Why is pain so exhausting?
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One of the most common feelings associated with persisting pain is fatigue and this fatigue can become overwhelming. People with chronic pain can report being drained of energy and motivation to engage with others or the world around them.
In fact, a study from the United Kingdom on people with long-term health conditions found pain and fatigue are the two biggest barriers to an active and meaningful life.
But why is long-term pain so exhausting? One clue is the nature of pain and its powerful effect on our thoughts and behaviours.
Short-term pain can protect you
Modern ways of thinking about pain emphasise its protective effect – the way it grabs your attention and compels you to change your behaviour to keep a body part safe.
Try this. Slowly pinch your skin. As you increase the pressure, you’ll notice the feeling changes until, at some point, it becomes painful. It is the pain that stops you squeezing harder, right? In this way, pain protects us.
When we are injured, tissue damage or inflammation makes our pain system become more sensitive. This pain stops us from mechanically loading the damaged tissue while it heals. For instance, the pain of a broken leg or a cut under our foot means we avoid walking on it.
The concept that “pain protects us and promotes healing” is one of the most important things people who were in chronic pain tell us they learned that helped them recover.
But long-term pain can overprotect you
In the short term, pain does a terrific job of protecting us and the longer our pain system is active, the more protective it becomes.
But persistent pain can overprotect us and prevent recovery. People in pain have called this “pain system hypersensitivity”. Think of this as your pain system being on red alert. And this is where exhaustion comes in.
When pain becomes a daily experience, triggered or amplified by a widening range of activities, contexts and cues, it becomes a constant drain on one’s resources. Going about life with pain requires substantial and constant effort, and this makes us fatigued.
About 80% of us are lucky enough to not know what it is like to have pain, day in day out, for months or years. But take a moment to imagine what it would be like.
Imagine having to concentrate hard, to muster energy and use distraction techniques, just to go about your everyday tasks, let alone to complete work, caring or other duties.
Whenever you are in pain, you are faced with a choice of whether, and how, to act on it. Constantly making this choice requires thought, effort and strategy.
Mentioning your pain, or explaining its impact on each moment, task or activity, is also tiring and difficult to get across when no-one else can see or feel your pain. For those who do listen, it can become tedious, draining or worrying.
No wonder pain is exhausting
In chronic pain, it’s not just the pain system on red alert. Increased inflammation throughout the body (the immune system on red alert), disrupted output of the hormone cortisol (the endocrine system on red alert), and stiff and guarded movements (the motor system on red alert) also go hand in hand with chronic pain.
Each of these adds to fatigue and exhaustion. So learning how to manage and resolve chronic pain often includes learning how to best manage the over-activation of these systems.
Loss of sleep is also a factor in both fatigue and pain. Pain causes disruptions to sleep, and loss of sleep contributes to pain.
In other words, chronic pain is seldom “just” pain. No wonder being in long-term pain can become all-consuming and exhausting.
What actually works?
People with chronic pain are stigmatised, dismissed and misunderstood, which can lead to them not getting the care they need. Ongoing pain may prevent people working, limit their socialising and impact their relationships. This can lead to a descending spiral of social, personal and economic disadvantage.
So we need better access to evidence-based care, with high-quality education for people with chronic pain.
There is good news here though. Modern care for chronic pain, which is grounded in first gaining a modern understanding of the underlying biology of chronic pain, helps.
The key seems to be recognising, and accepting, that a hypersensitive pain system is a key player in chronic pain. This makes a quick fix highly unlikely but a program of gradual change – perhaps over months or even years – promising.
Understanding how pain works, how persisting pain becomes overprotective, how our brains and bodies adapt to training, and then learning new skills and strategies to gradually retrain both brain and body, offers scientifically based hope; there’s strong supportive evidence from clinical trials.
Every bit of support helps
The best treatments we have for chronic pain take effort, patience, persistence, courage and often a good coach. All that is a pretty overwhelming proposition for someone already exhausted.
So, if you are in the 80% of the population without chronic pain, spare a thought for what’s required and support your colleague, friend, partner, child or parent as they take on the journey.
More information about chronic pain is available from Pain Revolution.
Michael Henry, Physiotherapist and PhD candidate, Body in Mind Research Group, University of South Australia and Lorimer Moseley, Professor of Clinical Neurosciences and Foundation Chair in Physiotherapy, University of South Australia
This article is republished from The Conversation under a Creative Commons license. Read the original article.
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6 Daily Habits To Keep Your Brain Young & Sharp
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Without brain health, we do not have health. So here are six ways to keep it in order:
Food for thought
The six areas to focus on are as follows:
- Physical exercise: as we at 10almonds sometimes say, what’s good for the heart is good for the brain (because the brain is only as healthy as the circulation feeding it). For this reason, the recommendation here is for physical exercise that improves heart health—so, walking, running, swimming, dancing, etc.
