one week before it will be published so fingers crossed that it’s over by the time you’re reading it, but if not, then I’ll just have to accept it as it is. My flare is likely caused by a few things. First, I recently moved and moving is stressful (even a relatively easy move like I had) and stress can cause a flare. Second, I moved from a dry climate in the interior of British Columbia to the wet, lower mainland of BC. I always notice my symptoms, especially pain gets worse when it rains… but then I knowingly moved to a rainy climate (*face palm*). All jokes aside, my symptoms are increased pain, increased fatigue, really bad jaw pain, my left foot is super veiny and sore (my calf is fine though so unlikely anything super serious). How the heck can I manage all of this?

Even on a flare I’ve managed to explore my new neighborhood.
  1. Acceptance. Yes, I know some of you are rolling your eyes or saying that this is ridiculous or unlikely to work. But I find it does. I accept that my pain is here, while knowing that the intensity changes hour by hour, sometimes even minute by minute, and I know that when my flare is over I’ll go back to baseline. Acceptance is helpful. I’ve been doing body scans and other mindfulness activities to help with the acceptance, but honestly just acknowledging my experience without getting wrapped up in it is helpful. Check out this acceptance practice.
  2. Exercise, Movement and Stretching. If you read this blog regularly you know that I like to exercise. And I still pace myself by trying to stay consistent with what I do. I definitely increase my stretching during flares. Particularly I focus on the areas that seem to hurt or need it the most. For example, my jaw is the worst today as I write this, and I’ve made sure to do jaw stretches throughout the day. For more on jaw pain specifically, check out this podcast episode with Dr. Shirazi.
  3. Warm Baths. I LOVE my baths. I literally take a bath 4-5x a week in the winter months. And with the rain, I’m definitely needing them. They help relax my muscles, keep me warm, and are very relaxing. Trust me when I say I could never (and would never) live in an apartment without a bathtub. Knowing what is vital to your self-care is essential to dealing with a flare. Check out this podcast episode on it.
  4. Dressing Warmly and in Layers. Vancouver, if you’ve never been, is a city where everyone dresses in layers. It will likely rain at some point during the day, though you never know exactly when. It could also start off cool and warm up, or vice versa. So I’ve been making sure to put on 3 layers when I go out, and have a pair of mittens on me. I need to remember a hat and/or an umbrella, but I’m working on it!
  5. Hydration. I tend to drink a lot of water. Admittedly more when I’m working. Staying on top of my water intake is so important to managing my flares and really my health! I’m trying to drink 5 full glasses of water a day minimum. I basically keep a glass of water next to me all day and every time it’s empty, I refill it. Listen to my podcast conversation with Beau Berman about gut health and how important drinking water is to him.
  6. Omega-3’s and Vitamin D. I typically try to get these from the foods I eat. Lots of fish mostly (rich in both), as well as mushrooms, spinach, avocado and tofu and really a variety of others foods are rich in vitamin D. These are really important for reducing inflammation naturally and honestly are just really good for you! Also, Vitamin D is a way to combat with the “winter blues” (which I often get) and the more severe, Seasonal Affective Disorder.

So those are the 6 things that I am doing, but what are the 5 things that I’m not but probably should be?

  1. Acupuncture. This is actually an evidence-based and recommended treatment for chronic pain. I’ve had it in the past and I’m hoping to start back up with bi-monthly sessions next month. Listen to the podcast episode on recommended treatments for chronic pain for more info.
  2. Massage. I miss getting massages. It’s been nearly a year since I had one, and this is also a service I used to get bi-monthly. I’ll likely also start these back up soon as well. Clearly I need to. The benefits of massage can be heard in the podcast episode with Danielle Potvin.
  3. NSAIDs. I’m not a fan of these drugs to be honest. They can cause stomach problems when on them long term. I’ve drastically cut back on them and only take them to supplement the more natural medications I take (i.e., CBD). If you’re aware of the risks and find them helpful then this can be a helpful solution.
  4. Natural supplements. The only natural supplement I currently take is magnesium bis-glycinate which is a muscle relaxant (and I mainly use it when I’m menstruating). Other recommended supplements are fish oil, ginger (which I sometimes have in food and/or tea), turmeric (which I sometimes have in tea), and gingko. These are definitely worth checking out to use in addition to some of the other suggestions.
  5. Limit Stress. Oh I can’t wait until I’m passed the stress of the move and starting up new counselling practices. The truth is there is always some kind of stress in our lives and it really comes down to how we manage stress. I typically do a good job with mindfulness, meditation, yoga, and relaxation practices. So this might just be a reminder to do a bit more of that. And also, if you are able to avoid stress then that’s a good plan (I do not plan on moving again for quite some time!).
Taking it easy on Halloween. Needed some time to relax after the move.

