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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Lose Weight (Healthily!)
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What Do You Have To Lose?
For something that’s a very commonly sought-after thing, we’ve not yet done a main feature specifically about how to lose weight, so we’re going to do that today, and make it part of a three-part series about changing one’s weight:
- Losing weight (specifically, losing fat)
- Gaining weight (specifically, gaining muscle)
- Gaining weight (specifically, gaining fat)
And yes, that last one is something that some people want/need to do (healthily!), and want/need help with that.
There will be, however, no need for a “losing muscle” article, because (even though sometimes a person might have some reason to want to do this), it’s really just a case of “those things we said for gaining muscle? Don’t do those and the muscle will atrophy naturally”.
One reason we’ve not covered this before is because the association between weight loss and good health is not nearly so strong as the weight loss industry would have you believe:
And, while BMI is not a useful measure of health in general, it’s worth noting that over the age of 65, a BMI of 27 (which is in the high end of “overweight”, without being obese) is associated with the lowest all-cause mortality:
BMI and all-cause mortality in older adults: a meta-analysis
Important: the above does mean that for very many of our readers, weight loss would not actually be healthy.
Today’s article is intended as a guide only for those who are sure that weight loss is the correct path forward. If in doubt, please talk to your doctor.
With that in mind…
Start in the kitchen
You will not be able to exercise well if your body is malnourished.
Counterintuitively, malnourishment and obesity often go hand-in-hand, partly for this reason.
Important: it’s not the calories in your food; it’s the food in your calories
See also: Mythbusting Calories
The kind of diet that most readily produces unhealthy overweight, the diet that nutritional scientists often call the “Standard American Diet”, or “SAD” for short, is high on calories but low on nutrients.
So you will want to flip this, and focus on enjoying nutrient-dense whole foods.
The Mediterranean Diet is the current “gold standard” in this regard, so for your interest we offer:
Four Ways To Upgrade The Mediterranean Diet
And since you may be wondering:
Should You Go Light Or Heavy On Carbs?
The dining room is the next most important place
Many people do not appreciate food enough for good health. The trick here is, having prepared a nice meal, to actually take the time to enjoy it.
It can be tempting when hungry (or just plain busy) to want to wolf down dinner in 47 seconds, but that is the metabolic equivalent of “oh no, our campfire needs more fuel, let’s spray it with a gallon of gasoline”.
To counter this, here’s the very good advice of Dr. Rupy Aujla, “The Kitchen Doctor”:
Interoception & Mindful Eating
The bedroom is important too
You snooze, you lose… Visceral belly fat, anyway! We’ve talked before about how waist circumference is a better indicator of metabolic health than BMI, and in our article about trimming that down, we covered how good sleep is critical for one’s waistline:
Visceral Belly Fat & How To Lose It
Exercise, yes! But in one important way.
There are various types of exercise that are good for various kinds of health, but there’s only one type of exercise that is good for boosting one’s metabolism.
Whereas most kinds of exercise will raise one’s metabolism while exercising, and then lower it afterwards (to below its previous metabolic base rate!) to compensate, high-intensity interval training (HIIT) will raise your metabolism while training, and for two hours afterwards:
…which means that unlike most kinds of exercise, HIIT actually works for fat loss:
So if you’d like to take up HIIT, here’s how:
How (And Why) To Do HIIT (Without Wrecking Your Body)
Want more?
Check out our previous article about specifically how to…
Burn! How To Boost Your Metabolism
Take care!
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ADHD 2.0 – by Dr. Edward Hallowell & Dr. John Ratey
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A lot of ADHD literature is based on the assumption that the reader is a 30-something parent of a child with ADHD. This book, on the other hand, addresses all ages, and includes just as readily the likelihood that the person with ADHD is the reader, and/or the reader’s partner.
