The 7 Approaches To Pain Management
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More Than One Way To Kill Pain
This is Dr. Deepak Ravindran (MD, FRCA. FFPMRCA, EDRA. FIPP, DMSMed). He has decades of experience and is a specialist in acute and chronic pain management, anesthesia, musculoskeletal medicine, and lifestyle medicine.
A quick catch-up, first:
We’ve written about chronic pain management before:
Managing Chronic Pain (Realistically!)
As well as:
Science-Based Alternative Pain Relief
Dr. Ravindran’s approach
Dr. Ravindran takes a “trauma-informed care” approach to his professional practice, and recommends the same for others.
In a nutshell, this means starting from a position of not “what’s wrong with you?”, but rather “what happened to you?”.
This seemingly subtle shift is important, because it means actually dealing with a person’s issues, instead of “take one of these and call my secretary next month”. Read more:
Pain itself can be something of a many-headed hydra. Dr. Ravindran’s approach is equally many-headed; specifically, he has a 7-point plan:
Medications
Dr. Ravindran sees painkillers (and a collection of other drugs, like antidepressants and muscle relaxants) as a potential means to an end worth exploring, but he doesn’t expect them to be the best choice for everyone, and nor does he expect them to be a cure-all. Neither should we. He also advises being mindful of the drawbacks and potential complications of these drugs, too.
Interventions
Sometimes, surgery is the right choice. Sometimes it isn’t. Often, it will change a life—one way or the other. Similar to with medications, Dr. Ravindran is very averse to a “one size fits all” approach here. See also:
The Insider’s Guide To Making Hospital As Comfortable As Possible
Neuroscience and stress management
Often a lot of the distress of pain is not just the pain itself, but the fear associated with it. Will it get worse if I move wrong or eat the wrong thing? How long will it last? Will it ever get better? Will it get worse if I do nothing?. Dr. Ravindran advises tackling this, with the same level of importance as the pain itself. Here’s a good start:
Stress, And Building Psychological Resilience
Diet and the microbiome
Many chronic illnesses are heavily influenced by this, and Dr. Ravindran’s respect for lifestyle medicine comes into play here. While diet might not fix all our ills, it certainly can stop things from being a lot worse. Beyond the obvious “eat healthily” (Mediterranean diet being a good starting point for most people), he also advises doing elimination tests where appropriate, to screen out potential flare-up triggers. You also might consider:
Four Ways To Upgrade The Mediterranean Diet
Sleep
“Get good sleep” is easy advice for those who are not in agonizing pain that sometimes gets worse from staying in the same position for too long. Nevertheless, it is important, and foundational to good health. So it’s important to explore—whatever limitations one might realistically have—what can be done to improve it.
If you can only sleep for a short while at a time, you may get benefit from this previous main feature of ours:
How To Nap Like A Pro (No More “Sleep Hangovers”!)
Exercise and movement
The trick here is to move little and often; without overdoing it, but without permitting loss of mobility either. See also:
The Doctor Who Wants Us To Exercise Less, And Move More
Therapies of the mind and body
This is about taking a holistic approach to one’s wellness. In Dr. Ravindran’s words:
❝Mind-body therapies are often an extremely sensitive topic about which people hold very strong opinions and sometimes irrational beliefs.
Some, like reiki and spiritual therapy and homeopathy, have hardly any scientific evidence to back them up, while others like yoga, hypnosis, and meditation/mindfulness are mainstream techniques with many studies showing the benefits, but they all work for certain patients.❞
In other words: evidence-based is surely the best starting point, but if you feel inclined to try something else and it works for you, then it works for you. And that’s a win.
Want to know more?
You might like his book…
The Pain-Free Mindset: 7 Steps to Taking Control and Overcoming Chronic Pain
He also has a blog and a podcast.
Take care!
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Margarine vs Butter – Which is Healthier
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Our Verdict
When comparing margarine to butter, we picked the butter.
Why?
Once upon a time, when margarines were filled with now-banned trans fats, this would have been an easy win for butter.
Nowadays, the macronutrient/lipid profiles are generally more similar (although margarine often has a little less saturated fat), except one thing that butter has in its favor:
More micronutrients. What exactly they are (and how much) depends on the diet and general health of the cows from whom the milk to make the butter came, but they’re not something found in plant-based butter alternatives at this time.
Nevertheless, because of the saturated fat content, it’s not advisable to use more than a very small amount of either (two tablespoons of butter would put one at the daily limit already, without eating any other saturated fat that day).
Read more: Butter vs Margarine
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How To Build a Body That Lasts – by Adam Richardson
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This book is written on a premise, and that premise is: “your age doesn’t define your mobility; your mobility defines your age”.
To this end, we are treated to 328 pages of why and how to improve our mobility (mostly how; just enough on the “why” to keep the motivation flowing).
