Managing Chronic Pain (Realistically!)
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Realistic chronic pain management
We’ve had a number of requests to do a main feature on managing chronic pain, so here it is!
A quick (but important) note before we begin:
Obviously, not all chronic pain is created equal. Furthermore, we know that you, dear reader with chronic pain, have been managing yours for however long you have, learning as you go. You also doubtlessly know your individual condition inside out.
We also know that people with chronic health conditions in general are constantly beset by well-meaning unsolicited advice from friends and family, asking if you’ve heard about [thing you heard about 20 years ago] that will surely change your life and cure you overnight.
It’s frustrating, and we’re going to try to avoid doing that here, while still offering the advice that was asked for. We ask you, therefore, to kindly overlook whatever you already knew, and if you already knew it all, well, we salute you and will not be surprised if that’s the case for at least some readers. Chronic pain’s a… Well, it’s a chronic pain.
All that said, let’s dive in…
How are you treating your body right now?
Are you hydrated; have you eaten; are you standing/sitting/lying in a position that at least should be comfortable for you in principle?
The first two things affect pain perception; the latter can throw a spanner in the works if something’s not quite right.
Move your body (gently!)
You know your abilities, so think about the range of motion that you have, especially in the parts of your body that hurt (if that’s “everywhere”, then, our sympathies, and we hope you find the same advice applies). Think about your specific muscles and joints as applicable, and what the range of motion is “supposed” to be for each. Exercise your range of motion as best you can (gently!) to the point of its limit(s) and/or pain.
- If you take it past that limit, there is a good chance you will make it worse. You don’t want that.
- If you don’t take it to the limit, there is a good chance your range of movement will deteriorate, and your “safe zone” (i.e., body positions that are relatively free from pain) will diminish. You definitely don’t want that, either.
Again, moderation is key. Yes, annoying as the suggestion may be, such things as yoga etc can help, if done carefully and gently. You know your limits; work with those, get rest between, and do what you can.
For most people this will at least help keep the pain from getting worse.
Hot & Cold
Both of these things could ease your pain… Or make it worse. There is an element of “try it and see”, but here’s a good general guide:
Here’s How to Choose Between Using Ice or Heat for Pain
Meditation… Or Distraction
Meditating really does help a lot of people. In the case of pain, it can be counterintuitively helpful to focus for a while on the sensation of the pain… But in a calm, detached fashion. Without judgement.
“Yes, I am experiencing pain. Yes, it feels like I’m being stabbed with hot knives. Yes, this is tortuous; wow, I feel miserable. This truly sucks.”
…it doesn’t sound like a good experience, does it? And it’s not, but paying it attention this way can paradoxically help ease things. Pain is, after all, a messenger. And in the case of chronic pain, it’s in some ways a broken messenger, but what a messenger most needs is to be heard.
The above approach a) is good b) may have a limit in how long you can sustain it at a time, though. So…
The opposite is a can be a good (again, short-term) approach too. Call a friend, watch your favorite movie, play a video game if that’s your thing. It won’t cure anything, but it can give you a little respite.
Massage
Unless you already know this makes your pain worse, this is a good thing to try. It doesn’t have to be a fancy spa; if the nature of your pain and condition permits, you can do self-massage. If you have a partner or close friend who can commit to helping, it can be very worth them learning to give a good massage. There are often local courses available, and failing that, there is also YouTube.
Here’s an example of a good video for myofascial release massage, which can ease a lot of common kinds of chronic pain:
Some quick final things to remember:
- If you find something helps, then it helps, do that.
- That goes for mobility aids and other disability aids too, even if it was designed for a different disability. If it helps, it helps. You’re not stealing anyone’s thunder (or resources) by using something that makes your life easier. We’re not in this life to suffer!
- There is no such thing as “this pain is not too much”. The correct amount of pain is zero. Maybe your body won’t let you reach zero, but more than that is “too much” already.
- You don’t have to be suffering off the scale to deserve relief from pain
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What’s the difference between miscarriage and stillbirth?
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What’s the difference? is a new editorial product that explains the similarities and differences between commonly confused health and medical terms, and why they matter.
Former US First Lady Michelle Obama revealed in her memoir she had a miscarriage. UK singer-songwriter and actor Lily Allen has gone on the record about her stillbirth.
Both miscarriage and stillbirth are sadly familiar terms for pregnancy loss. They can be traumatic life events for the prospective parents and family, and their impacts can be long-lasting. But the terms can be confused.
Here are some similarities and differences between miscarriage and stillbirth, and why they matter.
christinarosepix/Shutterstock Let’s start with some definitions
In broad terms, a miscarriage is when a pregnancy ends while the fetus is not yet viable (before it could survive outside the womb).
