PAIN SERIES! PART THREE

Hello again!

Previously in our pain series we’ve discussed:

·       what acute pain is

·       what persistent pain is and how it differs from acute pain

·       the factors that contribute to pain becoming persistent

Today we will discuss some strategies to help manage persistent pain. Before we get started, I want to acknowledge how overwhelming persistent pain can be, especially the longer it goes on. If you’re struggling with persistent pain, then I urge you to seek guidance from your local osteopath or other healthcare provider.

The main goals of managing persistent pain are, addressing any musculoskeletal (MSK) imbalances, normalising movement and regulating the nervous system.

1.      Addressing any musculoskeletal imbalances

When we experience ongoing pain, the body develops musculoskeletal patterns that help ‘protect the injury’ but these can often create more input for the nervous system and contribute to ongoing pain signalling and subsequently lead to deconditioning /weakening of muscles (which further contributes to pain).

An osteopath (or other health professional), can assess for these MSK imbalances, treat any restrictions and give advice on how best to strengthen any weaknesses.

2.      Normalising movement

Its human nature to avoid discomfort and pain! In the context of persistent pain, it is very common to hear patients discuss the activities they avoid from fear of aggravating it. Navigating this can be tricky, especially on your own.

This fear-based avoidance continues to teach the nervous system that there is risk and ties into the snowballing of persistent pain. It also leads to the deconditioning that we spoke about previously & potential exacerbation of pain.

The trick to normalising movement is to start where you’re at… you want to progress from activities that are pain-free or ‘manageable’ and progress them at a rate that allows your nervous system to learn that things are ‘safe’ again.

For some people, this may look like a 10-minute walk on a flat surface, that progresses to 20-minutes and eventually an incline. Or, returning to floor-based core exercises before moving onto body weights before getting back to the heavy-lifting that they’re accustomed to.

Normalising movement when dealing with persistent pain is just as much about building confidence as it is about the actual physical movements themselves. This is why I highly recommend working with a professional.

This process takes time, is far from linear and can be incredibly frustrating at times but is so, SO important when it comes to getting you back doing the things that matter to you.

3.      Regulating the nervous system

As we’ve discussed at length, the nervous system is central to the development and progression of persistent pain... that’s why it must be addressed as part of your management plan.

BREATHWORK is a big one here! Our breath is one of the most accessible ways for us to instantly impact our nervous system. The way that we’re designed means that, if you’re able to spend a few minutes focusing on your breath – getting it deep into your ribs and lengthening your out-breath – you WILL down-regulate your nervous system and drop out of fight-or-flight. THAT is a power move!

Asides from generally moving us away from a hyper-vigilant/fearful nervous system, it can also help manage pain flare-ups in the moment. There are soooooo many different ways to practice breathwork, I recommend discussing with your osteopath what method would work best for you or which would be most effective for pain management.

Sleep and nutrition are also big factors in helping regulate our nervous system. They can be a little harder to control than our breath though.

Nutrition: Try to make sure that you’re getting ample protein with each meal to avoid energy crashes that often result in seeking high-sugar foods which can impact sleep later and are generally inflammatory. Also, aim to include as many different coloured, plant-based foods as these are rich in anti-oxidants and help reduce systemic inflammation in the body

Sleep: Everybody has different sleep needs, find out what your optimal hours of sleep are and aim to be in bed at a time that allows you to achieve that. Having a proper wind-down routine can help. Some ‘easy’ strategies include reducing screen time an hour before bed and avoiding working in bed (at any time of day).

Its not all doom-and-gloom when it comes to persistent pain! Yes, it absolutely can be an overwhelming and all-consuming experience but there are so many ways to address it. It would be remiss of me to suggest that ALL pain can be miraculously cured because, unfortunately, sometimes it can’t. BUT it is always possible to get you to a point where you’re more informed about your pain, managing it better and participating in your life more fully.

Again, if you’re struggling, I highly recommend you chatting to your local osteopath or other healthcare provider.

I hope that this helps and gives you a little more hope in your pain journey!

Love, Zo x