Importantly, Richardson doesn’t expect that every reader is a regular gym-bunny or about to become one, doesn’t expect you to have several times your bodyweight in iron to life at home, and doesn’t expect that you’ll be doing the vertical splits against a wall any time soon.
Rather, he expects that we’d like to not dislocate a shoulder while putting the groceries away, would like to not slip a disk while being greeted by the neighbor’s dog, and would like to not need a 7-step plan for putting our socks on.
What follows is a guide to “on the good end of normal” mobility that is sustainable for life. The idea is that you might not be winning Olympic gymnastics gold medals in your 90s, but you will be able to get in and out of a car door as comfortably as you did when you were 20, for example.
Bottom line: if you want to be a superathlete, then you might need something more than this book; if you want to be on the healthy end of average when it comes to mobility, and maintain that for the rest of your life, then this is the book for you.
Click here to check out How To Build A Body That Lasts, and build a body that lasts!
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Kimchi Fried Rice
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Fried rice is not something that leaps to many people’s minds when one says “health food”. But it can be! Today’s recipe is great for many aspects of health, but especially the gut, because of its star ingredient, the kimchi—as well as the fiber in the rest of the dish, which is mostly a variety of vegetables, as well as the rice, which we are assuming you got wholegrain. An optional egg per person adds more healthy fats too!
You will need
- Avocado oil, for frying. We picked avocado oil for its healthy fats profile, neutral taste, and high smoke point (we’ll be working at very high temperatures today that might make olive oil or coconut oil smoke). We also recommend against seed oils (e.g. sunflower or canola) for health reasons.
- 1lb cooked and cooled rice—here’s our recipe for Tasty Versatile Rice if you don’t have leftovers you want to use
- 7oz kimchi, roughly chopped
- 4 spring onions, finely chopped
- 4oz white cabbage, finely shredded
- 3oz frozen peas, defrosted
- 1 bulb garlic, thinly sliced
- 1 carrot, grated
- ½ red pepper, finely diced
- 2 tbsp chili oil (or 2 tbsp extra virgin olive oil and 1 red chili, very finely chopped) ← don’t worry about the smoke point of this; it’s going to be for drizzling
- 1 tbsp dark soy sauce
- 2 tsp black pepper, coarse ground
- Optional: 1 egg per person
- Note: we didn’t forget to include salt; there’s simply enough already in the dish because of the kimchi and soy sauce.
Method
(we suggest you read everything at least once before doing anything)
1) Lightly oil a wok (or similar) and crank up the heat as high as your stove can muster. Add the garlic and spring onions; keep them moving. When they’re turning golden, add the cabbage, carrot, and red pepper. Add them one by one, giving the wok a chance to get back to temperature each time before adding the next ingredient.
2) When the vegetables are beginning to caramelize (if the temperature is good, this should only be a couple of minutes at most), add the rice, as well as the kimchi, peas, soy sauce, and black pepper. Toss everything ensure it’s all well-combined and evenly cooked. When it’s done (probably only another minute or two), take it off the heat.
3) Optional: if you’re adding eggs, fry them now. Serve a bowl of kimchi-fried rice per person, adding 1 fried egg on top of each.
4) Drizzle the chili oil as a colorful, tasty garnish that’s full of healthful polyphenols too.
Enjoy!
Want to learn more?
For those interested in some of the science of what we have going on today:
- Making Friends With Your Gut (You Can Thank Us Later)
- The Many Health Benefits Of Garlic
- Black Pepper’s Impressive Anti-Cancer Arsenal (And More)
- Tasty Polyphenols ← this is about how foods that are pungent, bitter, spicy, etc tend to have the highest polyphenol contents
- Eggs: All Things In Moderation?
Take care!
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Thinking of trying a new diet? 4 questions to ask yourself before you do
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We live in a society that glorifies dieting, with around 42% of adults globally having tried to lose weight. Messages about dieting and weight loss are amplified on social media, with a never-ending cycle of weight loss fads and diet trends.
Amid often conflicting messages and misinformation, if you’re looking for diet advice online, it’s easy to become confused and overwhelmed.
So before diving into the latest weight loss trend or extreme diet, consider these four questions to help you make a more informed decision.
PeopleImages.com – Yuri A/Shutterstock 1. Is the diet realistic?
Have you considered the financial cost of maintaining the diet or lifestyle, and the time and resources that would be required? For example, do you need to purchase specific products, supplements, or follow a rigid meal plan?
If the diet is coming from someone who is trying to sell you something – such as a particular weight-loss product you need in order to follow the diet – this could be a particular red flag.
Many extreme diet recommendations come from a place of privilege and overlook food access, affordability, cooking skills, where you live, or even your culture and ethics.
If the diet has these sorts of issues it can lead to frustration, stress, stigmatisation and feelings of failure for the person trying to adhere to the diet. But the problem may be with the diet itself – not with you.
