MASSAGE THERAPY

Ahhhhhh...a rub down, what bliss. There may be more to massage than bliss. Massage helps pain by reducing muscle spasm and relieving soreness. In addition, massage has been found to be an excellent stress reliever. Massage is often called "body work" and there are practically hundreds of ways to do this body work. Many practitioners use a variety of massage techniques rather than just one method. The techniques of massage are based on the use of pressure or friction to alter the muscle and soft tissue structure.

When looking for a massage therapist, ask about licensure. Most states require a license to practice. Choose a therapist who has a relaxing and quiet work environment. Ask others if they have used a particular therapist. Word of mouth is a good bet. Sessions last anywhere from one hour to one-and-a-half hours.

RELAXATION

Relaxation can help reduce pain. When you're in pain muscles tend to become tight and tense. When you tighten muscles in the painful area, they usually hurt even more. Relaxation training can reduce pain by reducing muscle tension and anxiety. There are many different ways to relax the body but we are introducing you to two methods that can help you reduce muscle tension. These two methods are breathing retraining and progressive muscle relaxation.

Breathing Retraining: When you are in pain or under stress, breathing often becomes fast and shallow. Unfortunately, this type of breathing tires out the muscles of the chest and shoulders, and can cause the rest of your muscles to tighten. By slowing down your breathing rate and using muscles in your stomach area rather than your chest area to breathe, you can relax all of your body muscles. Breathing retraining is a basic step in most relaxation methods.

Progressive Muscle Relaxation (PMR): By tensing and then relaxing specific muscle groups you can relax your whole body with PMR. There are a few things to keep in mind when doing PMR. First, don't tense the muscles to the point of pain or spasm. Just tense them enough to feel some tension (about 30-50% strength) and then relax the muscle completely and quickly. Second, if your mind wanders to worries or other things during the session, focus your attention back to the feeling of your muscles and the voice on the tape. Third, continue to breath slowly throughout the practice using the breathing method you just learned. Finally, don't worry if you don't feel completely relaxed at first. The more you practice the more quickly you will learn to relax.

EXERCISE AND ACTIVITY PACING

Why is pacing physical activities so important? When you first begin to have pain, you may try to "take it easy" on the painful area until it heals. After a few weeks, however, your doctor may suggest that you find ways to increase muscle strength and flexibility through exercise. Many people find themselves either remaining less active because it hurts to move or they get frustrated with too little activity and push themselves to use the injured area even though it hurts. Both over-activity and under-activity, or no activity, can slow the recovery process. The results of over-activity can be a sudden increase in pain that may last a couple of days before the pain returns to a normal level. This may be due to increased swelling, muscle spasms, or nerve irritation. On the other hand, if you are inactive your muscles get "out of shape" or "deconditioned." By pacing your daily activities, you can gradually improve your ability to move around without causing pain flare-ups or set backs. Therefore, you will get more done by pacing activities because you won't spend as much time in extreme pain that can often stop you from doing daily activities. Over time, you can recover better if you gradually increase your physical activity levels.

Balancing exercise and pain: When you are in pain it is often difficult to imagine how you will start exercising again. You may think that if an activity hurts, such as walking, it means that you are causing more harm to your body. Most physicians agree, however, that keeping muscles strong and flexible increases the body's healing process and can decrease pain over time. This is because when muscles are not used enough they become shortened and weak, or "deconditioned." Deconditioned muscles are not as flexible or able to support your weight and can become sore very easily. Other common problems related to too little exercise are trouble falling asleep, weight gain, and an increased chance of straining muscles.

Exercise may be as simple as a walking, swimming, or a stretching program. Some physicians may also suggest specific physical therapy exercises. Before you start an exercise program, always talk to your doctor about what kind of exercise you should do and if you have any physical limitations.

How to pace your activities:

1. First, while doing your daily activities (walking, housework, or computer work) notice when your pain starts to increase somewhat more than 2 points on a 10 point scale. That amount of time or work will be your starting limit.
2. Once you know where your limit is for each activity, try to stick to that limit and do not overdo yourself. For example, if you have a 10-minute limit for washing dishes or mowing the lawn, after 10 minutes either take a break or change to another activity that uses different muscles. Try to work to your set limit and not to the point when the pain forces you to stop.
3. Gradually increase the amount of time that you are doing physical activities and decrease the length of your breaks.

