Pain Management Programs
Pain clinics and self-management programs
You may be referred to a pain management program or clinic by your doctor or specialist. These are in-person programs. Essentially, these programs teach you how to cope with your pain and give you the knowledge and emotional tools that you need to carry on coping at home.
You may see a variety of specialists within the clinic, taking part in various treatments and exercises to cater to your individual needs. This article explains that “Self-management education complements traditional patient education in supporting patients to live the best possible quality of life with their chronic condition.”
Pros
- Give you the tools to manage your pain effectively at home
- The opportunity to see a variety of specialists under one roof
- Proven results in reducing symptoms for the long term
- Commonly referred to by doctors
Cons
- Must attend a clinic regularly (need transport)
- The clinic may not be near your home
- Can be costly if being privately funded
- Long-wait times in government-funded programs
Online pain management programs
There are pain management programs available online that you can carry out in the comfort of your own home. Some programs are designed for specific conditions, and others help with chronic pain in general. The structure of programs can also vary in terms of duration (e.g., 12-week programs), pricing (free, paid, freemium), and accessibility (website, app, both).
You’ll find other programs with varying focuses. For example, the Curable app focuses on pain psychology. The Kaia app focuses on back pain and gentle exercise. Meditation apps help to bring relief through mindfulness, relaxation, and distraction.
Exercise
When you live with chronic pain, often the thought of exercise can become worrisome. It’s common to be concerned that exercising is going to worsen your chronic pain, which can sometimes lead to fear avoidance. This simply means you begin to fear movement and therefore start to avoid it.
In fact, avoiding exercise feeds into the pain cycle, leading to weakening muscles and deconditioning of the body’s general health, as well as increased stress and pain as explained in this study. Gentle regular exercise helps to keep pain at bay, strengthens the body, and helps with general health.
It’s important to pace yourself when dealing with pain, especially if you’re new to being active. You can build up the time and intensity of the exercise as you start to feel more confident. There are various low-impact exercise options you could consider.
Pros
- Maintains general health
- Increases fitness
- Builds stamina
- Prevents deconditioning
- Reduces inflammation
- Tackles fear avoidance
- Builds confidence
- Helps to manage weight
- Increases immune function
- Increases energy levels
- Aids in better sleep patterns
- Reduces pain
- Reduces cognitive issues
- Reduces stress levels
- Good for mental health
Cons
- Must be built up to gradually
- Requires confidence and willpower
- Could cause a flare
Yoga
Yoga focuses on a series of movements or postures, typically combined with breathing techniques. These movements help to increase balance, flexibility, and range of motion among other benefits. This low-impact exercise can be as advanced or as simple as you like, meaning it can be tailored to your level of functioning and comfort.
Pros
- Improves flexibility and range of movement
- Strengthens muscles and joints
- Improves balance
- Can reduce stress/provide relaxation
- Can be tailored to suit you
- Doesn’t require specific equipment
- Can be carried out in a class or on your own at home
- Low impact
Cons
- Need to practice yoga regularly, guidelines say twice a week, to gain full benefits
Tai Chi
Tai Chi utilizes calm deep breathing techniques, as within yoga. While yoga involves holding positions, tai chi involves moving your body in slow, flowing movements which are based on martial arts. As well as being good for your physical health, tai chi can aid in reducing stress.
Pros
- Can improve posture
- Increases muscle strength
- Improves balance
- Increases mobility
- Can reduce stress/provide relaxation
- Low impact
- Doesn’t require special equipment
- Can attend classes or practice at home
Cons
- Not enough research on reducing pain
Pilates
Pilates focuses on exercises to specifically increase core strength. Special equipment may be used to provide resistance to strengthen specific muscles, or to provide support while carrying out exercises. Typically, when this equipment is being used, you will be with a Pilates teacher who will guide you.
Pros
- Can increase muscle tone
- Increases core strength
- Can improve mobility
- Can improve mental health
- Some exercises can be carried out at home
- Can vary in intensity to suit your needs when working one on one, or at home
Cons
- Not a great deal of scientific research done into its effects on chronic pain
- Some exercises require special equipment
- Some classes can be high intensity
- Could cause a flare
Swimming
Swimming can be a great exercise for general fitness! It takes the weight off your joints, making it low impact and often less painful to perform movements. You can go at your own pace and choose a swimming stroke that suits you. Some swimming pools offer swimming lessons and classes for those who may need guidance and encouragement. Often aqua aerobics classes are offered; these are classes within which you are taught exercises to do in the water. The water not only takes the weight off your joints but also provides resistance to build muscle tone when doing certain aqua aerobics exercises.
