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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Broccoli vs Asparagus – Which is Healthier?
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Our Verdict
When comparing broccoli to asparagus, we picked the broccoli.
Why?
Both are great! But broccoli does distinguish itself:
In terms of macros, broccoli has slightly more protein, carbs, and fiber. The two vegetables have the same glycemic index. We’ll call this a slight win for broccoli based mainly on the higher fiber, but it’s not by a huge amount.
When it comes to vitamins, broccoli has more of vitamins B5, B6, B9, C, K, and choline, whereas asparagus has more of vitamins A, B1, B2, B3, and E. This would already be a 6:5 marginal win for broccoli, but it’s worth bearing in mind that broccoli’s margins are greater, especially with broccoli having around 15x the amount of vitamin C. So, a clear win for broccoli, respectable as asparagus may be.
In the category of minerals, broccoli has more calcium, magnesium, manganese, phosphorus, potassium, and selenium, while asparagus boasts more copper, iron, and zinc. A 6:3 win for broccoli here.
Both vegetables also contain generous amounts of antioxidant polyphenols and other beneficial phytochemicals, often a little different from each other, so that’s a case for enjoying both.
Still, if you’re going to pick just one, we recommend the broccoli!
Want to learn more?
You might like to read:
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You’re Not Forgetful: How To Remember Everything
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Elizabeth Filips, medical student busy learning a lot of information, explains how in today’s video:
Active processing
An important thing to keep in mind is that forgetting is an active process, not passive as once believed. It has its own neurotransmitters and pathways, and as such, to improve memory, it’s essential to understand and manage forgetting.
So, how does forgetting occur? Memories are stored with cues or tags, which help retrieve information. However, overloading cues with too much information can cause “transient forgetting”—that is to say, the information is still in there somewhere; you just don’t have the filing system required to retrieve the data. This is the kind of thing that you will try hard to remember at some point in the day when you need it, fail, and then wake up at 3am with an “Aha!” because your brain finally found what you were looking for. So, to avoid that, use unique and strong cues to help improve recall (mnemonics are good for this, as are conceptual anchors).
While memory does not appear to actually be finite, there is some practical truth in the “finite storage” model insofar as learning new information can overwrite previous knowledge, iff your brain mistakes it for an update rather than addition. So for that reason, it’s good to periodically go over old information—in psychology this is called rehearsal, which may conjure theatrical images, but it can be as simple as mentally repeating a phone number, a mnemonic, or visually remembering a route one used to take to go somewhere.
Self-perception affects memory performance. Negative beliefs about one’s memory can worsen performance (so don’t say “I have a bad memory”, even to yourself, and in contrast, find more positive affirmations to make about your memory), and mental health in general plays a significant role in memory. For example, if you have ever had an extended period of depression, then chances are good you have some huge gaps in your memory for that time in your life.
A lot of what we learned in school was wrong—especially what we learned about learning. Traditional (vertical) learning is harder to retain, whereas horizontal learning (connecting topics through shared characteristics) creates stronger, interconnected memories. In short, your memories should tell contextual stories, not be isolated points of data.
Embarking on a new course of study? Yes? (If not, then why not? Pick something!)
It may be difficult at first, but experts memorize things more quickly due to built-up intuition in their field. For example a chess master can glance at a chess board for about 5 seconds and memorize the position—but only if the position is one that could reasonably arise in a game; if the pieces are just placed at random, then their memorization ability plummets to that of the average person, because their expertise has been nullified.
What this means in practical terms: building a “skeleton” framework before learning can enhance memorization through logical connections. For this reason, if embarking on a serious course of study, getting a good initial overview when you start is critical, so that you have a context for the rest of what you learn to go into. For example, let’s say you want to learn a language; if you first quickly do a very basic bare-bones course, such as from Duolingo or similar, then even though you’ll have a very small vocabulary and a modest grasp of grammar and make many mistakes and have a lot of holes in your knowledge, you now have somewhere to “fit” every new word or idea you learn. Same goes for other fields of study; for example, a doctor can be told about a new drug and remember everything about it immediately, because they understand the systems it interacts with, understand how it does what it does, and can compare it mentally to similar drugs, and they thus have a “place” in that overall system for the drug information to reside. But for someone who knows nothing about medicine, it’s just a lot of big words with no meaning. So: framework first, details later.
