My Choices

Complementary Choices

When traditional medical interventions are not successful, it may be appropriate to enhance your plan of treatment by including changes in your lifestyle that would promote healing and wellness. These strategies can be used in conjunction with conventional medical treatment. Although not required, we recommend you inform your healthcare team of your choices. Non drug therapies used in the treatment of pain treat the mind, body and spirit simultaneously. As with all medicine, you need to evaluate the safety and effectiveness of the treatment to be used as a complement to traditional western medicine. Complementary practices strive to reduce your stress which may result in diminished pain, fewer medications and better sleep. Many of these techniques provide relief through movement and relaxation and provide a connection between the body and the mind.

As you take increased responsibility for your own home care you may become less dependent on medication. Pain management will change at different stages of wellness.

It is our hope that one or more of these will help lessen your pain and stress, provide body awareness and build your strength and confidence. If any make you feel better even for a short time, you will feel successful. The multidisciplinary approach to chronic pain may be the best treatment for you. When investigating your individual choices, consider the training of the practitioner, ideally choosing those who are licensed, credentialed and experienced professionals. Please note that many of these methods may not be reimbursed by insurance.

It may be best to begin with the relaxation and breathing techniques before trying others. 

Abdominal Breathing

Abdominal breathing can be a very effective technique for managing chronic pain. This technique is a key component of the pain management techniques that rely on relaxation. It is important for you to master abdominal breathing before moving on to other relaxation exercises. Take as much time as necessary to comfortably move forward to try another technique. Practice, patience, and commitment are key as you learn this technique.

By following the steps provided for the breathing exercise, you will help your body accomplish the following:

  • Increase oxygen supply to the brain and muscles 

  • Improve the efficiency of the excretion of bodily toxins

  • Connect the body to the mind 

  • Heighten overall concentration 

  • Trigger a relaxation response

Please take the time to make a few preparations before beginning 

  • Use the exercises during a quiet time, when you will not be interrupted by other people or tasks 

  • Select a comfortable chair or position before you begin the exercise

  • Be sure your computer is close enough so that you can easily hear the instructions; if you are using a laptop, move to a comfortable location

  • Reduce possible distractions or noises-turn off radios or televisions 

  • If you wish, use a soothing background noise to assist you with relaxing

If you wish to add music to your breathing or relaxation exercises, follow these guidelines:

  • Avoid music with words, a theme, or a predictable tempo 

  • Nature sounds such as water, wind, and birds may be helpful

  • Minimalist music can support relaxation-this type of music uses a limited number of tones, arranged in an unpredictable rhythm that is not distracting

Click on an exercise title to listen to the audio files, or right-click to save to your desktop. 

PLAY-10.gifAbdominal breathing exercise guided by a male voice

PLAY-10.gifAbdominal breathing exercise guided by a female voice 

Acupuncture 

The insertion and manipulation of strategically placed fine needles into exterior body locations to prevent or cure diseases and illnesses, as well as relieve pain and provide anesthesia. Acupuncture affects the body’s flow of energy in pathways through the body. Multiple treatments are necessary.

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Appreciation and Positive Thinking

We have the power to change our attitudes, thinking, and perceptions. Positive thinking does not mean that we cover up other difficult emotions but that we acknowledge them and choose to put our attention elsewhere. Bringing positive emotions into your life can help you improve in many ways, including:

  • Improve your immune function

  • Increase muscle flexibility

  • Reduce your risk for illness

  • Lower your blood pressure

  • Promote the release of serotonin

  • Decrease the flow of stress hormones

  • Decrease your physical and emotional tension

  • Think more clearly and creatively

  • Learn more easily

  • Turn stressful situations into challenges

  • Foster a positive and hopeful attitude

  • Increase your emotional resiliency

  • Promote an outlook that will help you manage your pain

Negative feelings can have negative consequences. For example, when we experience the dread of anticipating pain, the part of the brain that deals with pain becomes active even before the pain is experienced. Interrupting the experience of dread through laughter or pleasure can help distract you and decrease its negative effects.

