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It looks great in the movies: A depressed person dealing with serious pain or sudden injury pain pairs up with an intuitive physical therapist, motivational physician or insightful therapist. After a few sleepless nights and a little "hard work" to get better, their pain magically resolves as they realize that a positive outlook is all it ever really took. If only that’s how it really worked. Most people with chronic pain know that life is a little more complicated than the movies. Even as people learn new ways to alleviate pain, they struggle to balance them with the demands of professional and personal lives. Sure, you could do your physical therapy routine every day, but who would organize mom’s birthday party? Or you could spend time chilling out before bed, but who would bathe and tuck in the kids? Even grabbing a few minutes to exercise can feel impossible when you’ve already put in a full day at the office—and a full day dealing with pain. Below are some tips for keeping it simple and finding little ways to weave pain-fighting habits into your hectic life, as well as guidelines for getting started. Exercise Your doctor says you should do it. Your friends invite you to do it. You even want to do it. So, why aren’t you at the gym right now? Exercise is one of the toughest feel-better hurdles to surmount because it’s a delicate balance: Not enough exercise leads to pain, but so does too much exercise. Gentle exercise can get you on the right track, increasing your ability to move fluidly, perform everyday activities and tackle each day with a sense of optimism. It can also help you address some of chronic pain’s unhappy friends, including fatigue, insomnia and depression. If you’re getting off the couch for the first time, or the first time in a long time, start very, very slowly. Don’t worry about government guidelines just yet. Instead, look at your current activity level, and add just a few minutes of gentle exercise. Try a short walk, a brief swim, a few minutes on a stationary bike or just do some basic stretching or seated yoga. When you use yourself as a benchmark, you’ll soon see progress. Relieve Stress Living a low-stress life is an elusive goal for many, but stress levels can contribute to muscle tension, raising your day-to-day pain. Stress preys on our mind-body connection, too, lowering pain tolerance and effectively making the same pain feel worse and worse. Try this: One day a week, or even one day a month, set your phone alarm to go off each hour that you're awake. When you hear it buzz or ring, close your eyes for a few seconds, take a deep breath and exhale. Do it just once, or repeat for 5-10 breaths, which should only take a few seconds of your time. Then, move on with your day. You may find that the simple habit of stopping and checking in--even though it can seem like an annoyance--helps you reset and feel more present in your day. Even the simplest habits, like a hot shower after a hard day, five minutes of sitting quietly or practicing a progressive relaxation exercise (imagine yourself relaxing piece-by-piece, from head to toe) can be hugely effective. Whether or not you feel immediate relief, you’re building a mindset of habitual relaxation that can ease pain over time. Sleep Regularly You probably don’t need a research study to tell you that it’s important to get enough sleep and that sleeping poorly can make you more susceptible to pain and a host of other health woes. But did you know that a negative mood can also contribute to sleeplessness? If you only have a few minutes to yourself each day, try scheduling them right before bed so that you slip between the sheets with a smile and a positive outlook. Also, try to stick to the same bedtime and wake-up time each day, so that your brain and your body are ready for sleep. Yoga and Stretching As a part of your exercise routine, yoga and stretching can contribute to both physical fitness and relaxation, especially when combined with breathing exercises. A qualitative study of yoga and chronic pain found that Hatha postures in particular created a sense of acceptance and body awareness for pain clinic patients. Try a local Hatha or gentle yoga class or use online exercise videos to carefully attempt a few basic poses. It’s best to enlist the help of a qualified and certified teacher to make sure you’re practicing the exercises correctly, especially if you have physical limitations, chronic injury or pain issues. Try Medication If pain is out of control--limiting your ability to sleep, contribute meaningfully to your social circle or be productive at work--it may be time for a heart-to-heart with a physician you trust. If you’re not established with a pain specialist, try a primary care provider first. When you schedule your appointment, request a longer-than-usual time slot so that you have a chance to explain your symptoms and concerns. Take notes, and a friend if you need to, and be prepared to tell your practitioner how much pain you have (on a scale of 1 to 10 or 1 to 100), how often you have pain, what causes your pain or makes it feel better, and how pain impacts your day-to-day life. This might include details such as missing work or social events, difficulty running errands or climbing stairs, and even emotional difficulties, such as feelings of hopelessness, numbness or despair. Discuss medications from over-the-counter non-steroidal anti-inflammatory drugs (NSAIDs) to prescription muscle relaxants, anti-convulsants and antidepressants (which can have pain relief as a secondary effect). Ask about topical treatments as well, such as capsaicin or lidocaine patches (prescription only). In addition, use your pharmacist as a resource to manage side effects and to find ways of taking your medications to maximize their effectiveness. Experiment with Heat and Ice Heat and ice are cheap, easy self-care techniques that can ease pain. Sure, they won’t cure a ruptured disc or make your fibromyalgia fade away, but they’re do-it-yourself techniques that provide some relief and, if nothing else, a sense that you’re taking control. Instead of placing ice packs or heating pads directly on your skin, layer them over a towel or your clothing to avoid burns. Experiment to see which works for you, or try alternating heat and cold (especially if your pain is muscular). Don't leave an ice pack or heating pad in place for more than 20 minutes or you could damage your skin. Get a Massage Research outcomes have been mixed, but many chronic pain patients swear by the benefits of massage. While the experts duke out massage’s true effectiveness, both short- and long-term, a bodywork sessions may be worth a try, especially if you’re having trouble relaxing or are beginning to work exercise into your daily routine. Taking time for yourself has no side effects, either. While massage can be cost prohibitive for some, you can often find deals online (think Groupon or Living Social) or find a local massage therapy school in your area with plenty of students who need hands-on practice, which can be free to volunteers or available at very low-cost compared to your local spa. Try hypnosis Hypnosis is similar to guided relaxation. It’s not a form of mind control. Rather, it’s a way of relaxing and creating mental suggestions. A hypnotist or hypnotherapist can help you counter negative thoughts and anxieties related to pain, such as “This will never get better,” or “I can’t do this anymore.” And hypnosis only works if you want it to, so you don’t need to worry that you’ll lose control. While you don’t need to add every item here to your to-do list, adding a few could bring surprising relief. Whether you turn a critical eye to your sleep schedule, take a few deep breaths tomorrow or stop by the drug store to pick up a heating pad, know that the mere act of believing you can impact your pain can improve your confidence and sense of overall wellbeing. That’s a form of relief, too. Sources University of Nebraska-Lincoln Wellness Initiative, "Chronic Pain and Depression: Managing Pain when You're Depressed," wellness.unl.edu, accessed on May 22, 2013. War-Related Illness and Injury Study Center, "Exercise to Help Manage Chronic Pain and/or Fatigue," www.warrelatedillness.va.gov, accessed on May 22, 2013. NYU Langone Medical Center, "Non-Medication Pain Relief for Chronic Pain," www.med.nyu.edu, accessed on May 22, 2013. O'Brien EM, Waxenberg LB, Atchison JW, Gremillion HA, Staud RM, McCrae CS, Robinson ME. "Negative mood mediates the effect of poor sleep on pain among chronic pain patients." The Clinical Journal of Pain. 2010 May;26(4):310-9.
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