For some people, pain can be relieved without using medicine. They use relaxation, imagery, distraction, and skin stimulation. You may need the help of health professionals to learn to do these for yourself. Friends or family members can help with some of them. The techniques are also useful along with pain medicines. Information about nondrug treatments for pain also may be available at a local hospice, cancer treatment center, or hospital pain clinic.
How Does Relaxation Work?
Relaxation relieves pain or keeps it from getting worse by reducing tension in the muscles. It can help you fall asleep, give you more energy, make you less tired, reduce your anxiety, and make other pain relief methods work better. Some people, for instance, find that taking a pain medicine or using a cold or hot pack works faster and better when they relax at the same time.
Are There Any Basic Guidelines for Using Relaxation Techniques?
* Understand that your ability to relax may vary from time to time and that relaxation cannot be forced.
* Remember that it may take up to 2 weeks of practice to feel the first results of relaxation.
* Try several relaxation methods until you find one that works for you.
* Stick with the same method so that it becomes easy and routine for you. Use it regularly for at least 5 to 10 minutes twice a day.
* Check for tension throughout the day by noticing tightness in each part of your body from head to foot. Relax any tense muscles. You may use a quick technique such as inhale/tense, exhale/relax, described below.
* If you have any lung problems, check with your doctor before using any relaxation technique that requires deep breathing.
Is There Any Special Position I Should Be in When I Am Doing Relaxation Exercises?
Relaxation may be done sitting up or lying down. Choose a quiet place whenever possible. Close your eyes. Do not cross your arms and legs because that may cut off circulation and cause numbness or tingling. If you are lying down, be sure you are comfortable. Put a small pillow under your neck and under your knees or use a low stool to support your lower legs.
How Do I Use Relaxation?
There are many methods. Here are some for you to try:
Visual concentration and rhythmic massage:
* Open your eyes and stare at an object, or close your eyes and think of a peaceful, calm scene. With the palm of your hand, massage near the area of pain in a circular, firm manner. Avoid red, raw, swollen, or tender areas. You may wish to ask a family member or friend to do this for you.
* Breathe in (inhale) deeply. At the same time, tense your muscles or a group of muscles. For example, you can squeeze your eyes shut, frown, clench your teeth, make a fist, stiffen your arms and legs, or draw up your arms and legs as tightly as you can.
* Hold your breath and keep your muscles tense for a second or two.
* Let go! Breathe out (exhale) and let your body go limp.
Slow rhythmic breathing:
* Stare at an object or close your eyes and concentrate on your breathing or on a peaceful scene.
* Take a slow, deep breath and, as you breathe in, tense your muscles (such as your arms).
* As you breathe out, relax your muscles and feel the tension draining.
* Now remain relaxed and begin breathing slowly and comfortably, concentrating on your breathing, taking about 9 to 12 breaths a minute. Do not breathe too deeply.
* To maintain a slow, even rhythm as you breathe out, you can say silently to yourself, “In, one, two; out, one, two.” It may be helpful at first if someone counts out loud for you. If you ever feel out of breath, take a deep breath and then continue the slow breathing exercise. Each time you breathe out, feel yourself relaxing and going limp. If some muscles are not relaxed such as your shoulders, tense them as you breathe in and relax them as you breathe out. You need to do this only once or twice for each specific muscle group.
* Continue slow, rhythmic breathing for a few seconds up to 10 minutes, depending on your need.
* To end your slow rhythmic breathing, count silently and slowly from one to three. Open your eyes. Say silently to yourself: “I feel alert and relaxed.” Begin moving about slowly.
Other methods you can add to slow rhythmic breathing:
* Listen to slow, familiar music through an earphone or headset.
* Progressive relaxation of body parts. Once you are breathing slowly and comfortably, you may relax different body parts, starting with your feet and working up to your head. Think of words such as limp, heavy, light, warm, or floating. Each time you breathe out, you can focus on a particular area of the body and feel it relaxing. Try to imagine that the tension is draining from that area. For example, as you breathe out, feel your feet and ankles relaxing; the next time you breathe out, feel your calves and knees relaxing, and so on up your body.
Relaxation tapes: We recommend
Will I Have Any Problems With Using Relaxation Techniques
Some people who have used relaxation for pain relief have reported the following problems and solutions to them:
* Relaxation may be difficult to use with severe pain. If you have this problem, use a quick and easy relaxation method such as visual concentration with rhythmic massage or breathe in/tense, breathe out/relax.
* You may have a feeling of “suffocation.” If so, take a deep breath.
* Sometimes breathing too deeply for a while can cause shortness of breath. If this is your problem, take shallow breaths and/or breathe more slowly.
* You may fall asleep. If you do not wish to fall asleep, sit in a hard chair while doing the relaxation exercise or set a timer or alarm.
* You might get feelings of depression or withdrawal. Sometimes being relaxed makes you aware of problems you have been worrying about subconsciously. If this happens, talk to someone who can help you sort out your feelings.