Research demonstrates that acting "as if" you are happy can have significant effects on our physiology. Smiling, even when we do not feel happy, can help move us in a more positive emotional direction. Living "as if" we are happy, joyous, and appreciative increases the likelihood that we will experience those feelings. This does not mean that we have to put on an act for others. It allows us to "try on" more positive facial expressions or participate in conversations and activities consistent with a more positive attitude.

  • Read uplifting or humorous books, positive essays, religious texts, or inspiring quotes-reflect and come up with new ideas for positive approaches to living. 

  • Make a list of things in your life to appreciate-or even keep a "gratitude journal." Change your daily routine in some way-look for something new and pause to appreciate it. 

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Acupressure

Chinese healing method in which pressure is applied to specified points on the body in order to reduce or minimize pain.

Aromatherapy

The use of essential/volatile plant oils and other natural aromatic substances for psychological and physical therapeutic benefit. Scents are used in candles, oils, and other vessels for relaxation and mood enhancement.

Biofeedback 

A technique in which you learn to consciously have more control over your body in such ways as heart rate, temperature, perspiration, and muscle contractions. A machine is used to measure temperature, blood pressure and electrical activity in muscles. This information is then provided to you and the biofeedback professional will teach you exercises to change the signals you send to your muscles, thereby helping you control your response to pain and teach your body to relax.

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Breathing

Deep breathing is an excellent beginning relaxation technique. Smooth, rhythmical breathing is key to effective exercising.

Try this exercise with the goal of five to eight repetitions: 

  • Stand or sit erect, head up, arms hanging relaxed at your sides or resting in your lap 

  • Place your hands on your abdomen just below the belly button 

  • Inhale deeply and slowly through your nose, expanding your chest or abdomen as much as possible. Hold for a count of three. Your hands should move out with your stomach as you inhale.

  • Exhale slowly through pursed lips, making a "shhh" sound for a count of six as the air leaves your lungs. Prolong the exhalation as much as possible, relaxing the chest and the shoulders. 

Once you have mastered the deep breathing technique, you can incorporate the following shoulder and trunk exercises: 

  • Shoulder Blade Pinch:  Inhale as you pull your shoulders back; exhale as you relax them forward. 

  • Forward Arm Reach and Overhead Arm Reach: Inhale as you raise your arms; exhale as you lower them. 

  • Sideways Arm Reach: Inhale as you swing your arms apart; exhale as you swing them back together. 

  • Side Trunk Bend: Exhale as you lean to the side; inhale as you straighten to erect position. 

Adapted from the Arthritis Foundation Exercise Program

Chiropracty

Technique based on manipulation of the spine. A chiropractor may help particularly with back pain relief.

Cognitive Behavioral Therapy

Through discussion with therapist, strategies are developed to treat/change observable behavior patterns. Depression and anxiety are common in individuals with chronic pain.

Counseling

Most any form of psychological counseling may be helpful with your treatment of your pain as it will help you cope with your feelings. Ask your healthcare provider for recommendations.

Cranio-Sacral Therapy

With roots in osteopathic medicine, Cranio-Sacral Therapy views the whole body as one fluid continuum. It works to help restore balance and function by
working with the environment of the central nervous system.

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Distraction

When you are required to focus on multiple things at one time, the mind is distracted from thinking about the pain. Distraction exercises will cause you to concentrate on one thing and block out everything else. The distraction may be as simple as a short shopping trip, reading, counting backwards, watching television, walking around the block, playing a game or going to a movie. It is helpful to plan activities whenever possible. Try the following distraction techniques to understand how distraction techniques work:

  •  Hold an ice cube in your hand

  •  Flick a rubber band on your wrist

  •  Pinch yourself hard on the back of your hand

Energy Medicine 

These therapies are based on the concept that human beings conduct a subtle form of energy. Those practicing energy medicine believe that illness results from disturbances of these subtle energies. Work is then done to restore and rebalance the flow of the body’s energy. Examples include Reiki, Qi gong, and healing touch. 

Healing Touch 

This is a non-invasive technique that uses the hands to clear, energize, and balance energy fields. The practitioner and the participant blend energetically to facilitate the participant’s health and healing, using heart-centered care.