Helpful hints for pacing your activities:

1. Break activities or work into smaller parts rather than plunging into the whole day at once.
2. Use an alarm clock or kitchen timer to remind yourself to take a break.
3. Write down a daily schedule to plan out how to pace your activities over the week.
4. Notice any physical feelings that may signal the start of a pain flare (e.g., muscle strain, tension, spasm) and use that signal to take a break.
5. Alternate more physical tasks (mowing lawn) with less physical tasks (looking at mail). Rest does not necessarily mean doing nothing.

Example:

ALTERNATIVE THERAPY

Complimentary medicine and alternative medicine, or holistic therapies, cover a wide variety of practices. If you decide to investigate a complimentary or alternative practice for the treatment of your pain symptoms, here are some helpful steps.

• Before trying any alternative or complementary methods of therapy, ask your practitioner to help you investigate as thoroughly as you can to make sure that the pain won't worsen. Work with your practitioner to document any effect--good or bad--of the proposed therapy.
• Be aware that there may be possible problems with taking certain herbal remedies with medication and treatments that your physician has prescribed. For example, taking some herbal remedies along with medicines prescribed by your doctor may cause unwanted side effects, or may reduce the efficiency of the medication that your doctor has given you.
• Always ask whether any treatment you are considering has been properly evaluated, no matter how dramatic the recommendations. Also, ask about the possible side effects that you might experience with the alternative therapy, or if the therapy might interfere with treatments that your doctor has prescribed.
• When you hear stories of the effects of a treatment, you should remember that enthusiasm is no substitute for proof that the treatment works. Doctors have known for years that some people, often as many as 30-50%, will feel better when given a "sugar pill." This is known as the placebo effect. On the one hand, the placebo effect shows us how our beliefs and expectations can affect the way we physically feel. On the other hand, the placebo effect makes it difficult to know whether a treatment really works before it has been scientifically tested.

Be very cautious if:

• Someone tells you that you must stop all medications or treatments with your doctor for their therapy to work;
• Products promise to cure quickly;
• Case histories are used to prove a claim for a treatment, potion, herb or device for medical problems considered incurable;
• Advertisements or sales promotions for potions or treatments that claim to cleanse the body of poisons and toxins or strengthen your immune system with secret formulas.

It may sound silly, but some foods and drinks may change the amount of pain you have. In order to recognize a basic pattern, keep a food diary that will allow you to note the food you eat as well as your pain levels. Be sure to note any relationship between the food you eat and your pain levels around the time of meals.

For example:

Caffeine: Caffeine can be helpful for a few types of pain problems. When taken with aspirin or acetaminophen it seems to make them better at reducing pain. However, when caffeine is taken in great quantities and/or on a daily basis, it can actually be the cause of headaches and increase other kinds of pain. If you need to reduce caffeine, you may feel a "craving" for it because it is addictive. Reduce it gradually over 2-3 weeks.

Caffeine Content of Common Beverage
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Beverage Measure Caffeine (mg)

Coffee
Brewed, ground 8 ounces 80-200
Instant 1 teaspoon 50-60
Decaffeinated 1 teaspoon 2-5

Tea
Brewed 3 minutes 36
Brewed 5 minutes 46
(regular bag) 20-100

Soft drinks
12 ounces 43-65
Several sodas have additional caffeine in varying amounts.

Hot cocoa
8 ounces 5-10
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Alcohol: Because alcohol expands the blood vessels, it will increase existing headaches and can trigger migraines. If you drink alcoholic beverages before sleep, it will disrupt your sleep pattern by shortening deep sleep and dream stages. Alcohol is not a good pain reliever and can have bad effects on other parts of your body. Use of alcohol with prescription medications is a dangerous mix.

We have tried to make the How's Your Health error-free. However, those involved in its preparation can not warrant that all of the information is accurate and complete. When you use How's Your Health as a guide for your health and medical care, be sure to discuss any questions about it with your doctor, nurse, or other health care worker.