Other Strategies to Relieve Pain

Some people use other strategies to relieve pain instead of or in addition to medicine.
Some strategies include:

• Relaxation

• Imagery

• Distraction

• Skin stimulation
  

Health care providers can teach you how to use these techniques. Friends or family members can help you as well.

Benefits of Relaxation

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, and make you feel less tired. It can also reduce your anxiety. Other pain relief methods work faster and better when you relax at the same time.

Basic Relaxation Guidelines

• How well you are able to relax may change from time to time. You cannot force relaxation.

• Try many types of relaxation methods until you find one that works for you.

• Stick with one method so that it becomes easy and routine for you. Use it at least 5-10 minutes twice a day.

• Check your body from head to toe for tension during the day. Try to relax any tense muscles. Use a quick technique such as inhale/tense, exhale/relax. This is explained later.

• If you have any lung problems, check with your doctor before using any deep breathing techniques.
  

Find a Comfortable Position

You can try to relax while sitting up or lying down. Choose a quiet place if you can. 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.

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 where the pain is in a circular, firm manner. Avoid red, raw, swollen, or tender areas. You can ask a family member or friend to do this for you.

Inhale/Tense, Exhale/Relax

1. Breathe in (inhale) deeply. At the same time, tense your muscles or a group of muscles. For instance, 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.

2. Hold your breath and keep your muscles tense for a second or two.

3. Let go! Breathe out (exhale) and let your body go limp.
   

Slow Rhythmic Breathing

1. Stare at an object or close your eyes and focus on your breathing or on a peaceful scene.

2. Take a slow, deep breath and as you breathe in, tense your muscles (such as your arms).

3. As you breathe out, relax your muscles and feel the tension draining.

4. Now remain relaxed and begin breathing slowly and comfortably. Focus on your breathing, taking about 9 to 12 breaths a minute. Do not breathe too deeply.

5. 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 return to 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 relax them as you breathe out. You need to do this only once or twice for each muscle group.

6. To end your slow rhythmic breathing, count silently and slowly from one to three. Open your eyes. Say to yourself: “I feel alert and relaxed.” Begin moving about slowly.
   

Other Methods

Try adding the other methods below to slow rhythmic breathing.

Imagery

Imagine that the air you breathe in blows a healing ball of energy to the site 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 pain away from your body.

To end the imagery, count slowly to three, breathe in deeply, open your eyes, and say to yourself: "I feel alert and relaxed." Begin moving about slowly.

Music

Listen to slow music that you like through an earphone or headset. Music with a beat slower than the heartbeat is generally more relaxing for adults.

Progressive Relaxation

Once you are breathing slowly and comfortably, you may relax different body parts. Start with your feet and work 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 certain part of the body and feel it start to relax. Try to imagine that the tension is draining from that part. For instance, as you breathe out, feel your feet and ankles start to relax. The next time you breathe out, feel your calves and knees start to relax, and so on up your body.

Mindfulness Meditation

This method can induce deep states of relaxation. It works like progressive relaxation and guided imagery. Yet unlike these techniques, you do not ignore physical feelings, or physical pain. Instead, you observe them from a center of calmness. The main focus would be the feelings such as pressure, burning, pulling, pulsing, etc. The focus of this method is being with things just as they are, on purpose, in the present moment. This is done to improve healing and to help you feel free from pain.

The body scan is a good method to start with for people with chronic pain. Lie in a comfortable position and focus on your
breathing. Use your breathing to move your attention slowly through the body. Try to be aware of what you are feeling in your body. As thoughts, feelings, and sounds come up, practice simply seeing them and letting them be as they are.

As you observe the sensations in the hurt area, notice how they are changing. Move slowly, scanning this way through your whole body as best you can. Try to stay with the physical feelings. Avoid dropping away from the “thoughts” or your reactions about the pain. How you deal with pain may begin to change, and that can impact everything.

Guided Relaxation

Ask your doctor or nurse to suggest websites or apps that you can access. These methods can often provide step-by-step instructions.

Common Problems

Some people who have used relaxation for pain relief have mentioned some common problems. Listed below are problems and ways to manage them.

Relaxation may be hard to use with severe pain. If you have this problem, use a quick and easy method to relax. This includes methods such as visual concentration with rhythmic massage or breathe in/tense, breathe out/relax.

Some people report a feeling of "suffocation." If you feel this way, take a deep breath.

