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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Why Going Gluten-Free Could Be A Bad Idea
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Is A Gluten-Free Diet Right For You?
This is Rachel Begun, MS, RD. She’s a nutritionist who, since her own diagnosis with Celiac disease, has shifted her career into a position of educating the public (and correcting misconceptions) about gluten sensitivity, wheat allergy, and Celiac disease. In short, the whole “gluten-free” field.
First, a quick recap
We’ve written on this topic ourselves before; here’s what we had to say:
On “Everyone should go gluten-free”
Some people who have gone gluten-free are very evangelical about the lifestyle change, and will advise everyone that it will make them lose weight, have clearer skin, more energy, and sing well, too. Ok, maybe not the last one, but you get the idea—a dietary change gets seen as a cure-all.
And for some people, it can indeed make a huge difference!
Begun urges us to have a dose of level-headedness in our approach, though.
Specifically, she advises:
- Don’t ignore symptoms, and/but…
- Don’t self-diagnose
- Don’t just quit gluten
One problem with self-diagnosis is that we can easily be wrong:
But why is that a problem? Surely there’s not a health risk in skipping the gluten just to be on the safe side? As it turns out, there actually is:
If we self-diagnose incorrectly, Begun points out, we can miss the actual cause of the symptoms, and by cheerfully proclaiming “I’m allergic to gluten” or such, a case of endometriosis, or Hashimoto’s, or something else entirely, might go undiagnosed and thus untreated.
“Oh, I feel terrible today, there must have been some cross-contamination in my food” when in fact, it’s an undiagnosed lupus flare-up, that kind of thing.
Similarly, just quitting gluten “to be on the safe side” can mask a different problem, if wheat consumption (for example) contributed to, but did not cause, some ailment.
In other words: it could reduce your undesired symptoms, but in so doing, leave a more serious problem unknown.
Instead…
If you suspect you might have a gluten sensitivity, a wheat allergy, or even Celiac disease, get yourself tested, and take professional advice on proceeding from there.
How? Your physician should be able to order the tests for you.
You can also check out resources available here:
Celiac Disease Foundation | How do I get tested?
Or for at-home gluten intolerance tests, here are some options weighed against each other:
MNT | 5 gluten intolerance tests and considerations
Want to learn more?
Begun has a blog:
Rachel Begun | More than just recipes
(it is, in fact, just recipes—but they are very simple ones!)
You also might enjoy this interview, in which she talks about gluten sensitivity, celiac disease, and bio-individuality:
Want to watch it, but not right now? Bookmark it for later
Take care!
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Ice Baths: To Dip Or Not To Dip?
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Many Are Cold, But Few Are Frozen
We asked you for your (health-related) view of ice baths, and got the above-depicted, below-described, set of responses:
- About 31% said “ice baths are great for the health; we should take them”
- About 29% said “ice baths’ risks outweigh their few benefits”
- About 26% said “ice baths’ benefits outweigh their few risks”
- About 14% said “ice baths are dangerous and can kill you; best avoided”
So what does the science say?
Freezing water is very dangerous: True or False?
True! Water close to freezing point is indeed very dangerous, and can most certainly kill you.
Fun fact, though: many such people are still saveable with timely medical intervention, in part because the same hypothermia that is killing them also slows down the process* of death
Source (and science) for both parts of that:
Cold water immersion: sudden death and prolonged survival
*and biologically speaking, death is a process, not an event, by the way. But we don’t have room for that today!
(unless you die in some sudden violent way, such as a powerful explosion that destroys your brain instantly; then it’s an event)
Ice baths are thus also very dangerous: True or False?
False! Assuming that they are undertaken responsibly and you have no chronic diseases that make it more dangerous for you.
What does “undertaken responsibly” mean?
Firstly, the temperature should not be near freezing. It should be 10–15℃, which for Americans is 50–59℉.
You can get a bath thermometer to check this, by the way. Here’s an example product on Amazon.
Secondly, your ice bath should last no more than 10–15 minutes. This is not a place to go to sleep.
What chronic diseases would make it dangerous?
