How Do I Manage Chronic Pain?

First, know your diagnosis. How can you treat a problem that has not been diagnosed? You will not know your traditional or alternative medical treatment options unless you have a specific diagnosis. Whether the condition is fibromyalgia, arthritis or cancer, there are treatment options available for you. Without a diagnosis, you will not receive adequate treatment. So pursue finding the answer for why you have chronic pain, which gives you the opportunity to accept the truth about your body. In that case, you can learn to live and thrive despite a painful diagnosis.

Second, know your body. You must identify the specific activities and movements that increase and decrease your pain and symptoms. You should be able to readily list your aggravating and relieving factors. That is helpful first for your physician, therapist or other healthcare practitioner as they develop your diagnosis and treatment plan.

Third, modify your lifestyle based on your list from #2 (aggravating and relieving factors). Here are some examples. 

a. Lie down on on your back for 10 minutes without a pillow and place ice on the painful area. This may give enough pain relief to get you through the afternoon of chores.

b. Avoid the chair that causes your back to hurt. Find another chair. Or if sitting in that chair for 1 hour causes your back to hurt, stand up and stretch every 30 minutes.

c. Sit in the back row of church so that you can stand up as frequently as needed. This may be the modification that enables you to get back to church again.

d. Do a specific exercise that decreases your pain, and repeat it every hour.

e. Consistently walk for 30 minutes per day because that keeps your pain better controlled.

f. The next time you buy a car, get one that is higher off the ground because getting in and out of a low car always aggravates your pain.

g. Cook for 15 minutes at a time if standing too long aggravates your pain.

Fourth, take medication as prescribed for a time period. If it is ineffective, follow up with your doctor to see what other medicine may be appropriate. Some medicine is most effective when taken consistently, so do not skip doses or days.

Fifth, comply with doctor's orders. This includes lifting restrictions, activity restrictions, lifestyle modifications, prescriptions and other medical treatments (such as Physical Therapy or chiropractic care). If you truly want to get better, what are you doing to make that happen? Are you doing the home exercise program from your PT?

Sixth, be sure you have exhausted your treatment options. Have you tried Physical Therapy, Aquatic Therapy, Chiropractor, Accupuncture, Massage Therapy, Exercise, Weight Loss, Medication, Natural Remedies, Vitamins/Supplements, Topical Rubs/Creams, Ice/Heat, Over-the-counter treatments, Injections, Diet changes, etc? 

Lastly, do your own research and be your own advocate. If you know the answer to #1, then find support groups, websites, books and articles on your diagnosis. Find out the best local or national specialists in your area of chronic pain.

Chronic pain is very difficult to live with, but you ARE still alive! God has blessed you with this life, so learn to best manage your pain so that you can fulfill your purpose for living!

What Should I Do For Chronic Back Pain?

First, you should see your primary care physician. He/she will decide if you need a referral to a specialist. 

Second, consider your most conservative treatment options, such as medication and Physical Therapy (PT). There are several types of Physical Therapy options. If you have seen a Physical Therapist before and still have chronic back pain, maybe you need to find a therapist that specializes in the spine. 

There are three main forms of specialty PT that are most effective for chronic back pain. Mechanical Diagnosis and Therapy (MDT), Manual Therapy, and Aquatic Therapy. Your primary doctor, spine specialist or pain specialist may prescribe PT for you and refer you to a specific PT clinic. But do not hesitate to do your own research on local PTs in order to find the clinic that will best meet your needs. It is your choice where to get your Physical Therapy once it is prescribed (just like you choose your pharmacy). Just remember that not all PTs are the same. Some clinics specialize in orthopedic rehab, neurological rehab, pediatric rehab, spine rehab, aquatic therapy, geriatrics, etc, so select carefully in order to maximize your time, effort and cost. Getting the proper Physical Therapy could help you to prevent injections or even surgery. 

Third, if you are still not getting better, follow up with your doctor/specialist. You may be a candidate for injections or other treatments. Injections are effective for some back patients. Some get short-term relief, some get long-term relief and some get no relief, depending on your diagnosis and other factors.