For more on all this, enjoy:
Click Here If The Embedded Video Doesn’t Load Automatically!
Want to learn more?
You might also like to read:
How To Boost Your Memory Immediately (Without Supplements)
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Gut Feelings – by Dr Will Cole
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More and more, science is uncovering links between our gut health and the rest of our health—including our mental health! We all know “get some fiber and consider probiotics”, but what else is there that we can do?
Quite a lot, actually. And part of it, which Dr. Cole also explores, is the fact that the gut-brain highway is a two-way street!
The book looks a lot especially at the particular relationship between shame and eating. The shame need not initially be about eating, though it can certainly end up that way too. But any kind of shame—be it relating to one’s body, work, relationship, or anything else, can not only have a direct effect on the gut, but indirect too:
Once our “eating our feelings” instinct kicks in, things can spiral from there, after all.
So, Dr. Cole walks us through tackling this from both sides—nutrition and psychology. With chapters full of tips and tricks, plus a 21-day plan (not a diet plan, a habit integration plan), this book hits shame (and inflammation, incidentally) hard and leads us into much healthier habits and cycles.
In short: if you’d like to have a better relationship with your food, improve your gut health, and/or reduce inflammation, this is definitely a book for you!
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The Truth About Handwashing
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Washing Our Hands Of It
In Tuesdays’s newsletter, we asked you how often you wash your hands, and got the above-depicted, below-described, set of self-reported answers:
- About 54% said “More times per day than [the other options]”
- About 38% said “Whenever using the bathroom or kitchen
- About 5% said “Once or twice per day”
- Two (2) said “Only when visibly dirty”
- Two (2) said “I prefer to just use sanitizer gel”
What does the science have to say about this?
People lie about their handwashing habits: True or False?
True and False (since some people lie and some don’t), but there’s science to this too. Here’s a great study from 2021 that used various levels of confidentiality in questioning (i.e., there were ways of asking that made it either obvious or impossible to know who answered how), and found…
❝We analysed data of 1434 participants. In the direct questioning group 94.5% of the participants claimed to practice proper hand hygiene; in the indirect questioning group a significantly lower estimate of only 78.1% was observed.❞
Note: the abstract alone doesn’t make it clear how the anonymization worked (it is explained later in the paper), and it was noted as a limitation of the study that the participants may not have understood how it works well enough to have confidence in it, meaning that the 78.1% is probably also inflated, just not as much as the 94.5% in the direct questioning group.
Here’s a pop-science article that cites a collection of studies, finding such things as for example…
❝With the use of wireless devices to record how many people entered the restroom and used the pumps of the soap dispensers, researchers were able to collect data on almost 200,000 restroom trips over a three-month period.
The found that only 31% of men and 65% of women washed their hands with soap.❞
Source: Study: Men Wash Their Hands Much Less Often Than Women (And People Lie About Washing Their Hands)
Sanitizer gel does the job of washing one’s hands with soap: True or False?
False, though it’s still not a bad option for when soap and water aren’t available or practical. Here’s an educational article about the science of why this is so:
UCI Health | Soap vs. Hand Sanitizer
There’s also some consideration of lab results vs real-world results, because while in principle the alcohol gel is very good at killing most bacteria / inactivating most viruses, it can take up to 4 minutes of alcohol gel contact to do so, as in this study with flu viruses:
In contrast, 20 seconds of handwashing with soap will generally do the job.
Antibacterial soap is better than other soap: True or False?