- Healthy diet: shocking nobody, this is important too. Specifically, a diet rich in fruits, vegetables, and healthy proteins and fats is important—partly for the heart benefits that give indirect benefits to the brain, and partly because the brain is built of stuff and so we have to consume that stuff in order to rebuild it (omega-3s features strongly here, for instance). Remember to hydrate, too! The body can’t do anything without water.
- Good sleep: yes, the famous 7–9 hours sleep per night, and yes, even at your age, whatever that might be. This is important for memory consolidation, cell repair, toxin removal, and more. Sleep deprivation, on the other hand, leads to cognitive decline and brain shrinkage.
- Mental stimulation: ideally, engaging those parts of the brain you most wish to protect (e.g. language, memory, or whatever is most important to you).
- Social interaction: this one gets underestimated a lot, but it’s important to have meaningful conversations (not just polite smalltalk from a small menu of stock phrases), and that these should be two-way, i.e. involving both listening/reading and speaking/writing. Ideally, all four of those, which for most people means online and offline social interactions.
- Stress management: because chronic stress damages brain cells and accelerates cognitive decline, it’s important to manage that; practices like mindfulness meditation go a very long way and make a big difference.
For more on all of these, enjoy:
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Want to learn more?
You might also like to read:
The Physical Exercises That Build Your Brain ← this is different from just exercising for one’s heart and thus the brain by extension, and rather, is specific exercises that strengthen specific parts of the brain.
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7-Minute Face Fitness For Lymphatic Drainage & Youthful Jawline
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Valeriia Veksler is a registered nurse with a background in cosmetic medicine. She’s been practicing for 7 years, and on the strength of that, is going to teach us how to give our face some love for 7 minutes:
The routine, step by step
Preparation: clean your face and apply your usual moisturizer. Breathe deeply: Inhale through the nose, exhale to release tension.
Neck massage: use fingertips in circular motion from the bottom of the neck to the hairline and back for 30 seconds. This helps promote blood flow to the face.
Sternocleidomastoid massage: use knuckles to massage in circles from the sternal area up to the jawline and down to the collarbone for 30 seconds. Keep posture straight, shoulders down, and relax muscles.
Collarbone pressure: apply and release pressure with fingertips above the collarbones for 30 seconds. This stimulates lymphatic flow and helps reduce puffiness.
Under-chin massage: use knuckles to massage side-to-side under the chin for 30 seconds. Relax the under-chin area and promote lymphatic drainage.
Jawline massage: with knuckles, massage from the chin towards the ears in circular motion for 30 seconds. Relax the jaw.
Nasolabial fold and nose massage: place index fingers near nostrils and move mouth in a “O” shape, then massage around the nostrils and up the nose for 30 seconds.
Smile line lift: press palms on the smile lines and slide hands up towards the temples for 30 seconds. This helps lift the face and sculpt cheekbones.
Under-eye massage: use index fingers in a hook shape, massaging under the eyes along the bone structure for 30 seconds. This promotes blood flow and lymphatic drainage.
Temple lift: use fingertips to lift the area near the left temple for 30 seconds, then assist with the opposite hand to lift further. Repeat on the other side. This reduces crow’s feet and lifts the corners of the eyes.
Forehead lift: place hands on the forehead, lock fingers, and gently elevate the skin upwards. Glide fingers towards the hairline for 30 seconds. This promotes blood flow and smooths the forehead.
Relax 11 Lines: place fingers at the center of the forehead, gently press into the tissue, and let them glide away from each other towards the eyebrows for 30 seconds.
Bonus:
- Ensure good posture throughout.
- Relax, stay mindful, and breathe deeply during the exercises.
- Feel the warmth and energy from improved circulation, after the routine.
For more on all of this plus a visual demonstration of everything, enjoy:
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You might also like to read:
Top 10 Foods That Promote Lymphatic Drainage and Lymph Flow
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It’s Not Hysteria – by Dr. Karen Tan
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Firstly, who this book is aimed at: in case it wasn’t clear, this book assumes you have, or at least have had, a uterus. If that’s not you, then well, it’ll still be an interesting read but it won’t be about your reproductive health.
Secondly, about that “reproductive health”: it’s mostly not actually about reproductive health literally, but rather, the health of one’s reproductive organs and the things that they affect—which is a lot more than the ability to reproduce!
Dr. Tang takes us on a (respectably in-depth) tour of the relevant anatomy, before moving on to physiology, before continuing to pathology (i.e. things that can go wrong, and often do), and finally various treatment options, including elective procedures, and the pros and cons thereof.