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Heat and Cold

Simple method of placing hot and/or cold materials on pain source to help muscles relax and numb the pain.

Herbal Medicine

A substance made from a plant or part of a plant that is used for therapeutic purposes.

Homeopathy

Treatment of illness with greatly diluted medicines. Homeopathy seeks to stimulate the body's ability to heal itself by giving very small doses of highly diluted substances.

Hypnotherapy

A state of consciousness in which a person’s attention is focused towards images, thoughts, perceptions, feelings, motivations, sensations, behaviors, or a combination of these. You can be trained to change your level of awareness and perception of pain. 

Laughter

Laughter itself can stimulate our body to release endorphins and dopamine. These natural substances support feelings of pleasure and wellness, and they can also help relieve pain. However, laughter is "healing" only when it includes others and is not meant to cause harm-in other words, when it comes from positive feelings.

  • Begin by taking a few slow, deep breaths to relax yourself-we tend to breathe shallowly when we are stressed 

  • As you breathe out, make a HA-HA-HA sound, or use HE or HO, if that is the sound of your natural laugh 

  • Keep repeating until your diaphragm muscles are contracting rhythmically and your automatic laugh response kicks in 

  • Try to build up to doing laughing for twenty minutes

  • Have someone laugh with you as it is more fun and effective if you laugh with someone

  • Enjoy jokes and humorous cartoons-share jokes with others

  • Watch silly movies or comedy shows on television

  • Spend time with funny or upbeat people as laughter is usually contagious

  • Think about a stressful situation, but find something good or comical about it. 

Laughter Exercises

  • Stand or sit in front of a mirror and make as many funny faces as you can.
  • Be creative and don't let your inhibitions get in your way

  • One way to start with is the "Lion Pose" from the practice of yoga. Simply open your mouth wide and stick your tongue out! 

  • Practice by yourself or invite someone to join in the fun

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Laughter Yoga

An exercise ro

utine that combines unconditional laughter with yogic breathing. 

Social laughter clubs can be located in about 60 countries.

 

Massage Therapy

This gentle relaxation technique involves hands on healing from a trained professional that may help relieve muscular and joint pain.

Mind-Body Medicine 

Medicine that focuses on the interactions among the brain, mind, body, and behavior, while considering ways in which emotional, mental, social, spiritual, and behavioral factors can directly affect health. Mind-body medicine techniques include relaxation, hypnosis, visual imagery, meditation, yoga, biofeedback, group support, spirituality, and prayer. This technique allows you to tune into yourself and have an inner awareness.

Manipulative and Body-Based Therapy 

Manipulative and body-based methods are based on manipulation and/or movement of one or more parts of the body, including chiropractic techniques, massage, and reflexology. 

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Meditation 

The process of meditation brings about mental calmness and physical relaxation by suspending the stream of thoughts that normally occupy the mind. It is used to reduce stress, alter hormone levels, and elevate one’s mood. Meditation might sound like an Eastern religious practice, but also has deep roots in Judaism.  

The easiest method is to count silently from 1-10, counting one number as you exhale each breath.  The point is not to reach "10", but to distract the mind.  Always, the reasoning is to be gentle with yourself.  There is no one who meditates who doesn't have stray thoughts pop into their head.  Simply notice them and let them go.  A beginner might meditate for twenty minutes twice a day.  An advanced person might do this for hours.

Music Therapy 

Using music as a tool in pain management is another way to break the pain cycle.  You may choose to contact a music therapist, who is a certified trained professional using music clinically in an individualized manner based on clients’ needs. Some of the goals a music therapist might work on are decreasing pain perception, helping to process thoughts and feelings associated with having pain, learning coping strategies such as relaxation or distraction techniques, and intervening to reduce use of pain medication if appropriate. You may also choose to use music on your own. Read the following scenarios/suggestions and try the exercises that pertain to you.

  • When in an environment that has loud noises exacerbating pain or causing physical tension (e.g. medical equipment, noise from neighbors), turn on music that you enjoy to mask the noises that concern you.