This is the loss of an “intra-uterine” pregnancy, when an embryo is implanted in the womb to then develop into a fetus. The term miscarriage excludes ectopic pregnancies, where the embryo is implanted outside the womb.
However, stillbirth refers to the end of a pregnancy when the fetus is normally viable. There may have been sufficient time into the pregnancy. Alternatively, the fetus may have grown large enough to be normally expected to survive, but it dies in the womb or during delivery.
The Australian Institute of Health and Welfare defines stillbirth as a fetal death of at least 20 completed weeks of gestation or with a birthweight of at least 400 grams.
Internationally, definitions of stillbirth vary depending on the jurisdiction.
How common are they?
It is difficult to know how common miscarriages are as they can happen when a woman doesn’t know she is pregnant. There may be no obvious symptoms or something that looks like a heavier-than-normal period. So miscarriages are likely to be more common than reported.
Studies from Europe and North America suggest a miscarriage occurs in about one in seven pregnancies (15%). More than one in eight women (13%) will have a miscarriage at some time in her life.
Around 1–2% of women have recurrent miscarriages. In Australia this is when someone has three or more miscarriages with no pregnancy in between.
Australia has one of the lowest rates of stillbirth in the world. The rate has been relatively steady over the past 20 years at 0.7% or around seven per 1,000 pregnancies.
Who’s at risk?
Someone who has already had a miscarriage or stillbirth has an increased risk of that outcome again in a subsequent pregnancy.
Compared with women who have had a live birth, those who have had a stillbirth have double the risk of another. For those who have had recurrent miscarriages, the risk of another miscarriage is four-fold higher.
Some factors have a u-shaped relationship, with the risk of miscarriage and stillbirth lowest in the middle.
For instance, maternal age is a risk factor for both miscarriage and stillbirth, especially if under 20 years old or older than 35. Increasing age of the male is only a risk factor for stillbirth, especially for fathers over 40.
An older dad can be a risk factor for stillbirth, but not miscarriage. Elizaveta Galitckaia/Shutterstock Similarly for maternal bodyweight, women with a body mass index or BMI in the normal range have the lowest risk of miscarriage and stillbirth compared with those in the obese or underweight categories.
Lifestyle factors such as smoking and heavy alcohol drinking while pregnant are also risk factors for both miscarriage and stillbirth.
So it’s important to not only avoid smoking and alcohol while pregnant, but before getting pregnant. This is because early in the pregnancy, women may not know they have conceived and could unwittingly expose the developing fetus.
Why do they happen?
Miscarriage often results from chromosomal problems in the developing fetus. However, genetic conditions or birth defects account for only 7-14% of stillbirths.
Instead, stillbirths often relate directly to pregnancy complications, such as a prolonged pregnancy or problems with the umbilical cord.
Maternal health at the time of pregnancy is another contributing factor in the risk of both miscarriage and stillbirths.
Chronic diseases, such as high blood pressure, diabetes, hypothyroidism (underactive thyroid), polycystic ovary syndrome, problems with the immune system (such as an autoimmune disorder), and some bacterial and viral infections are among factors that can increase the risk of miscarriage.
Similarly mothers with diabetes, high blood pressure, and untreated infections, such as malaria or syphilis, face an increased risk of stillbirth.
In many cases, however, the specific cause of pregnancy loss is not known.
How about the long-term health risks?
Miscarriage and stillbirth can be early indicators of health issues later in life.
For instance, women who have had recurrent miscarriages or recurrent stillbirths are at higher risk of cardiovascular disease (such as heart disease or stroke).
Our research has also looked at the increased risk of stroke. Compared with women who had never miscarried, we found women with a history of three or more miscarriages had a 35% higher risk of non-fatal stroke and 82% higher risk of fatal stroke.
Women who had a stillbirth had a 31% higher risk of a non-fatal stroke, and those who had had two or more stillbirths were at a 26% higher risk of a fatal stroke.
We saw similar patterns in chronic obstructive pulmonary disease or COPD, a progressive lung disease with respiratory symptoms such as breathlessness and coughing.
Our data showed women with a history of recurrent miscarriages or stillbirths were at a 36% or 67% higher risk of COPD, respectively, even after accounting for a history of asthma.
Long-term health risks of recurrent miscarriages or stillbirths include developing lung disease later in life. PRPicturesProduction/Shutterstock Why is all this important?
Being well-informed about the similarities and differences between these two traumatic life events may help explain what has happened to you or a loved one.