If you have trouble using these methods, ask your doctor or nurse to refer you to a therapist who is experienced in relaxation techniques. Do not continue any relaxation technique that increases your pain, makes you feel uneasy, or causes any unpleasant effects.
What Is Biofeedback?
With the help of special machines, people can learn to control certain body functions such as heart rate, blood pressure, and muscle tension. Biofeedback is sometimes used to help people learn to relax. Cancer patients can use biofeedback techniques to reduce anxiety and help them cope with their pain. Biofeedback usually is used with other pain-relief methods.
What Is Imagery, and How Does It Work?
Imagery is using your imagination to create mental pictures or situations. The way imagery relieves pain is not completely understood. Imagery can be thought of as a deliberate daydream that uses all of your senses – sight, touch, hearing, smell, and taste. Some people believe that imagery is a form of self-hypnosis. Certain images may reduce your pain both during imagery and for hours afterward. If you must stay in bed or can’t go out of the house, you may find that imagery helps reduce the closed-in feeling; you can imagine and revisit favorite spots in your mind. Imagery can help you relax, relieve boredom, decrease anxiety, and help you sleep.
How Do I Use the Technique of Imagery?
Usually, imagery for pain relief is done with the eyes closed. A relaxation technique may be used first. The image can be something such as a ball of healing energy or a picture drawn in your mind of yourself as a person without pain (for example, imagine that you are cutting wires that transmit pain signals from each part of your body to your brain). Here is an exercise with the first image – the ball of energy. It is a variation of the technique credited to
* Close your eyes. Breathe slowly and feel yourself relax.
* Concentrate on your breathing. Breathe slowly and comfortably from your abdomen.
* As you breathe in, say silently and slowly to yourself:
“In, one, two.” As you breathe out, say: “Out, one, two.” Breathe in this slow rhythm for a few minutes.
* Imagine a ball of healing energy forming in your lungs or on your chest. It may be like a white light. It can be vague. It does not have to be vivid. Imagine this ball forming, taking shape.
* When you are ready, imagine that the air you breathe in blows this healing ball of energy to the area of your pain. Once there, the ball heals and relaxes you.
* When you breathe out, imagine the air blows the ball away from your body. As it goes, the ball takes your pain with it. (Be careful: Do not blow as you breathe out; breathe out naturally.)
* Repeat the last two steps each time you breathe in and out.
* You may imagine that the ball gets bigger and bigger as it takes more and more discomfort away from your body.
* To end the imagery, count slowly to three, breathe in deeply, open your eyes, and say silently to yourself: “I feel alert and relaxed.” Begin moving about slowly.
Are There Any Problems With Using Imagery?
The problems are similar to the ones that may occur with relaxation techniques.
What Is Distraction, and How Does It Work?
Distraction means turning your attention to something other than the pain. Many people use this method without realizing it when they watch television or listen to the radio to “take their minds off” the pain. Distraction may work better than medicine if pain is sudden and intense or if it is brief, lasting only 5 to 45 minutes. Distraction is useful when you are waiting for pain medicine to start working. If pain is mild, you may be able to distract yourself for hours. Some people think that a person who can be distracted from pain does not have severe pain. This is not necessarily true. Distraction can be a powerful way of temporarily relieving even the most intense pain.
How Can I Use Distraction?
Any activity that occupies your attention can be used for distraction. If you enjoy working with your hands, crafts such as needlework, model building, or painting may be useful. Losing yourself in a good book might divert your mind from the pain. Going to a movie or watching television are also good distraction methods. Slow, rhythmic breathing can be used for distraction as well as relaxation. You may find it helpful to listen to rather fast music through a headset or earphones. To help keep your attention on the music, tap out the rhythm. You can adjust the volume to match the intensity of pain, making it louder for very severe pain. This technique does not require much energy, so it may be very useful when you are tired.
Are There Any Drawbacks To Using Distraction for Pain Relief?
After using a distraction technique, some people report that they are tired, irritable, and feel more pain. Some also find that other people do not believe they are in pain if distraction provides pain relief. If these are problems for you, you may not wish to use distraction or you may simply be careful about which distraction methods you use and when you use them.
What Is Skin Stimulation, and How Does It Work To Relieve Pain?
Skin stimulation is the use of pressure, friction, temperature change, or chemical substances to excite the nerve endings in the skin. Scientists believe that the same nerve pathways transmit the sensations of pain, heat, cold, and pressure to the brain. When the skin is stimulated so that pressure, warmth, or cold is felt, pain sensation is lessened or blocked. Skin stimulation also alters the flow of blood to the affected area. Sometimes skin stimulation will get rid of the pain, or the pain will be less during the stimulation and for hours after it is finished. Note: If you are having radiation therapy, check with your doctor or nurse before using skin stimulation. You should not apply ointments, salves, or liniments to the treatment area, and you should not use heat or extreme cold on treated areas.
Where Is Skin Stimulation Done?
Skin stimulation is done either on or near the area of pain. You also can use skin stimulation on the side of the body opposite to the pain. For example, you might stimulate the left knee to decrease pain in the right knee. Stimulating the skin in areas away from the pain can be used to increase relaxation and may relieve pain.