She also talks the reader through talking about things with gynecologists and other healthcare providers, and making sure concerns are not dismissed out-of-hand (something that happens a lot, of course).
The style throughout is quite detailed prose, but without being difficult at all to read, and (assuming one is interested in the topic) it’s very engaging.
Bottom line: if you would like to know more about uteri and everything that is (or commonly/unfortunately) can be attached to them, the effects they have on the rest of the body and health, and what can be done about things not being quite right, then this is a good book for that.
Click here to check out It’s Not Hysteria, and understand more of what’s going on down there!
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Slow-Cooker Moroccan Tagine
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Tagine (طاجين) (tā-jīn) is a traditional dish named after, well, the traditional dish that it’s cooked in. Here’s an example tagine pot on Amazon. It’s a very nifty bit of kit, and while it’s often used for cooking over charcoal, one of its features is that if you have a hot sunny day, you can just leave it out in the sun and it will cook the contents nicely. Today though, we’re going to assume you don’t have one of these, and are going to give instructions for cooking a tagine-style dish with a slow cooker, which we’re going to assume you do have.
You will need
- 2 large red onions, finely chopped
- 2 large red peppers, cut into 1″ chunks
- 2 large zucchini, cut into ½” chunks
- 1 large eggplant, cut into ½” chunks
- 3 cups tomato passata
- 2 cups cooked chickpeas
- 16 pitted Medjool dates, chopped
- ½ bulb garlic, finely chopped
- 1 tbsp ras el-hanout
- A little extra virgin olive oil
Method
(we suggest you read everything at least once before doing anything)
1) Let your slow cooker heat up while you chop the things that need chopping
2) Add a splash of olive oil to the slow cooker; ensure the base is coated and there’s a little oil spare in there too; a thin coat to the base plus a couple of tbsp should do it nicely.
3) Add the onions and garlic, and leave for an hour.
4) Add the passata, dates, ras el-hanout, stir it and leave for an hour.
5) Add the chickpeas, peppers, and eggplant; stir it and leave for an hour.
6) Add the zucchini, stir it and leave for an hour.
7) Serve—it goes great with its traditional pairing of wholegrain couscous, but if you prefer, you can use our tasty versatile rice. In broader culinary terms, serving it with any carb is fine.
Enjoy!
Want to learn more?
For those interested in some of the science of what we have going on today:
- Level-Up Your Fiber Intake! (Without Difficulty Or Discomfort)
- What Matters Most For Your Heart? Eat More (Of This) For Lower Blood Pressure
- Our Top 5 Spices: How Much Is Enough For Benefits?
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Could the shingles vaccine lower your risk of dementia?
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A recent study has suggested Shingrix, a relatively new vaccine given to protect older adults against shingles, may delay the onset of dementia.
This might seem like a bizarre link, but actually, research has previously shown an older version of the shingles vaccine, Zostavax, reduced the risk of dementia.
In this new study, published last week in the journal Nature Medicine, researchers from the United Kingdom found Shingrix delayed dementia onset by 17% compared with Zostavax.
So how did the researchers work this out, and how could a shingles vaccine affect dementia risk?
Melinda Nagy/Shutterstock From Zostavax to Shingrix
Shingles is a viral infection caused by the varicella-zoster virus. It causes painful rashes, and affects older people in particular.
Previously, Zostavax was used to vaccinate against shingles. It was administered as a single shot and provided good protection for about five years.
Shingrix has been developed based on a newer vaccine technology, and is thought to offer stronger and longer-lasting protection. Given in two doses, it’s now the preferred option for shingles vaccination in Australia and elsewhere.
In November 2023, Shingrix replaced Zostavax on the National Immunisation Program, making it available for free to those at highest risk of complications from shingles. This includes all adults aged 65 and over, First Nations people aged 50 and older, and younger adults with certain medical conditions that affect their immune systems.
What the study found
Shingrix was approved by the US Food and Drugs Administration in October 2017. The researchers in the new study used the transition from Zostavax to Shingrix in the United States as an opportunity for research.
They selected 103,837 people who received Zostavax (between October 2014 and September 2017) and compared them with 103,837 people who received Shingrix (between November 2017 and October 2020).
By analysing data from electronic health records, they found people who received Shingrix had a 17% increase in “diagnosis-free time” during the follow-up period (up to six years after vaccination) compared with those who received Zostavax. This was equivalent to an average of 164 extra days without a dementia diagnosis.
The researchers also compared the shingles vaccines to other vaccines: influenza, and a combined vaccine for tetanus, diphtheria and pertussis. Shingrix and Zostavax performed around 14–27% better in lowering the risk of a dementia diagnosis, with Shingrix associated with a greater improvement.