Do check with your doctor if you have any doubts, as no list we make can be exhaustive and we don’t know your personal medical history, but the main culprits are:
- Cardiovascular disease
- Hypertension
- Diabetes (any type)
The first two are for heart attack risk; the latter is because diabetes can affect core temperature regulation.
Ice baths are good for the heart: True or False?
True or False depending on how they’re done, and your health before starting.
For most people, undertaking ice baths responsibly, repeated ice bath use causes the cardiovascular system to adapt to better maintain homeostasis when subjected to thermal shock (i.e. sudden rapid changes in temperature).
For example: Respiratory and cardiovascular responses to cold stress following repeated cold water immersion
And because that was a small study, here’s a big research review with a lot of data; just scroll to where it has the heading“Specific thermoregulative adaptations to regular exposure to cold air and/or cold water exposure“ for many examples and much discussion:
Health effects of voluntary exposure to cold water: a continuing subject of debate
Ice baths are good against inflammation: True or False?
True! Here’s one example:
Uric acid and glutathione levels (important markers of chronic inflammation) are also significantly affected:
Uric acid and glutathione levels during short-term whole body cold exposure
Want to know more?
That’s all we have room for today, but check out our previous “Expert Insights” main feature looking at Wim Hof’s work in cryotherapy:
A Cold Shower A Day Keeps The Doctor Away?
Enjoy!
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Tiramisu Crunch Bites
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It’s coffee, it’s creamy, it’s nutty, it’s chocolatey, what’s not to love? It has all the well-loved flavors of tiramisu, but this recipe is a simple one, and it’s essentially stuffed dates in a way you’ve never had them before. They’re delectable, decadent, and decidedly good for your health. These things are little nutrient-bombs that’ll keep you reaching for more.
You will need
- Coffee (we will discuss this)
- 150g (5.5oz) mascarpone (if vegan or lactose-intolerant, can be substituted with vegan varieties, or at a pinch, pressed silken tofu)
- 500g (1lb) dates (Medjool are ideal)
- Twice as many almonds as you have dates
- 50g (2oz) dark chocolate (the darkest, bitterest, you can find)
- Edible flower petals if you can source them (some shops sell dried rose petals for this purpose)
Method
(we suggest you read everything at least once before doing anything)
1) Take the mascarpone and whisk (or blend) it with the coffee. What kind of coffee, you ask? Many will use instant coffee (1tbsp granules mixed with enough boiling water to dissolve it), and that is actually healthiest (counterintuitive but true) but if you care for flavor over health, and have the means to make espresso, make it ristretto (so, stop it halfway through filling up an espresso cup), let it cool, and use that. Absolute bonus for flavor (not for health): if you have the means to make Turkish coffee, use an equivalent amount of that (again, cooled).
You will now have coffee-flavoured mascarpone. It’s great for your gut and full of antioxidant polyphenols. Set it aside for the moment.
2) Take the dark chocolate and melt it. Please don’t microwave it or try to do it in a pan directly over the hob; instead, you will need to use a Bain-Marie. If you don’t have one made-for-purpose, you can place a metal or heatproof glass bowl in a saucepan, with something to stop it from touching the floor of the pan. Then boil water in the pan (without letting the water get into the bowl), and melt the chocolate in the bowl—this will allow you to melt it evenly without burning the chocolate.
You will now have melted dark chocolate. It has its own set of polyphenols, and is great for everything from the brain to the gut microbiome.
3) Cut the dates lengthways on one side and remove the stone. Stuff them carefully with the coffee-flavored mascarpone (you can use a teaspoon, or use a piping kit if you have one). Add a couple of almonds to each one. Place them all on a big plate, and drizzle the melted chocolate over them. Add the petals if you have them.
The dates and almonds deliver extra vitamins and minerals in abundance (not to mention, lots of fiber), and also are an amazing combination even just by themselves. With the mascarpone and chocolate added, this winning on new levels. We’re not done yet, though…
4) Chill them in the fridge for about 30 minutes.
Serve!