So that’s it! 11 ways in total to manage a flare. Keep making the most of it everyone!

Support my content on Patreon.

My Experience at the World Pain Summit ’21, Part 2

If you read last week’s blog post then you know that I recently attended the World Pain Summit, put on by the Alberta Pain Society. I did this as both an allied healthcare practitioner (as a clinical counsellor) and as a person with lived experience. By the way, this event is apparently always free to people with lived experience, so keep an eye out for it next year. The summit was 3 days and had so much info, that this is going to be part 2 of a 3-part post, and focuses on the content of Day 2. Without further ado, here’s what I learned.

How Living with a Dog Can Improve Quality of Life and Well-Being in People with Persistent Pain. The first bit of interesting info was a bit of an aside – only 1% of the curricula for healthcare professionals is on pain, which means if your doctor doesn’t understand (and isn’t attending these kinds of conferences) that is likely why (definitely not an excuse – all healthcare professionals should be attending conferences/summits/etc throughout their careers). The most interesting parts of this session was the statistics on dog/pet owners (cats and other kinds of pets count):

  • they report lower pain
  • less depression and anxiety and loneliness – i.e., better mental health
  • improved well-being and meaning/purpose in life

Having a pet also gives you a non-judgmental listener whom you can talk to, and petting an animal releases oxytocin in our brains, which has a calming effect. Yay for pets!

This is my parents’ dog, Beau.

Is Supported Pain Self-Management Your First Choice or Last Resort?: 5 Key Coaching Support Skills. This was present by Pete Moore, a person with lived experience, who wrote a book on the subject. The 5 key skills he talked about were: (1) goal setting and action planning; (2) practicing daily activities – I know ADLs can be hard for some people but they are important to well-being; (3) problem solving; (4) keeping active, moving, including stretching and exercise; and (5) knowing what to do if you have a set-back (i.e., planning for that in advance). Much of this involves having a support team, pacing, prioritizing, being patient with yourself, learning relaxation skills, tracking your progress, and resilience.

Pete Moore presented this cycle, which really resonated with me and probably many others.

How a Pain Doctor is Using Social Media to Spread Knowledge About Chronic Pain. This was a session more for healthcare professionals on how to start a YouTube channel (and why they should). But some interesting factors for Spoonies: the current quality of medical information on YouTube is very low, so please be careful and look for trusted sources (i.e., trained healthcare professionals in different areas).

My YouTube channel is for meditations (with an emphasis on pain and illness).
Let me know if I should include other psychoeducational content and skills.

Trauma, Illness, and Healing – Dr. Gabor Mate’s keynote. I’ve written a ton about Dr. Mate’s work in the past, and there was obviously some repeat in content about trauma, childhood abuse, insecure attachments and stress and their relationship to chronic pain and illness. A couple of things I will share:

  • mind body practices (like yoga) should be included in chronic pain treatment
  • a lot of back pain is associated with psychoemotional stress (tension, stress, trauma)
  • Go to a physician for what they can do (prescribe medications, perform surgery, etc.) and find other practitioners to help you with the other parts of treatment
  • diagnoses are descriptions, not explanations
  • psychological and spiritual support is important

If you’re not familiar with Dr. Mate’s work, check out When the Body Says No (I also did a post about the book awhile back).

Dr. Gabor Mate is world leading expert on the trauma-stress interaction with illness.
Image from: https://californiahealthline.org/news/addiction-rooted-in-childhood-trauma-says-prominent-specialist/

Challenging Chronicity Thoughts: Words Matter. So this was a mental health session, if the title isn’t clear! It emphasized that psychological factors are an important component of pain experience and are the most powerful psychological predictor of adverse health and mental health outcomes associated with pain – they even affect our treatment responses to medications, injections, physical therapy, and most other treatments. Recovery is not just about talking (to a therapist), needs and activity but also about ways of thinking. Two important notes for my fellow Spoonies: (1) pain is perceived by your brain (all in your head) but it is real; and (2) the word pain takes you right to thinking about/feeling pain (check out this podcast episode I did on externalizing language and pain/illness).

Chronicity thoughts are about way more than language. I highly recommend seeking therapy if you find you think about your illness/pain a lot.

Next week I’ll bring you a post on the information from the final day of the summit. I hope that you find some of this helpful when thinking about illness and well-being. Keep making the most of it everyone!

Support my content on Patreon and get 2 free e-books plus bonus content from the podcast

Daily Yoga: Hip Openers

This week we’re doing some more yoga postures that I absolutely love for the hips: reclined butterfly and a butterfly forward fold. I find they help with a nice stretch in my hips, which is something I need. As always, please consult with your healthcare team before making any lifestyle changes, such as adding yoga. If you already do yoga, I’d love to hear if you like these poses or what poses you do. Until next week, keep making the most of it everyone!