Many diets promoted online will be expensive, or require a lot of time and resources. artem evdokimov/Shutterstock 2. Is there evidence to support this diet?
Self-proclaimed “experts” online will often make claims focused on specific groups, known as target populations. This might be 30- to 50-year-old men with diabetes, for example.
In some cases, evidence for claims made may come from animal studies, which might not be applicable to humans at all.
So be aware that if research findings are for a group that doesn’t match your profile, then the results might not be relevant to you.
It takes time and a lot of high-quality studies to tell us a “diet” is safe and effective, not just one study. Ask yourself, is it supported by multiple studies in humans? Be critical and question the claims before you accept them.
For accurate information look for government websites, or ask your GP or dietitian.
3. How will this diet affect my life?
Food is much more than calories and nutrients. It plays many roles in our lives, and likewise diets can influence our lives in ways we often overlook.
Socially and culturally, food can be a point of connection and celebration. It can be a source of enjoyment, a source of comfort, or even a way to explore new parts of the world.
So when you’re considering a new diet, think about how it might affect meaningful moments for you. For example, if you’re going travelling, will your diet influence the food choices you make? Will you feel that you can’t sample the local cuisine? Or would you be deterred from going out for dinner with friends because of their choice of restaurant?
4. Will this diet make me feel guilty or affect my mental health?
What is your favourite meal? Does this diet “allow” you to eat it? Imagine visiting your mum who has prepared your favourite childhood meal. How will the diet affect your feelings about these special foods? Will it cause you to feel stressed or guilty about enjoying a birthday cake or a meal cooked by a loved one?
Studies have shown that dieting can negatively impact our mental health, and skipping meals can increase symptoms of depression and anxiety.
Many diets fail to consider the psychological aspects of eating, even though our mental health is just as important as physical health. Eating should not make you feel stressed, anxious, or guilty.
So before starting another diet, consider how it might affect your mental health.
Moving away from a dieting mindset
We’re frequently told that weight loss is the path to better health. Whereas, we can prioritise our health without focusing on our weight. Constant messages about the need to lose weight can also be harmful to mental health, and not necessarily helpful for physical health.
Our research has found eating in a way that prioritises health over weight loss is linked to a range of positive outcomes for our health and wellbeing. These include a more positive relationship with food, and less guilt and stress.
Our research also indicates mindful and intuitive eating practices – which focus on internal cues, body trust, and being present and mindful when eating – are related to lower levels of depression and stress, and greater body image and self-compassion.
But like anything, it takes practice and time to build a positive relationship with food. Be kind to yourself, seek out weight-inclusive health-care professionals, and the changes will come. Finally, remember you’re allowed to find joy in food.
Melissa Eaton, Accredited Practising Dietitian; PhD Candidate, University of Wollongong; Verena Vaiciurgis, Accredited Practising Dietitian; PhD Candidate, University of Wollongong, and Yasmine Probst, Associate Professor, School of Medical, Indigenous and Health Sciences, University of Wollongong
This article is republished from The Conversation under a Creative Commons license. Read the original article.
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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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Top 10 Unhealthy Foods: How Many Do You Eat?
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The items on this list won’t come as a shocking surprise to you, but it can be a good opportunity to do a quick tally and see how many of these have snuck into your diet:
The things that take away health instead of adding it
Without further ado, they are…
- Alcohol: not only is it high in empty calories, but also it’s bad for pretty much everything, especially increasing the risks of liver disease, high blood pressure, and stroke.
- Processed snacks: low in nutrition; contain unhealthy fats, refined sugars, and artificial additives that often aren’t great.
- Potato chips: get their own category for being especially high in fat, sodium, and empty calories; contribute to heart disease and weight gain.
- Processed cheese: some kinds of cheese are gut-healthy in moderation, but this isn’t. Instead, it’s just loaded with saturated fats, sodium, and sugars, and is pretty much heart disease in a slice.
- Donuts: deep-fried, sugary, and made with refined flour; cause blood sugar spikes and crashes, and what’s bad for your blood sugars is bad for almost everything else.
- French fries & similar deep-fried foods: high in saturated fats and sodium; contribute to obesity and heart issues, are not great for blood sugars either.
- White bread: made with refined flour; cause blood sugar spikes and metabolic woes.
- Sodas: high in sugar or artificial sweeteners; can easily lead to weight gain, diabetes, and tooth decay.
- Processed meats: high in calories and salt; strongly associated with heart disease and cancer.
- Hot dogs & fast food burgers: get their own category for being the absolute worst of the above-mentioned processed meats.
This writer scored: no / rarely / no / no / no / rarely / rarely / rarely / no / no
How about you?
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Want to learn more?
You might also like to read:
Take care!
Don’t Forget…
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