Fourth, increase your fitness level. Get on a weight loss program if you are overweight or obese. Start exercising regularly. This, by itself, could drastically decrease your back pain. It is urgent that you start to do cardio exercise 5-7x per week. Work up to at least 30 minutes per day of moderate to heavy cardio exercise (a walking program may be the easiest, cheapest and most convenient option).

Fifth, if you have done all of the above and still have chronic back pain, see your specialist again, or get a second or third opinion. You should at least know your diagnosis, prognosis and treatment options. If you do not know these yet, ask more questions until you get the answers you seek.

As a PT, I obviously recommend PT over other treatment options. I recently saw a patient with chronic back pain for >20 years and radiating leg pain for >1 year. Within 1 PT session his leg pain was gone and within 3-5 sessions, his back pain was gone! A PT will help to find the cause of your pain, the proper treatment(s), and the best ways to prevent future episodes. 

Dealing With Chronic Pain

Chronic pain can affect every aspect of your life, but it does not have to take over your life. Here are some practical tips to help you deal with chronic pain.

1. Know your treatment options. What treatments have you tried (medicines, therapies, surgeries, injections)? What doctors/specialists have you seen so far? Do not be afraid to get a second and third opinion, especially if you have unanswered questions about the diagnosis and treatment options for your condition. Be sure to ask your healthcare providers all your questions about your symptoms, concerns and needs. 

2. Exercise! Find a form of exercise that is most tolerable and do it frequently. Exercise produces natural feel-good hormones in your body called endorphins! There are countless exercise benefits for your heart, lungs, muscles, metabolism, digestion, mind and every system of your body, so do not stop exercising or moving because of chronic pain. More than likely, exercise will make you feel better and lack of exercise will make you feel worse.

3. Modify your postures. Look at your posture and find ways to improve it. Use upright chairs, lumbar support rolls, extra pillows, etc to improve and maintain good posture. Start standing and walking with upright posture. Use assistive devices (cane, walker, crutches, braces) as needed to help improve your posture and balance.

4. Modify positioning. Do you sit all day in your recliner chair or sofa? Are there certain positions that aggravate your symptoms for an extended time that you can avoid? Change positions frequently. Stand up and walk around often, even if it is only for a few minutes at a time. You may need to avoid certain chairs, beds, or couches. Be picky about where you choose to sit when you are in public. 

5. Find a hobby. Give yourself something to wake up for every day. Choose something that promotes activity and movement, such as gardening, yoga, or cooking. Having an active hobby will benefit you both physically and mentally.

6. Stay social. Do not isolate yourself because of your pain. Spend time doing activities with your family and friends. Or find ways/places to make friends. Find a local support group for individuals with your condition. 

7. Do not neglect the power of prayer. Jesus performed miraculous healings, and God still does miracles today!

Daily tasks that cause LOW BACK PAIN

These are some specific types of injuries that cause low back pain.

1. Falls. Falling can cause numerous injuries, from broken bones to torn muscles/tendons to internal bleeding and worse. So do whatever it takes to prevent falling.
2. Lifts. Lifting wrong is a major cause of low back pain. The heavier the object you are lifting, the higher the risk for injury. So be sure to lift the right way, whether you are lifting a 5-lb. or a 50-lb. object.
3. Housework. Doing housework can easily cause low back pain if you do it incorrectly. So be sure to check your body mechanics with every part of your housework.
4. Yardwork. Similar to housework, yardwork also needs to be performed with caution and with intentionally good technique. This is especially true when working with heavier equipment or with strenuous outdoor tasks.
5. Exercise. Exercise is so important for improved health, and I recommend it to all my patients. However, I have also treated many patients who injured their backs from exercising. So be sure to learn the proper exercise techniques. Then check your technique every time you do the exercise.
6. Sports. Some sports injuries are pure, unavoidable accidents. But many are preventable, with proper warm-ups, stretching, staying warm (ex: baseball), shoewear (ex: running), slowly working up to higher levels, and/or sports-specific strengthening.

Over the next few days I will talk more about these areas in greater detail. Stay tuned! You do not have to live with low back pain if you take the necessary steps to prevent it!