Where risk factors can be modified, such as smoking and obesity, this information can be empowering for individuals who wish to reduce their risk of miscarriage and stillbirth and make lifestyle changes before they become pregnant.
More information and support about miscarriage and stillbirth is available from SANDS and Pink Elephants.
Gita Mishra, Professor of Life Course Epidemiology, Faculty of Medicine, The University of Queensland; Chen Liang, PhD student, reproductive history and non-communicable diseases in women, The University of Queensland, and Jenny Doust, Clinical Professorial Research Fellow, School of Public Health, The University of Queensland
This article is republished from The Conversation under a Creative Commons license. Read the original article.
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Figs vs Banana – Which is Healthier?
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Our Verdict
When comparing figs to banana, we picked the banana.
Why?
Both of these fruits have a reputation for being carb-heavy (though their glycemic index is low in both cases because of the fiber), and they both have approximately the same macros across the board. So a tie on macros.
When it comes to vitamins, figs have more of vitamins A, B1, E, and K, while banana has more of vitamins B2, B3, B5, B6, B9, C, and choline. So, a win for banana there.
In the category of minerals, figs have more calcium and iron, while banana has more copper, magnesium, manganese, phosphorus, potassium, and selenium. Another win for banana.
Adding up the section makes for a win for bananas, but by all means, enjoy either or both; diversity is good!
Want to learn more?
You might like to read:
Which Sugars Are Healthier, And Which Are Just The Same?
Take care!
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When “Normal” Health Is Not What You Want
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It’s Q&A Day at 10almonds!
Have a question or a request? You can always hit “reply” to any of our emails, or use the feedback widget at the bottom!
In cases where we’ve already covered something, we might link to what we wrote before, but will always be happy to revisit any of our topics again in the future too—there’s always more to say!
As ever: if the question/request can be answered briefly, we’ll do it here in our Q&A Thursday edition. If not, we’ll make a main feature of it shortly afterwards!
So, no question/request too big or small
❝When going to sleep, I try to breathe through my nose (since everyone says that’s best). But when I wake I often find that I am breathing through my mouth. Is that normal, or should I have my nose checked out?❞
It is quite normal, but when it comes to health, “normal” does not always mean “optimal”.
- Good news: it is correctable!
- Bad news: it is correctable by what may be considered rather an extreme practice that comes with its own inconveniences and health risks.
Some people correct this by using medical tape to keep their mouth closed at night, ensuring nose-breathing. Advocates of this say that after using it for a while, nose-breathing in sleep will become automatic.
We know of no hard science to confirm this, and cannot even offer a personal anecdote on this one. Here are some pop-sci articles that do link to the (very few) studies that have been conducted:
- Mouth taping may be a trending sleep hack, but the science behind it is slim
- Mouth Taping for Sleep: Does it Work? And What are the Side Effects?
This writer’s personal approach is simply to do breathing exercises when going to sleep and first thing upon awakening, and settle for imperfection in this regard while asleep.
Meanwhile, take care!
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DBT Made Simple – by Sheri van Dijk
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This book offers very clear explanations of DBT. In fact, a more fitting title might have been “DBT made clear”, because it does it without oversimplification.
This is a way in which van Dijk’s work stands out from that of many writers on the subject! Many authors oversimplify, to the point that a reader may wonder “is that all it is?” when, in reality, there’s rather more to it.
This work is, therefore, refreshingly comprehensive, without sacrificing clarity.
Van Dijk also takes us through the four pillars of DBT:
- Mindfulness
- Distress tolerance
- Emotional regulation
- Interpersonal effectiveness
Each of these can help an individual alone; together, they produce a composite effect with a synergy that makes each more effective. Hence, pillars.
On the topic of “an individual”, you may be wondering “is this book for therapists or the general public?” and the answer is yes, yes it is.
That is to say: it’s written with the assumption that the reader wants to learn DBT in order to practice it as a therapist… and/but is written in such a fashion that it’s very easy to apply the skills to oneself, too. As it’s an introductory guide—a comprehensive one, but without assuming prior knowledge—it’s a perfect resource for anyone to get a good grounding in the subject.
Bottom line: if you’ve been hearing about DBT (possibly from us!) and wondering where you might start, this book is an excellent place to begin.
Click here to check out DBT Made Simple, and start making many parts of life easier!
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Physical Sunscreen or Chemical Sunscreen – Which is Healthier?
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Our Verdict
When comparing physical sunscreens to chemical sunscreens, we picked the physical sunscreens.
Why?
It’s easy to vote against chemical sunscreens, because it has “chemical” in the name, which tends to be offputting PR-wise no matter how healthy something is.
But in this case, there’s actual science here too!
