This is an excerpt from End Back & Neck Pain by Vincent Fortanasce,David Gutkind & Robert Watkins.
Self-Treating Chronic Pain
Chronic discomforts of the spine or neck may be annoying and severely limiting. If you have chronic spinal pain that has not been aggravated recently, here are some basic self-intervention activities to help you feel better.
By definition, if your symptoms last longer than three months, you have chronic pain. Those with chronic discomfort have a unique set of dynamics to deal with. Many with chronic pain do not report abrupt activity limitations in the way that those with acute injuries or flare-ups do. Often chronic discomfort is described as a nagging stiffness, a deep aching, or an annoying and intensely frustrating feeling. It may be constant or intermittent, and it is usually not described as sharp, severe, or lancing.
Is It Pain or Stiffness?
If the complaint is pain, the recommendation will always be to use a cold pack. Often, however, chronic discomfort is accompanied by reports of stiffness and tightness that just won’t go away. In these cases, heat may be appropriate. When muscle stiffness is the main complaint, a hot pack or heating pad likely will offer relief. Heat is the application of choice when stiffness and muscle soreness are the complaints.
Heat is advantageous because it comfortably promotes circulation to the area, thereby helping to flush the muscles of metabolic by-products that have built up over time from long-term muscle spasm. Reducing the chemical buildup in the muscle tissue can have a large effect on how you feel. True, a cold pack can accomplish this, too. But some people cannot fully relax onto a cold pack, thereby preventing the spasm from subsiding. In these cases heat is appropriate.
A typical time to stay on a heating pad or reusable hot pack is 20 minutes. You can use the heat as often as it is comfortable, so long as the skin has a chance to return to its normal color and temperature for at least 45 minutes before the next application. Obviously, the negative side effects are burns, some of which can be several layers deep if you’re not careful. As a rule, avoid using the hot pad directly at bedtime and set a timer or alarm to alert you when 20 minutes has passed. Often the heat is soothing, and dozing off is not uncommon. Unfortunately, this is how burns occur.
Analyze Your Activities
For acute discomfort, maintain a level of activity that you can tolerate. For chronic discomfort, begin by analyzing your home and work environments to identify activities and positions that are aggravating. Poor posture or movement habits may exacerbate the mechanism of your discomfort and keep the discomfort percolating. Immobilization over the long term is never the best answer. With chronic pain you will need to modify your activities and minimize those that exacerbate or increase the symptoms.
Exercise and Conditioning
There is no magic pill, but properly prescribed and consistently done exercise comes close. Remember that not all exercises are right for every condition. A little common sense mixed with professional instruction can go a long way toward developing a program that is therapeutic rather than harmful. For now, suffice it to say in most chronic pain cases, performing a stretch and exercise regimen can at least ease discomfort. A regular program can go a long way toward helping you feel better and tolerate more during the week. Perhaps the best way to begin is by choosing activities that address your overall level of fitness. Walking, swimming, and using a stationary bike are three simple activities that begin the process of improving your fitness level and easing discomfort.
Most chronic pain patients have some form of sleep loss which results in an escalation of their pain perception. The chemical serotonin acts as a pain dampener and is secreted in the deeper stages of sleep. Cortisol is serotonin’s opposite, working to ramp up the perception of discomfort. Cortisol is secreted when you are anxious, tired, or angry, three common traits that chronic pain patients express. Coincidental? Not likely.
One way to promote a restful night’s sleep is to avoid stimulants such as caffeine and chocolate late in the day. Turkey and dairy products such as milk and cheese tend to be useful late night snacks for promoting a good night’s sleep.
Stretching is another way to help calm the body into a restful mode. Long and soft stretches tend to be quieting to the nervous system, ramping down neurological input to help ease spasm and restrictive muscle pain. Stretches should be held for 60 seconds or longer and done two or three times each. The pull should be steady but conservative, well below symptom threshold. In most cases, stretching is the self-intervention that provides the most benefit for chronic pain sufferers. You can do all the stretches in designated sessions over the course of the day, or you can focus on the one or two that provide specific relief to your back or neck as often as necessary. In either case, you’ll be surprised at how much relief some simple stretching can provide.
Whether you take over-the-counter medication, change your body mechanics, modify your activity, use a lumbar belt or cervical soft collar for a brief period, begin some stretching activities, or use a hefty dose of ice for a time, you can get some immediate symptom relief through your own actions.
Read more about End Back & Neck Pain by Vincent Fortanasce, David Gutkind, Robert Watkins.