False, because the main way that soap protects us is not in its antibacterial properties (although it does also destroy the surface membrane of many bacteria and for that matter viruses too, killing/inactivating them, respectively), but rather in how it causes pathogens to simply slide off during washing.
Here’s a study that found that handwashing with soap reduced disease incidence by 50–53%, and…
❝Incidence of disease did not differ significantly between households given plain soap compared with those given antibacterial soap.❞
Read more: Effect of handwashing on child health: a randomised controlled trial
Want to wash your hands more than you do?
There have been many studies into motivating people to wash their hands more (often with education and/or disgust-based shaming), but an effective method you can use for yourself at home is to simply buy more luxurious hand soap, and generally do what you can to make handwashing a more pleasant experience (taking a moment to let the water run warm is another good thing to do if that’s more comfortable for you).
Take care!
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The Mental Health Dangers Of Oversharing
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Oversharers can be fun and amiable; the life of the party. In and of itself, this something that can be considered “pro-social” and thus healthy.
But the problem for one’s mental health in the long-run lies in the “over” part of oversharing. Sometimes, if not checking in with the other person’s comfort, oversharing can be “trauma-dumping”, and push people away. Alternatively, if the oversharing exposes an unmet need, it can make the other person feel obliged to try to help in some fashion, which in the long run may also cause awkwardness and withdrawal.
Some potential problems are purely internal, such the feelings of shame or anxiety that can come afterwards; “I should not have been so vulnerable”, “What if my friends think badly of me now?”, etc.
And of course, sometimes those fears are then validated by reality, if “friends” indeed take advantage of that, or withdraw their friendship. That’s a minority occurrence, but it doesn’t make it any less of a crushing thing if it happens.
Sometimes people overshare because of being a bad judge of what’s a socially-approved appropriate amount of sharing; sometimes people overshare out of a need for closeness, and perhaps the hope of hearing what one needed to hear previously.
The dangers of oversharing don’t mean that we should never speak about our experiences and feelings; in fact sometimes, it is the most healthy thing to do—be it because it’s something that needs communicating to a specific person, or because it’s something we just need to “get off our chest”.
In short, it can be good to share! It can also be good to do so judiciously, by conscious decision and not in response to a spur-of-the-moment impulse, and remember to prioritize our own safety.
Below, Alain de Botton explains more of the psychodynamics of this:
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10almonds tip, not included in the video: unsure whether your urge to share is too impulsive or not? Write a letter/email, and wait until the next day to decide whether or not to send it.
Want to read more?
Check out:
Breathe; Don’t Vent (At Least In The Moment)
Take care!
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Honeydew vs Cantaloupe – Which is Healthier?
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Our Verdict
When comparing honeydew to cantaloupe, we picked the cantaloupe.
Why?
In terms of macros, there’s not a lot between them—they’re both mostly water. Nominally, honeydew has more carbs while cantaloupe has more fiber and protein, but the differences are very small. So, a very slight win for cantaloupe.
Looking at vitamins: honeydew has slightly more of vitamins B5 and B6 (so, the vitamins that are in pretty much everything), while cantaloupe has a more of vitamins A, B1, B2, B3, C, and E (especially notably 67x more vitamin A, whence its color). A more convincing win for cantaloupe.
The minerals category is even more polarized: honeydew has more selenium (and for what it’s worth, more sodium too, though that’s not usually a plus for most of us in the industrialized world), while cantaloupe has more calcium, copper, iron, magnesium, manganese, phosphorus, potassium, and zinc. An overwhelming win for cantaloupe.
No surprises: adding up the slight win for cantaloupe, the convincing win for cantaloupe, and the overwhelming win for cantaloupe, makes cantaloupe the overall best pick here.
Enjoy!
Want to learn more?
You might like to read:
From Apples to Bees, and High-Fructose Cs: Which Sugars Are Healthier, And Which Are Just The Same?
Take care!
Don’t Forget…
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