The authors cover such topics as:
- ADHD mythbusting, before moving on to…
- The problems of ADHD, and the benefits that those exact same traits can bring too
- How to leverage those traits to get fewer of the problems and more of the benefits
- The role of diet beyond the obvious, including supplementation
- The role of specific exercises (especially HIIT, and balance exercises) in benefiting the ADHD brain
- The role of medications—and arguments for and gainst such
The writing style is… Thematic, let’s say. The authors have ADHD and it shows. So, expect comprehensive deep-dives from whenever their hyperfocus mode kicked in, and expect no stones left unturned. That said, it is very readable, and well-indexed too, for ease of finding specific sub-topics.
Bottom line: if you are already very familiar with ADHD, you may not learn much, and might reasonably skip this one. However, if you’re new to the topic, this book is a great—and practical—primer.
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10 “Harsh” Truths You Probably Need to Hear
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What do you think? Are they actually harsh? We’re not convinced, but either way they are helpful, which is the important part:
10 Helpful Truths
Here they are:
- Simple isn’t easy: simplicity doesn’t guarantee ease; focus on small, manageable habits that meet you where you are.
- Hard habits: the changes we resist most are often the ones we need most to grow.
- We stand in our own way: doubt and lack of commitment hinder progress; believe in possibilities and take consistent action.
- Success is failure: failure is often part of the route to success; it provides valuable lessons if we embrace and reflect on it.
- Nothing works forever: adapt and evolve as circumstances change; clinging to outdated habits can hinder progress.
- Effort doesn’t equal outcome: feeling like you’re working hard doesn’t always mean you’re making effective progress.
- Someone always has it easier: comparisons are inevitable but unhelpful; focus on your own unique path and progress.
- There’s no one best thing: results depend on creating systems that fit your lifestyle, not chasing a single magic solution.
- Mindset matters most: success requires examining your mindset, lifestyle, and priorities, not just physical actions.
- Do it anyway: push through resistance, especially on tough days; discipline and consistency create success.
For more on all of each of these, enjoy:
Click Here If The Embedded Video Doesn’t Load Automatically!
Want to learn more?
You might also like to read:
How To Really Pick Up (And Keep!) Those Habits
Take care!
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The Physical Exercises That Build Your Brain
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Jim Kwik: from broken brain to brain coach
Image from Kwik Learning This is Jim Kwik. He suffered a traumatic brain injury as a small child, and later taught himself to read and write by reading comic books. He became fascinated with the process of learning, and in his late 20s he set up Kwik Learning, to teach accelerated learning in classrooms and companies, which he continued until 2009 when he launched his online learning platform. His courses have now been enjoyed by people in 195 countries.
So, since accelerated learning is his thing, you might wonder…
What does he have to share that we can benefit from in the next five minutes?
Three brain exercises to improve memory and concentration
A lot of problems we have with working memory are a case of executive dysfunction, but there are tricks we can use to get our brains into gear and make them cumulatively stronger:
First exercise
You can strengthen your corpus callosum (the little bridge between the two hemispheres of the brain) by performing a simple kinesiological exercise, such as alternating touching your left elbow to your right knee, and touching your right elbow to your left knee.
Do it for about a minute, but the goal here is not a cardio exercise, it’s accuracy!
You want to touch your elbow and opposite knee to each other as precisely as possible each time. Not missing slightly off to the side, not falling slightly short, not hitting it too hard.
Second exercise
Put your hands out in front of you, as though you’re about to type at a keyboard. Now, turn your hands palm-upwards. Now back to where they were. Now palm-upwards again. Got it? Good.
That’s not the exercise, the exercise is:
You’re now going to do the same thing, but do it twice as quickly with one hand than the other. So they’ll still be flipping to the same basic “beat”, put it in musical terms, the tempo on one hand will now be twice that of the other. When you get the hang of that, switch hands and do the other side.
This is again about the corpus callosum, but it’s now adding an extra level of challenge because of holding the two rhythms separately, which is also working the frontal lobe of the cerebral cortex.
The pre-frontal cortex in particular is incredibly important to executive function, self-discipline, and being able to “do” delayed gratification. So this exercise is really important!
Third exercise
This one works the same features of the brain, but most people find it harder. So, consider it a level-up on the previous:
Imagine there’s a bicycle wheel in front of you (as though the bike is facing you at chest-height). Turn the wheel towards you with your hands, one on each side.