  • When engaged in physical exercises or tasks that are deemed safe by a professional but might still be causing you pain, play music with a good beat to accompany the movement at the same speed as you are moving.

  • When in a situation that is somewhat stressful (e.g. in the doctor’s office), be aware of your physical response to the stress (e.g. are your shoulders up? Are your muscles tense?) Take a few deep breaths (in through your nose, out through your mouth). Try listening to music that you prefer or sing some of your favorite songs.

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Psychological and Emotional Support

Chronic pain affects your psychological well-being and your relationships. The importance of psychological support cannot be understated in working with chronic pain. If your healthcare provider has not recommended a psychiatric evaluation, you may contact a psychologist or social worker on your own. 

Qi gong 

A component of traditional Chinese medicine that combines movement, meditation, and regulation of breathing to enhance the flow of qi (an ancient term given to what is believed to be vital energy) in the body, improve blood circulation, and enhance immune function. Qi helps to release tension and preserve mobility.

Reflexology 

This is a form of massage where a practitioner applies pressure to certain parts of the feet and hands to help promote relaxation and healing at specified points in the body. It is a science that believes each part of the body is interconnected through the nervous system via the hands and feet. Practicing reflexology can help restore balance throughout the body. 

Reiki 

Reiki is the practice of transmitting healing energy through the hands, based on ancient techniques. Reiki uses specific hand positions on or above parts of the body that correspond to the major organs and energy centers, such as the heart or adrenal glands. 

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Relaxation 

A state of deep rest in which the metabolism slows, less oxygen is needed, heart and respiration rates drop, blood pressure drops, and brain waves slow. 

If you only have a few minutes, take some time to relax right now. Click on the play button below for either a breathing exercise or a guided imagery relaxation exercise.
 

PLAY-10.gifProgressive_Relaxation


Spirituality

Studies have shown that religion can have a positive impact in overcoming chronic pain. There are many ways of incorporating religion and spirituality into your life.  These are just a few examples: 

Praying is ages old. But while most people might pray for the pain or illness to cease, a "higher" prayer would be for the strength and courage to deal with the pain. We are told it is even better if someone, a friend or relative, can pray with you.  

It is important in an illness to appreciate the moments that are relatively free of pain. The Psalms have been a source of strength for thousands of years. Every emotion known to humanity has been explored in these chapters. Whether you are angry or feeling rejected, you may find a psalm to reflect where you are. 

Whichever route you take, the idea is to accept what is happening and search the illness for clues as to what the message might be. Does your life need to change?  Do you need to reconcile with someone or some part of yourself? Be patient with yourself and with your sickness. The message may only dawn on you slowly. Local clergy or hospital chaplain can offer much in the way of counseling, information and support.

Support Groups

Sharing in a group environment may help you feel less isolated as well as expose you to alternative methods of coping, communicating, and living with chronic pain.

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Tai Chi

Ancient Chinese technique that is comprised of a series of slow, meditative body movements that can help promote inner peace and calm.

Visual Imagery 

Creating a mental image of a desired outcome, and repeatedly playing that image in the mind. 

PLAY-10.gifOcean_Beach

 

Visual Expression: Using Art to Understand Your Emotions 

To participate in this exercise, it is not necessary to have artistic ability, just a willingness to explore a creative process in order to express yourself through various art making materials. This form of art making directs your focus toward a personal process of creating and less on the product itself. This means being aware of your whole self: mind, body, and spirit during your time of creating. Discover various mediums, finding one with which you feel comfortable: paint, pen and ink, photos, fabric, wire, magazine images, words, etc. 

As you start to create and explore materials, think about a particular issue or experience and let an image begin to develop in your mind. If you are drawing or painting, start with a simple mark on the paper and move from there. Let yourself work freely, without criticism. Continue until the image "says it is finished."

Tips as You Prepare to Create

  • Collect your supplies. Use whatever you have at hand-pens or pencils, paper, crayons, paints, magazine pictures, etc. 

  • Give yourself a choice of colors-from black and white to pastels and bright colors. 

  • Choose materials that fit your state of mind-for instance, if you feel like ripping something, choose colored paper, or magazines. 