The benefits of Shingrix in terms of dementia risk were significant for both sexes, but more pronounced for women. This is not entirely surprising, because we know women have a higher risk of developing dementia due to interplay of biological factors. These include being more sensitive to certain genetic mutations associated with dementia and hormonal differences.
Why the link?
The idea that vaccination against viral infection can lower the risk of dementia has been around for more than two decades. Associations have been observed between vaccines, such as those for diphtheria, tetanus, polio and influenza, and subsequent dementia risk.
Research has shown Zostavax vaccination can reduce the risk of developing dementia by 20% compared with people who are unvaccinated.
But it may not be that the vaccines themselves protect against dementia. Rather, it may be the resulting lack of viral infection creating this effect. Research indicates bacterial infections in the gut, as well as viral infections, are associated with a higher risk of dementia.
Notably, untreated infections with herpes simplex (herpes) virus – closely related to the varicella-zoster virus that causes shingles – can significantly increase the risk of developing dementia. Research has also shown shingles increases the risk of a later dementia diagnosis.
This isn’t the first time research has suggested a vaccine could reduce dementia risk. ben bryant/Shutterstock The mechanism is not entirely clear. But there are two potential pathways which may help us understand why infections could increase the risk of dementia.
First, certain molecules are produced when a baby is developing in the womb to help with the body’s development. These molecules have the potential to cause inflammation and accelerate ageing, so the production of these molecules is silenced around birth. However, viral infections such as shingles can reactivate the production of these molecules in adult life which could hypothetically lead to dementia.
Second, in Alzheimer’s disease, a specific protein called Amyloid-β go rogue and kill brain cells. Certain proteins produced by viruses such as COVID and bad gut bacteria have the potential to support Amyloid-β in its toxic form. In laboratory conditions, these proteins have been shown to accelerate the onset of dementia.
What does this all mean?
With an ageing population, the burden of dementia is only likely to become greater in the years to come. There’s a lot more we have to learn about the causes of the disease and what we can potentially do to prevent and treat it.
This new study has some limitations. For example, time without a diagnosis doesn’t necessarily mean time without disease. Some people may have underlying disease with delayed diagnosis.
This research indicates Shingrix could have a silent benefit, but it’s too early to suggest we can use antiviral vaccines to prevent dementia.
Overall, we need more research exploring in greater detail how infections are linked with dementia. This will help us understand the root causes of dementia and design potential therapies.
Ibrahim Javed, Enterprise and NHMRC Emerging Leadership Fellow, UniSA Clinical & Health Sciences, University of South Australia
This article is republished from The Conversation under a Creative Commons license. Read the original article.
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Tasty Tofu Scramble
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If you’re trying to eat more plant-based, this is a great way to enjoy a culinary experience that hits the same notes as scrambled egg, with many similar nutritional benefits too, and some of its own!
You will need
- 1 cup (10oz) silken tofu
- ¼ bulb garlic, crushed
- 1 tbsp nutritional yeast
- 2 tsp chia seeds
- 2 tsp dried thyme, or 1 tsp fresh thyme, stripped (i.e. pulled off the stalks)
- 2 tsp turmeric
- 2 tsp black pepper, coarse ground
- 1 tsp red chili flakes
- ½ tsp MSG, or 1 tsp low-sodium salt
- Extra virgin olive oil, for frying
Method
(we suggest you read everything at least once before doing anything)
1) Heat a skillet with olive oil in it; if you want a low-calorie option, you can use quite little oil here; the tofu is a lot more forgiving than egg in this regard and is almost impossible to burn unless you actively try. If you don’t want a low-calorie option, feel free to be generous with the oil if you prefer; it’ll go into the tofu and make it fattier, much like egg.
2) Add the tofu. You can just drop it (carefully) straight in; you don’t need to press it or anything.
3) Scramble it with a spatula, just the same as you would if it were egg.
4) Add the rest of the ingredients, mixing them in as you continue to scramble it, until it reaches the desired consistency.
5) Serve! Serving it on wholegrain toast is a great option—but this dish can also be enjoyed any other way you might use scrambled eggs (including for making
egg-friedtofu-fried rice; just stir it into our Tasty Versatile Rice recipe!)Enjoy!
Want to learn more?
For those interested in some of the science of what we have going on today:
- Plant vs Animal Protein: Head to Head
- Black Pepper’s Impressive Anti-Cancer Arsenal
- Capsaicin For Weight Loss And Against Inflammation
- The Many Health Benefits Of Garlic
- Why Curcumin (Turmeric) Is Worth Its Weight In Gold
- If You’re Not Taking Chia, You’re Missing Out
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