Learn more
For those interested in some of the science of what we have going on today:
- Make The Heart-Healthiest Coffee ← this is about cafestol content and why instant is heart-healthiest (alas)
- The Bitter Truth About Coffee (Or Is It) ← this is about the health benefits (and some risks, but mostly benefits) of coffee
- Why You Should Diversify Your Nuts ← almonds are a top-tier choice, but other nuts are good too! This recipe could work well with hazelnuts, for example (we wouldn’t call it “tiramisu crunch bites” in that case, though, since the flavor profile would change)
- Which Sugars Are Healthier, And Which Are Just The Same? ← for any worrying “aren’t dates sugary, though?”
Enjoy!
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Kiwi vs Lemon – Which is Healthier?
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Our Verdict
When comparing kiwi to lemon, we picked the kiwi.
Why?
A fairly straightforward one today!
In terms of macros, kiwi has more protein, carbs, and fiber, the ratio of the latter two also giving it the lower glycemic index. An easy win for kiwi here.
In the category of vitamins, kiwi has more of vitamins A, B2, B3, B9, C, E, K, and choline, while lemon has more of vitamins B1 and B6. Yes, that’s right, lemon didn’t even win on the vitamin C that it’s famous for. In any case, a clear 8:2 win for kiwi.
Looking at minerals, kiwi has more calcium, copper, magnesium, manganese, phosphorus, potassium, and zinc, while lemon has more iron and selenium. So, looking at this 7:2 win for kiwi, you might want to reconsider that “glass of lemon water to replenish minerals” trend!
None of this is to knock lemons, by the way; lemons are still a very respectable fruit, nutritionally. Probably very few people are out there eating lemons the way one might eat kiwi…
(writer’s note: I say “very few”, as once upon a time when my son was small, I remember coming into the kitchen to find he had helped himself to lemon wedges and was just eating them, so it can happen. But I also one time when he was just as small, found him drinking hot sauce directly from the bottle, so hey, he clearly already enjoyed strong flavors. Lest I seem a very inattentive mother, I’ll say in my defense that our kitchen has no real toddler-height hazards when the oven is cold, and those items were from the bottom of the fridge, so easy to access if I leave the room for a moment to grab something)
…but what we do want to say here is: if you don’t care for lemons so much, you’re not missing out. If the lemon water isn’t calling to you, you can skip it guilt-free.
In any case, do enjoy either or both, but kiwi’s the clear winner here!
Want to learn more?
You might like to read:
Top 8 Fruits That Prevent & Kill Cancer ← kiwi is top of the list! It has some cool properties, as you’ll see, killing cancer cells while sparing healthy ones.
Take care!
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Pinch of Nom – by Kate Allinson & Kay Allinson
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“Home-style recipes”, because guess where most readers live!
And: slimming, because trimming the waistline a little is a goal for many after holiday indulgences.
The key idea here is healthy recipes that “don’t taste like diet food”—often by just switching out a couple of key ingredients, to give a significantly improved nutritional profile while remaining just as tasty, especially when flavors are enhanced with clever spicing and seasoning.
The food is simple to prepare, while being “special” enough that it could be used very credibly for entertaining too. For that matter, a strength of the book is its potential for use as a creative springboard, if you’re so inclined—there are lots of good ideas in here.
The recipes themselves are all you’d expect them to be, and presented clearly in an easy-to-follow manner.
Bottom line: if you’ve ever wanted to cook healthily but you need dinner on the table in the very near future and are stuck for ideas, this book is exactly what you need.
Click here to check out Pinch of Nom, and liven up your healthy cooking!
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How to be kind to yourself (without going to a day spa)
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“I have to be hard on myself,” Sarah told me in a recent telehealth psychology session. “I would never reach my potential if I was kind and let myself off the hook.”
I could empathise with this fear of self-compassion from clients such as Sarah (not her real name). From a young age, we are taught to be kind to others, but self-kindness is never mentioned.
Instead, we are taught success hinges on self-sacrifice. And we need a healthy inner critic to bully us forward into becoming increasingly better versions of ourselves.
But research shows there doesn’t have to be a trade-off between self-compassion and success.
Self-compassion can help you reach your potential, while supporting you to face the inevitable stumbles and setbacks along the way.