  • Experiment with obtaining and using different materials. Decide what allows you to most comfortably express yourself visually. 

  • Find a spot to work. Provide yourself privacy; you may not feel comfortable with letting other people see your work. 

  • Prepare your work area so you don't have to worry about making a mess or damaging anything.  You may want to select a work area where you can leave your project out. 

  • Make some random marks on the paper with the pen, marker or brush just to get a feel for the materials you have chosen to use-What can you do with them? How do they make you feel? 

Partial material was adapted from Art is a Way of Knowing: A Guide to Self-Knowledge and Spiritual Fulfillment Through Creativity by Pat B. Allen. 

 

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Yoga 

Yoga is a philosophy and discipline that can relax your body and your mind and affect your spirit. Through practices of holding a variety of body positions and the centering of the mind and breath in a meditative way, you will increase your body awareness, posture, flexibility, and mind and calmness of spirit. 

Whole Medical Systems 

Therapy that uses a combination of complementary and alternative medicine techniques to treat a condition. An example of a combination is Reiki plus meditation and yoga. 

Writing Exercises

Writing may help to focus and gain clarity as you deal with the pain and the stress that accompanies chronic pain. It is not necessary to write every day, but you may wish to establish an on-going writing program to help you with new challenges, as well as with difficult situations that arise or old memories that persist. Some positive benefits of writing will appear almost immediately after completing the writing process, while others may take up to four months to become apparent.

It does not matter if you have never been a writer before. This is for you. No one is going to grade you on your writing. It is just a chance to get your thoughts and feelings on paper.

Researcher Dr. James Pennebaker offers this guidance as you write to heal:

  • Select any event – recent or in the past. You may choose to write about the most difficult experience of your life, but it may be more helpful to write about the issues that are of concern to you right now. Do you spend a lot of time thinking about a particular issue? Writing can help you resolve that issue. Is there something that you cannot tell others because you are ashamed or embarrassed about it? Then write about that. It is most important to take action – to begin to write about something. 

  • Write whenever you want to, about whatever you wish. 

  • However, do not use writing as a substitute for actions which you should take, such as apologizing to someone you have wronged. 

  • Once you have selected a topic, just begin to write. If you find it difficult to begin, just write "I am finding it very difficult to write about this experience," and keep writing whatever comes into your mind. The important thing is to just start writing! 

  • Tell the story of your experience, with plenty of details. Don't make it a "newspaper account" with "just the facts." 

  • Be sure to include your feelings about the event. Write what you feel and explore why you feel that way. Linking your feelings with the troubling event will help provide you the health benefits of writing. 

  • If you run out of things to say, just repeat what you have already written. 

To gain the most benefit, try to write continuously for fifteen to twenty minutes, or longer. Write about the same topic for four sessions – on four consecutive days or within a week or so. There are several types of writing you may want to try.  

  • Journaling  Writing in a diary or journal that discusses thoughts and feelings evoked by the events of your life can help reduce stress and help you to discover things about yourself and your life. To be most helpful, you should write in detail about feelings and comprehension related to stressful events.


  • Appreciative Writing  Appreciation, compassion, caring, and joy are powerful emotions that can positively affect your health. In her book Journal to the Self, author Kathleen Adams describes the writing technique called Captured Moments. A Captured Moment is a very specific event or experience, as you remember it. Much like a camera shutter captures a split second of infinity on film, so does a Captured Moment preserve an instant of feeling and sensation. When writing about Captured Moments you focus on the senses, using sights, sounds, textures, smells, and feelings to creatively and vividly capture a special time. Here is a brief guide for how to get started
    • Begin by closing your eyes and slowly breathing in and out, allowing yourself to relax. 
    • Invite an image from a wonderful time to come into your mind—perhaps a wedding, reuniting with an old friend, holding a newborn baby. 
    • Bring yourself into that scene—letting yourself see, smell, hear, feel, and touch all that is in that memory. Fully immerse yourself in that experience, and relive it.
    • Then, open your eyes, and begin to write, letting the words flow, bringing the experience to life on your paper. 

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