Support my content on Patreon so I can keep bringing you more of it!

Processing…
Success! You're on the list.

Daily Yoga: Twists

Yoga has been one of the ways that has helped me a lot with my well-being in the past year or so. These are two versions of one of my favourite poses for the back – seated and laying twists. Yoga not only has a lot of physical health benefits (such as improving flexibility) and mindfulness benefits (such as mindful movement) but also mental health benefits as therapeutic yoga is used as an embodiment approach to mental health. As always, talk to your doctor or other healthcare professionals before changing your exercise routine.

For more ways to improve your well-being, check out the podcast. And for more mindfulness practices check out the meditation channel. Keep making the most of it everyone!

Support my content on Patreon.

Processing…
Success! You're on the list.

How Can I Become More Resilient?

This isn’t the first time I’ve posted about resiliency on this blog. The truth is, it’s a topic that comes up often. I see it on online support groups, on Instagram, and hear it in conversation with people. I also read it on other blogs, and many healthcare organizations post about it on their sites. Here’s the thing, if you have a chronic illness and you’re not feeling resilient, just know that you are not alone. A lot of people feel that way. Are people born resilient or do we develop resilience? I think it’s an interesting question and possibly a bit of both. Children tend to be more resilient than adults, suggesting we can lose some resilience as we age. In one of my courses for my graduate degree we had to more-or-less do a family tree. Except this family tree was supposed to trace something like a mental health or substance use issue. I chose to trace resilience, and found that going back just to my grandparents generation (that was the requirements for the project) there was a strong theme of resilience (my maternal grandmother/baba faced abuse, neglect, lost 2 children, and she and my mother were trapped in Siberia for a week during the Cold War – I know it sounds too crazy to be true). Yet she not only survived but was a loving parent to her other children and an amazing grandparent. Had my mom not shared my baba’s history I would not have know. She was that resilient.

Three generations of resilience in my family.

The good thing is, that even people with chronic illness can develop resilience. Warning: it does require work on your part. Luckily, some of the work may not feel like work at all… it just requires consistent commitment to it. I want to add, that many of these suggestions overlap with what the National MS Society suggests, in case you don’t want to just take my word for it.

  • finding meaning and committing to that action: what is the reason you get out of bed in the morning? If you don’t have a reason it will be difficult to do so. Is it your family? Or work? I know a lot of people with chronic illness go on disability, but work provides meaning and purpose for people. If you are on disability what is your purpose going to be instead?
  • improvisation/adaptability/problem solving: I think these all kind of overlap and go together. We often have to improvise in order to do things we enjoy. Maybe we can’t go on the 5k walk with our friends, but we could meet them for coffee afterwards. How flexible and adaptable are you to changing plans? Or asking others to? What’s an alternative way you can participate or do the things you like to do? I would go as far to make a list of ideas (remember when brainstorming there is no such thing as a dumb idea) and try out some to see if they work.
  • Self-care: we all know I love self-care, and this includes the basics (getting out of bed, making breakfast, taking a shower) and then doing activities like relaxation techniques, yoga, meditation, or prayer. What hobbies do you enjoy that you can participate in? Pick one a day. Reading is an example of something that is low energy and can be fulfiling.
  • Being able to tolerate “negative” emotions: I personally don’t categorize emotions as negative or positive. All emotions are important because they tell us very important things. If you’re not used to be able to just sit with emotions, try out this mindfulness practice that aims at helping people do just that.
  • Self-efficacy: I did a post on this recently, and you can read it here. Do you believe you can cope with your illness? Part of this is being a realistic optimist, being hopeful.
  • Using skills such as curiosity and humour: When is the last time you laughed? Are you able to have fun and joke around (and not in a self-deprecating way)? Do you get curious about your situation or feelings or sensations or emotions? What are you noticing about them right now as you read this? The noticing self is a helpful skill to develop. We touch on it in this podcast episode (about half way through).
  • Radical acceptance: This is a skill from Dialectical Behaviour Therapy (DBT) and essentially the same used in Acceptance and Commitment Therapy (ACT). It is about fully accepting your situation/thoughts/feelings/sensations/etc. Fully. Accepting. It doesn’t mean you have to like it. It’s hard to do a lot of the above without this kind of acceptance.
My curious, nonjudgmental, accepting, “what am I noticing” face.

I hope this helps give you some ideas for building resilience some more. Well-being and a good quality of life do require us to be resilient, and trust me, it is possible even with chronic illness. Here’s the link to the MS Society page on resilience. Take care, and keep making the most of it!

Support my content on Patreon.

Processing…
Success! You're on the list.