What is self-compassion?
Self-compassion has three key ingredients.
1. Self-kindness
This involves treating yourself with the same kindness you would extend towards a good friend – via your thoughts, feelings and actions – especially during life’s difficult moments.
For instance, if you find yourself fixating on a minor mistake you made at work, self-kindness might involve taking a ten-minute walk to shift focus, and reminding yourself it is OK to make mistakes sometimes, before moving on with your day.
2. Mindfulness
In this context, mindfulness involves being aware of your own experience of stress or suffering, rather than repressing or avoiding your feelings, or over-identifying with them.
Basically, you must see your stress with a clear (mindful) perspective before you can respond with kindness. If we avoid or are consumed by our suffering, we lose perspective.
3. Common humanity
Common humanity involves recognising our own experience of suffering as something that unites us as being human.
For instance, a sleep-deprived parent waking up (for the fourth time) to feed their newborn might choose to think about all the other parents around the world doing exactly the same thing – as opposed to feeling isolated and alone.
It’s not about day spas, or booking a manicure
When Sarah voiced her fear that self-compassion would prevent her success, I explained self-compassion is distinct from self-indulgence.
“So is self-compassion just about booking in more mani/pedis?” Sarah asked.
Not really, I explained. A one-off trip to a day spa is unlikely to transform your mental health.
Instead, self-compassion is a flexible psychological resilience factor that shapes our thoughts, feelings and actions.
It’s associated with a suite of benefits to our wellbeing, relationships and health.
A one-off trip to a day spa is unlikely to transform your mental health.
baranq/ShutterstockWhat does the science say?
Over the past 20 years, we’ve learned self-compassionate people enjoy a wide range of benefits. They tend to be happier and have fewer psychological symptoms of distress.
Those high on self-compassion persevere following a failure. They say they are more motivated to overcome a personal weakness than those low on self-compassion, who are more likely to give up.
So rather than feeling trapped by your inadequacies, self-compassion encourages a growth mindset, helping you reach your potential.
However, self-compassion is not a panacea. It will not change your life circumstances or somehow make life “easy”. It is based on the premise that life is hard, and provides practical tools to cope.
It’s a factor in healthy ageing
I research menopause and healthy ageing and am especially interested in the value of self-compassion through menopause and in the second half of life.
Because self-compassion becomes important during life’s challenges, it can help people navigate physical symptoms (for instance, menopausal hot flushes), life transitions such as divorce, and promote healthy ageing.
I’ve also teamed up with researchers at Autism Spectrum Australia to explore self-compassion in autistic adults.
We found autistic adults report significantly lower levels of self-compassion than neurotypical adults. So we developed an online self-compassion training program for this at-risk population.
Three tips for self-compassion
You can learn self-compassion with these three exercises.
1. What would you say to a friend?
Think back to the last time you made a mistake. What did you say to yourself?
If you notice you’re treating yourself more like an enemy than a friend, don’t beat yourself up about it. Instead, try to think about what you might tell a friend, and direct that same friendly language towards yourself.
2. Harness the power of touch
Soothing human touch activates the parasympathetic “relaxation” branch of our nervous system and counteracts the fight or flight response.
Specifically, self-soothing touch (for instance, by placing both hands on your heart, stroking your forearm or giving yourself a hug) reduces cortisol responses to psychosocial stress.
Yes, hugging yourself can help.
http://krakenimages.com/Shutterstock3. What do I need right now?
Sometimes, it can be hard to figure out exactly what self-compassion looks like in a given moment. The question “what do I need right now” helps clarify your true needs.
For example, when I was 37 weeks pregnant, I woke up bolt awake one morning at 3am.
Rather than beating myself up about it, or fretting about not getting enough sleep, I gently placed my hands on my heart and took a few deep breaths. By asking myself “what do I need right now?” it became clear that listening to a gentle podcast/meditation fitted the bill (even though I wanted to addictively scroll my phone).
Lydia Brown, Senior Lecturer in Psychology, The University of Melbourne
This article is republished from The Conversation under a Creative Commons license. Read the original article.
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