What Is Used To Stimulate the Skin?
Massage, pressure, vibration, heat, cold, and menthol preparations are used for skin stimulation.
How Do I Use Massage for Pain Relief?
For pain relief, massage is most effective when using slow, steady, circular motions. You can massage over or near the area of pain with just your bare hand or with any substance that feels good such as talcum powder, warm oil, or hand lotion. Depending upon where your pain is located, you may do it yourself or ask a family member or friend to give you a massage. Remember, having someone give you a foot rub, back rub, or hand rub can be very relaxing and may relieve pain. Some people find brushing or stroking lightly more comforting than deep massage. Use whatever works best for you. Note: If you are having radiation therapy, avoid massage in the treatment area.
How Do I Use Pressure?
Pressure can be applied with the entire hand, the heel of the hand, the fingertip or the knuckle, the ball of the thumb, or by using one or both hands to encircle your arm or leg. You can experiment by applying pressure for about 10 seconds to various areas over or near your pain to see if it helps. You can also feel around your pain and outward to see if you can find “trigger points,” small areas under the skin that are especially sensitive or that trigger pain. Pressure is usually most effective if it is applied as firmly as possible without causing pain. You can use pressure for up to about 1 minute. This often will relieve pain for several minutes to several hours after the pressure is released.
How Do I Use Vibration?
Vibration over or near the area of pain may bring temporary relief. For example, the scalp attachment of a handheld vibrator often relieves a headache. For low back pain, a long, slender battery operated vibrator placed at the small of the back may be helpful. You may use a vibrating device such as a small battery operated vibrator, a handheld electric vibrator, a large heat-massage electric pad, or a bed vibrator.
Which Is Better for Relieving Pain – Cold Or Heat?
As for any of the techniques described, you should use what works best for you. Heat often relieves sore muscles; cold lessens pain sensations by numbing the affected area. Many people with prolonged pain use only heat and have never given cold a try. Some people find that cold relieves pain faster, and relief may last longer.
What Are Some Comfortable and Convenient Ways To Use Cold or Heat?
For cold, try gel packs that are sealed in plastic and remain soft and flexible even at freezing temperatures. Gel packs are available at drugstores and medical supply stores. They are reusable and can be kept in the freezer when not in use. Wrap the pack with a layer of towels so that it is comfortable for you. An ice pack or ice cubes wrapped in a towel can be just as effective. To use heat for pain relief, a heating pad that generates its own moisture (Hydrocolater) is convenient. Gel packs heated in hot water, hot water bottles, a hot, moist towel, a regular heating pad, or a hot bath or shower can also be used to apply heat. For aching joints such as elbows and knees, you can wrap the joint in lightweight plastic wrap (tape the plastic to itself). This retains body heat and moisture. Note: Do not use heat or cold over any area receiving radiation therapy.
What Are Menthol Preparations?
Many menthol preparations are available for pain relief. There are creams, lotions, liniments, or gels that contain menthol. Brands include
How Do I Use Menthol Preparations?
First, test your skin by rubbing a small amount of the menthol preparation in a circle about 1 inch in diameter in the area of pain (or the area to be stimulated). This will let you know whether the menthol is uncomfortable to you or irritates your skin. If the menthol does not create a problem, rub some more into the area. The sensation caused by the menthol gradually increases and remains up to several hours. To increase the intensity and duration of the menthol sensation you can open your skin pores with heat (e.g., shower, sun) or wrap a plastic sheet over the area after the menthol application. (Don’t use a heating pad because it may cause a burn.) If you’re afraid others will find the odor offensive, you can use the menthol product when you are alone, or perhaps in the evening or through the night. Note: Many menthol preparations contain an ingredient similar to aspirin. A small amount of this aspirin-like substance is absorbed through the skin. If you have been told not to take aspirin, do not use these preparations until you check with your doctor.
What Precautions Should I Take if I Use Skin Stimulation?
Heat and cold can easily damage your skin. It is easy to burn the skin with hot water from the tap or with settings too high on the heating pad. Extreme cold can also burn your skin.
* Never use a heating pad on bare skin.
* Never go to sleep for the night with the heating pad on.
* Be very careful while using a heating pad if you are taking drugs or medicines that make you sleepy or if you do not have much feeling in the area.
* Limit heat or cold application to 5 to 10 minutes.
* Do not use heat or cold over any area where your circulation or sensation is poor.
* If you start to shiver when using cold, stop using it right away.
* Do not use cold so intense or for so long that the cold itself causes pain.
* Do not use heat over a new injury because heat can increase bleeding. Wait at least 24 hours.
* Do not rub menthol preparations over broken skin, a skin rash, or mucous membranes (such as inside your mouth or around your rectum). Make sure you do not get the menthol in your eyes.
* Avoid massage and vibration over red, raw, tender, or swollen areas.
* If skin stimulation increases your pain, stop using it.
* As noted earlier, if you are undergoing (or have undergone) radiation treatments, do not use any skin stimulation method without first checking with your doctor or nurse.