Now, do the same thing, but each of your hands is going in the opposite direction. So one is turning the wheel towards you; the other is turning it away from you.
Now, do the same thing, but one hand goes twice as quickly as the other.
Switch sides.
Why is this harder for most people than the previous? Because the previous involved processing discrete (distinct from each other) movements while this one involves analog continuous movements.
It’s like reading an analog clock vs a digital clock, but while using both halves of your brain, your corpus callosum, your pre-frontal cortex, and the motor cortex too.
Want to learn more?
You might enjoy his book, which as well as offering exercises like the above, also offers a lot about learning strategies, memory processes, and generally building a quicker more efficient brain:
Limitless: Upgrade Your Brain, Learn Anything Faster, and Unlock Your Exceptional Life
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What’s So Special About Alpha-Lipoic Acid?
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The Access-All-Areas Antioxidant
Alpha-Lipoic Acid (ALA) is one of the most bioavailable antioxidants in existence. A bold claim, but most antioxidants are only water-soluble or fat-soluble, whereas ALA is both. This has far-reaching implications—and we mean that literally, because its “go everywhere” status means that it can access (and operate in) all living cells of the human body.
We make it inside our body, and we can also get it in our diet, or take it as a supplement.
What foods contain it?
The richest food sources are:
- For the meat-eaters: organ meats
- For everyone: broccoli, tomatoes, & spinach
However, supplements are more efficient at delivering it, by several orders of magnitude:
Read more: Lipoic acid – biological activity and therapeutic potential
What are its benefits?
Most of its benefits are the usual benefits you would expect from any antioxidant, just, more of it. In particular, reduced inflammation and slowed skin aging are common reasons that people take ALA as a supplement.
Does it really reduce inflammation?
Yes, it does. This one’s not at all controversial, as this systematic review of studies shows:
(C-reactive protein is a marker of inflammation)
Does it really reduce skin aging?
Again yes—which again is not surprising for such a potent antioxidant; remember that oxidative stress is one of the main agonists of cellular aging:
As a special feature, ALA shows particular strength against sun-related skin aging, because of how it protects against UV radiation and increases levels of gluthianone, which also helps:
- Photochemical stability of lipoic acid and its impact on skin ageing
- Modern approach to topical treatment of aging skin
Where can I get some?
We don’t sell it, but here for your convenience is an example product on Amazon
Enjoy!
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Eat Dirt – by Dr. Josh Axe
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Dr. Axe describes leaky gut as “a serious disease with a silly name”, and hopes for people to take increased intestinal permeability (as it is otherwise known) seriously, because it can be found at the root of very many diseases, especially inflammatory / autoimmune diseases, which obviously also has significant implications for dementia (of which neuroinflammation is a fair part of the pathogenesis) and cancer (which has been described as largely a matter of immune dysfunction).
He starts strong, albeit anecdotally, with the story of his own mother’s battle with cancer and other diseases, and how her health did a U-turn (for the better) upon taking care of her gut as per the methods described in this book. Dr. Axe doesn’t go so far as to claim the gut-healthy protocol cured her cancer, but makes the (very reasonable) argument that it was a major contributory factor, especially as it was the main input variable that changed.
The book describes the various things that can go wrong with our gut and why, and for each of them presents a solution.
Some of it is as you might guess from the title—live a little dirtier, because the ubiquity of antimicrobials is leaving our immune system slack and maladjusted, causing it to varyingly a) turn on us b) not rise to the occasion when an actual pathogen arrives c) often both. Other matters of consideration include normal gut health nutrition (prebiotics and probiotics, skipping inflammatory foods), matters of medication (especially those that harm the gut), nutraceuticals such as Boswellia serrata, and even stress management.
He provides a program so that the reader can follow along step-by-step, and even a chapter of recipes, but the greatest value in the book is the explanation of gut pathology—because understanding that is foundational to recognizing a lot of things (and he does provide diagnostic questionnaires also, which are helpful).
Bottom line: if you’d like to improve almost any aspect of your health, then your gut is almost always an excellent place to start, and this book will set you on the right path.
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