Physical sunscreens physically block the UV rays.
- On the simplest of levels, mud is a physical sunscreen, as you can see widely used by elephants, hippos, pigs, and other animals.
- On a more sophisticated level, modern physical sunscreens often use tiny zinc particles (or similar) to block the UV rays in a way that isn’t so obvious to the naked eye—so we can still see our skin, and it looks just like we applied an oil or other moisturizer.
Chemical sunscreens interact with the UV rays in a way that absorbs them.
- Specifically, they usually convert it into relatively harmless thermal energy (heat)
- However, this can cause problems if there’s too much heat!
- Additionally, chemical sunscreens can get “used up” in a way that physical sunscreens can’t* becoming effectively deactivated once the chemical reaction has run its course and there is no more reagent left unreacted.
- Worse, some of the reagents, when broken down by the UV rays, can potentially cause harm when absorbed by the skin.
*That said, physical sunscreens will still need “topping up” because we are a living organism and our body can’t resist redistributing and using stuff—plus, depending on the climate and our activities, we can lose some externally too.
Further reading
We wrote about sunscreens (of various kinds) here:
And you can also read specifically about today’s topic in more detail, here:
What’s The Difference Between Physical And Chemical Sunscreens?
Take care!
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6 Ways To Look After Your Back
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Back To Back
When people think about looking after their back, often thought does not go much further than sitting with good posture, and perhaps even standing with good posture. And those things are important, but:
1) People’s efforts to have good posture often result in overcorrecting creating an anterior pelvic tilt that causes lower back problems.
Quick tip: if you’re sticking your butt out, you’re doing it wrong (no matter how great your butt is). Instead, to find the correct posture, go up on your tip-toes for a moment, then imagine a plumb-line down the center of your body, thus perpendicular to the floor, going all the way down to the ground. Now, slowly return your heels to the ground, but as you do so, keep your spine aligned to the plumb-line, so you’re not moving backwards as you drop, just directly down. This will land you in perfect posture.
Unless you have scoliosis. In which case, it’ll get you as close to good posture as is likely attainable from any quick tip.
2) There’s a lot more to looking after our back than just good posture!
Here are 5 other important things to do:
Be strong
Do strength-training for your back. How to do that is beyond the scope of today’s feature, but there are many good guides and also personal trainers that can be found.
Start off easy and work up, but do start. The stronger your back is, the less likely a momentary lapse in concentration is to throw out your back because you picked something up with imperfect form.
See also: Resistance Is Useful! (Especially As We Get Older)
Stretch intentionally
Many back injuries occur as a result of stretching and/or twisting awkwardly, so if you ensure your basic mobility and range of motion is good, the less likely it is that unthinkingly twisting around 270° to see where that wasp was going will slip a disk.
The more you stretch intentionally (carefully, please), the more you will be able to stretch unintentionally without injury.
See also: Building & Maintaining Mobility
Stand when you can, walk when you can
We humans have outrun our evolution in a lot of ways, and/but one thing our bodies are definitely not well-adapted for is sitting. Unless we are sitting in a low squat the way you might often see an orang-utan sitting, sitting is not a good way of being for us. Even sitting seiza-style or cross-legged is passable for a short while, not for too long.
So, while there sure are times we need to sit (especially if you’re driving!) minimizing those times is ideal. There are a lot of activities that are traditionally done sitting, where there’s no need for it to be so. For example, your writer here sits for the day’s main meal, but takes any smaller meal standing (and when guests visit for a coffee or such, I’ll offer them the couch while I myself prop up the fireplace). Standing desks are also great if you spend a lot of time at the computer for any reason.
See also: The Doctor Who Wants Us To Exercise Less & Move More
Rest when you need to
You can’t stand all the time! But know this: if you want to rest your legs, lying down is a lot better for your back (and internal organs) than sitting.
Taking a 5 minute break lying on your couch, or bed, or floor, is a perfectly good option and only social convention says otherwise.
If you want a compromise option, though? A recliner chair, in the reclined position, is a better for your back than being scrunched up in the Economy Class Flight position.
PS: About that bed situation…
What Mattress Is Best, By Science?
Kill pain before it kills you
Painkillers aren’t great for the health per se, but pain (or rather, our bodily responses to such) can be worse. Half the time, when it comes to musculoskeletal problems, things get a lot worse a lot more quickly because of how we overcompensate due to the pain. So, take your pain seriously, and remember, the right amount of pain is zero.
If you’re thinking “but pain relief option xyz isn’t good for me”, we strongly recommend checking out:
The 7 Approaches To Pain Management
Take care!
Don’t Forget…
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