Pros
- Low impact
- Can aid in preventing chronic illness
- Can suit all abilities
- Water takes the weight off your joints/can reduce pain
- Increases energy levels
- Aids in better sleep patterns
- Reduces pain
Cons
- Need to travel to a swimming pool
- Cost is involved for pool entry/attending classes
- Need to own/buy a swimming costume or trunks
- Chronic illness can make you sensitive to smells/environmental factors: may be sensitive to chlorine
Walking
Walking is a low-impact exercise that you can do anywhere, at any time. You can go right from your door, and you can control the distance you go and how challenging the route is. Being out in nature can be great for your mood and can be so much fun!
I have been through a personal journey of exercise with fibromyalgia and arthritis, starting from barely being able to walk up and down stairs without flaring and building up to going on regular hikes of up to 9 miles. I have picked up some tips along the way that can help you when you’re starting out:
- Take a comfortable backpack that is big enough to fit your supplies in, but which gives your back the appropriate support, for example, one with a chest strap to distribute weight evenly.
- Keep your backpack filled with supplies ready to pick and go, to ensure you have all you need.
- Take prescribed or over-the-counter painkillers with you in your bag, in case you need them while you’re out walking.
- Set goals that are realistic and don’t push yourself past that point even if you’re feeling pain-free.
- Take plenty of water to stay hydrated.
- Take some healthy snacks in case your blood sugar drops, you need a little boost, or you need to take your medication with some food.
- Take someone with you for support and encouragement, plus it’s more fun with a companion!
- Keep your phone fully charged and even carry a power pack in case you need to call someone.
- Use mobility aids if you have them, for example, I have a fold-down walking stick that I take with me in my bag.
- Invest in a small walking stool if you can: this is a fold-down stool you can fit in your bag to ensure that no matter where you are, you always have a place to take a rest.
- Take regular rests, even if you feel that you are doing well; allow yourself that time to catch your breath and take a drink. This will help to prevent flares.
Pros
- It’s free!
- Reduces pain over time
- Gets you outdoors
- You can go right from your door, so don’t need transport
- You don’t need special equipment unless you start hiking long distances
Cons
- Can cause a flare in symptoms
- You may require owning/buying support walking shoes, bags, etc.
- Works many muscle groups but not the whole body.
Cycling
Getting out on a bike gets you outdoors and increases your fitness levels. It can be really great for mental health, and a handy way to get around! You can incorporate cycling into your day-to-day routine, such as traveling to work or visiting a friend. Cycling is certainly a more aerobic exercise than those we have previously mentioned but is still low impact, so isn’t putting too much strain on your joints.
Pros
- Gets you outdoors
- Can be a form of transportation
- Good for the environment
- Works the lower body
Cons
- More aerobics may require an already-established sense of balance and core strength
- Bikes and equipment can be costly
- Need to take into account the cost of bike repairs in event of a flat tire etc.
- Can cause a flare in symptoms
- Focuses on strengthening the lower body rather than the whole body
- Need to be careful on roads
- Wrong bike size/frame can result in incorrect posture/injury
Dancing
You could attend dance classes, and fitness classes that incorporate dance, or you could just have a good old dance at home. Dancing can be so much fun. The music can really add to your motivation and help to boost your mood. It can be a fun activity to do with friends. There are so many dance styles to choose from, so there’s something for everyone!
Pros
- If it’s your thing, it can be really fun
- Many dance styles work the whole body
- Can be done at home with no equipment and no transport needed
Cons
- Need transport to classes
- Classes will cost money
- Often more high intensity/high impact depending on the style
- For some dance classes, you may need to buy outfits/dance shoes
Attending a gym
Many people choose to become members of a gym. There are many machines and weights to choose from within a gym, and often many types of fitness classes. You may be able to use weight machines to practice strengthening exercises, and other exercise machines to work for certain muscle groups.
If you’ve never been to a gym before you may choose to get guidance from a personal trainer who can talk you through what is safe for your specific needs and how to use the machinery.
Pros
- Lots of equipment/exercises/classes all available in one place
- Can work the whole body
- Many gyms offer classes for the other types of exercises we mentioned and have swimming pools
Cons
- Need transport to the gym
- Gym fees
- Using exercise machines and weights incorrectly could result in injury/increased pain
- May need to pay for a personal trainer to guide you
- Could cause a flare
- Don’t get the mood boost that being outdoors can bring
Precision Pain Care and Rehabilitation has two convenient locations in Richmond Hill – Queens and New Hyde Park – Long Island. Call the Queens office at (718) 215-1888, or (516) 419-4480 for the Long Island office, to arrange an appointment with our Interventional Pain Management Specialist, Dr. Jeffrey Chacko.