Sometimes breathing too deeply for a while can cause shortness of breath. If this is your problem, take shallow breaths. It may also help to breathe more slowly.

You may fall asleep. If you do not wish to fall asleep, sit in a hard chair while doing the exercise or set a timer or alarm.

You might feel depressed or withdrawn. Sometimes being relaxed makes you aware of problems you did not know you had. If this happens, talk to someone who can listen as you sort out your feelings.

If you have trouble using these methods, ask your doctor or nurse to refer you to a therapist who can help you. Do not keep doing any of these methods if they make your pain worse or make you uneasy or ill.

Distraction

Distraction means turning your focus to something other than the pain. Many people use this method without knowing it. You are using this method if you watch TV or listen to the radio to "take your mind off" the pain.

Distraction may work better than medicine if pain is sudden and intense or if it is brief, lasting only 5-45 minutes. It 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 true. This technique can be a great way to relieve even the most intense pain for a short amount of time.

How to Use Distraction

You can use any activity that distracts your mind. 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 TV are also good options. Slow, rhythmic breathing can be used to distract you as well.

You may find it helpful to listen to rather fast music through a headset or earphones. To help keep your focus 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. Doing this does not take much energy, so it may be very useful when you are tired.

Skin Stimulation

How to Use Massage

For pain relief, massage works best when you use slow, steady, circular motions. You can massage over or near the site of the pain with just your bare hand. You may wish to use any substance that feels good such as talcum powder, warm oil, or hand lotion.

You may massage the site yourself or ask a family member or friend to give you a massage. 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 feels better than deep massage. Use the method that works best for you.

Note: If you are having radiation treatments, avoid massage in the treatment area.

How to Use Pressure

You can apply pressure with the entire hand, the heel of the hand, the fingertip, the knuckle, or the ball of the thumb. You can apply pressure by using one or both hands to encircle your arm or leg. Apply pressure for about 10 seconds to different areas over or near your pain to see where it might help. You can also feel around your pain and outward to see if you can find "trigger points." These are small areas under the skin that are very sensitive or that trigger pain.

Pressure works best if you apply it as firmly as you can without causing pain. You can use pressure for up to about 1 minute. This will often relieve pain for minutes to several hours after the pressure is released.

Using Cold or Heat to Relieve Pain

As for any of the methods described, you should use what works best for you. Heat often relieves sore muscles. Cold lessens pain by numbing the area. Many people with prolonged pain use only heat and have never tried using cold. Some people find that cold relieves pain faster, and relief may last longer.

Best Ways to Use Cold or Heat

For cold, try gel packs that are sealed in plastic and remain soft and flexible when frozen. You can find gel packs at drugstores and medical supply stores. You can reuse them and keep them in the freezer when not in use. Wrap the pack with a layer of towels so that it is not too cold. An ice pack or ice cubes wrapped in a towel can work just as well.

You can apply heat many ways. You can use gel packs heated in hot water, hot water bottles, a hot moist towel, a regular heating pad, hot bath or shower to apply heat. For aching joints, such as elbows and knees, you can wrap the joint in lightweight plastic wrap to retain body heat and moisture (tape the plastic to itself).

Note: Do not use heat or cold over any area being treated with radiation.

How to Use Menthol Products

First, test your skin by rubbing a small amount of the menthol in a circle about 1 inch wide on the site of the pain or the part you want to be stimulated. If the menthol does not create a problem, rub some more into the area.

The sensation caused by the menthol slowly increases. It can remain up to several hours. Be careful when adding heat to the menthol area. Do not use a heating pad because it may cause burns. If others near you dislike
the odor, you can use the menthol product when you are alone or overnight.

Note: Many menthol products contain an ingredient like 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 products until you check with your doctor.

Safety Guidelines for Skin Stimulation

• Heat and cold can 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 injure 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 medicines that make you sleepy.

• Do not use heat or cold longer than 5-10 minutes at a time.

• Do not use heat or cold over any site where your circulation is poor, or you don’t have much feeling.

• 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. Heat can increase bleeding.

• Do not use heat over a medicine patch as this can affect how quickly the medicine is absorbed.

• Do not rub menthol products 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 over red, raw, tender, or swollen sites.

• If skin stimulation increases your pain, stop using it.

• If you are going through (or have gone through) radiation treatments, do not use any skin stimulation method without first checking with your doctor or nurse.