ENDURANCE & COPING SKILLS
In endurance strategies we do classes like spin class etc. we do an endurance ride: 60 minutes in which you work hard enough that you really wish you could quit – but not so hard that you have to. At the beginning, our instructor says “Ok, you’re going to get real uncomfortable. Get used to it.” Endurance rides hurt. It is not the pain of a chronic condition such as fibromyalgia or lower back pain, but it is pain nonetheless. The ability to persist despite discomfort is as important for chronic pain management as it is for completing an endurance ride. In life, we need to persist – even with pain – so we can spend time with the people we love, work, care for children, do the tasks of running a home, exercise, or pursue our personal goals.
We emphasize on about how people can “get used to” extended discomfort. For many different people, we used distraction and a bit of self-talk. We boost up the patients and tell them to say certain things to themselves like:
“I can do this.” “This is hard but I can finish if I pace myself.” “I’m going too fast – I need to slow down.” “I feel pretty good this morning.”
We tell them to be careful and should challenge negative thoughts such as “I can’t wait to be done” with more encouraging ones such as “I am glad that I can still do this.”
MEDICATIONS
Over-the-counter (OTC) medications are good for many types of pain. Over-the-counter means you can buy them without a prescription from your health care provider. OTC medicines include:
• Acetaminophen (Tylenol)
• Nonsteroidal anti-inflammatory drugs (NSAIDs) Acetaminophen is called a non-aspirin pain reliever.
• Acetaminophen can be used to lower a fever and soothe headaches and other common aches and pains.
• This medicine is easier on the stomach than other pain medications, and it is safer for children. Most doctors recommend acetaminophen first for arthritis pain because it has fewer side effects than other pain medications.
• Do not take more than 4 grams (4,000 mg) of acetaminophen on any one day. It can be harmful to the liver if you take more than the recommended dose.
• You can buy without a perscription, such as aspirin, ibuprofen (Advil, Motrin), or naproxen (Naprosyn, Aleve)
• Your doctor can prescribe, such as flurbiprofen (Ansaid), diclofenac (Voltaren, Cataflam), tolmetin (Tolectin), ketoprofen (Orudis, Oruvail), nabumetone (Relafen), dexibuprofen (Seractil), indomethacin (Indocin), meloxicam (Mobic, or a generic form), and celecoxib (Celebrex)
NERVE BLOCKS
Nerve blocks are used for pain treatment and management. There are several different types of nerve blocks that serve different purposes. Often a group of nerves, called a plexus or ganglion, that causes pain to a specific organ or body region can be blocked with the injection of medication into a specific area of the body. The injection of this nerve-numbing substance is called a nerve block.
• Therapeutic nerve blocks are used to treat painful conditions. Such nerve blocks contain local anesthetic that can be used to control acute pain.
• Diagnostic nerve blocks are used to determine sources of pain. These blocks typically contain an anesthetic with a known duration of relief.
• Prognostic nerve blocks predict the outcomes of given treatments. For example, a nerve block may be performed to determine if more permanent treatments (such as surgery) to block the activity of a nerve would be successful in treating pain.
• Preemptive nerve blocks are meant to prevent subsequent pain from a procedure that can cause problems including phantom limb pain.
• Nerve blocks can be used, in some cases, to avoid surgery.
SURGERY
Every year more than 15 million people in the U.S. have surgery. There are many reasons to have surgery. Some operations can relieve or prevent pain. Others can reduce a symptom of a problem or improve some body function. Some surgeries are done to find a problem. For example, a surgeon may do a biopsy, which involves removing a piece of tissue to examine under a microscope. Some surgeries, like heart surgery, can save your life.
In recent years there have been many advances in surgery. Not long ago, all surgeries involved cutting with a scalpel. Today, some surgeries are done with lasers. Some operations that once needed large incisions - cuts in the body - can now be done using much smaller incisions.
After surgery there can be a risk of complications, including infection, too much bleeding, reaction to anesthesia, or accidental injury. There is almost always some pain with surgery.
Discuss pain control options with your physician before you have surgery. Talk about pain control methods that have worked well, or not worked well for you in the past.
