© Konstantin Pelikh @123rf
Manage Pain at Home
To be a caregiver for someone suffering from chronic musculoskeletal pain benefits from a certain mindset. One of selflessness, service and empathy. It necessitates a broad knowledge of medical conditions and local resources, as well as an understanding of specific patient needs, preferences, and abilities. Being a caregiver is not a position one gets into for the money or the glory, especially when the patient is a loved one. The job is as tough as it is noble.
But an emergency can quickly expose ways in which we are not prepared. Shelter-in-place orders resulting from the COVID-19 pandemic clearly pointed out just how dependent caregivers tend to be on out-of-home resources. Rather than be handcuffed by a lack of access to outside people or facilities, we have the opportunity to look within for new ways to care in place.
Sometimes the best solutions arise when we’re forced to challenge old ways of doing things. Here are seven ways caregivers can help patients manage pain, which are minimally reliant on others, during this pandemic or future emergencies. Some of these may surprise both you and your patient for their simplicity.
1. Stress management
If the mere thought of losing access to out-of-home care makes you nervous, you’ll understand why stress management for you and your patient is first on this list. Study after study have shown that stress can have negative effects on pain. There are many simple ways to minimize stress at home including diaphragmatic breathing, meditation, progressive muscle relaxation. If those aren’t your cup of tea, try Guided Imagery, a relaxation technique which focuses your senses to create a mental escape, or ASMR (Autonomous Sensory Meridian Response), an auditory approach to relaxation. You might each practice these individually, or together.
Not having to travel outside the home can also reduce stress on all parties, so consider that a small victory.
2. Socialization and support groups for chronic pain
Connecting with people—whether in person, over the fence, virtually or on the phone—can brighten spirits and help take one’s mind off pain. With video conferencing applications like Zoom or FaceTime, there are more ways than ever to connect with friends, family, church groups, or others with similar interests. Connecting with doctors and physical/occupational therapists by phone or video is also an option to get professional help without leaving the premises.
The patient’s health care professional may also have suggestions on support groups or counseling. Keeping up interactions with others experiencing the same kind of challenges, related to pain and otherwise, can make people feel less alone.
3. Exercise
Nike is known for sponsoring world-class athletes, but its “just do it” attitude applies to everyone. This is its mission statement: To bring inspiration and innovation to every athlete* in the world. *If you have a body, you are an athlete.
In other words, all of us can get moving. A person doesn’t need a gym membership or the latest athletic wear (apologies, Nike) or to leave home to be an athlete. The goal is not to set world records. It’s to be active, improve blood flow and circulation, strengthen muscles, and improve the way one feels, physically and mentally. If it sounds like physical therapy, it pretty much is. There are plenty of activities a person can do in the home, including some simple exercises involving a can of soup and towel. Gentle yoga poses designed to increase balance and flexibility are also worth considering.
4. Cut back on alcohol
A study in Pain Medicine finds that “more than 25 million adults in the United States suffer from daily chronic pain, and approximately a quarter of these individuals use alcohol to manage their pain.” While it’s true that alcohol can alleviate some pain, it has also been associated with increased risk of liver disease, heart disease, depression, diabetes, and obesity.
Of the seven ways listed here to manage pain at home, none of them cause liver disease, addiction, heart disease, depression, diabetes, or obesity. Plus, cutting back on drinking will save a few bucks.
5. Interferential Therapy (INF) and Neuromuscular Stimulation (NMES)
Physical therapists often use INF in-clinic to relieve pain, and NMES to reduce muscle spasms, and improve blood flow. Some of these devices, categorically called TENS units (Transcutaneous Electrical Stimulation), are available for home use. To use them, patients place electrode pads on their skin and the device transmits electrical impulses through the skin. High-frequency INF penetrates deep into muscle tissue, stimulating nerves to release endorphins and enkephalins, the body’s natural pain relievers. But, you won’t find INF on all TENS units, such as those purchased over the counter. Be sure to look for one that has high-frequency INF. It can be used whenever the need arises, right at home. Treatment takes about 30 minutes and many patients use the device while watching TV. It’s a low-impact and non-addictive way to treat pain and stimulate muscles.
6. Track pain levels
Is the patient feeling better or worse than yesterday? How about a week ago? Or a month ago? Keeping track of how a person feels on a daily basis can be helpful. And if notes are also made about use of any pain management techniques, such as those described here, then overtime you will gain understanding about which treatments are working and which are not. The simple act of writing down pain levels before and after a treatment can inform your plan and motivate action. The VA uses this straightforward tool, the Defense Veterans Pain Rating Scale, to measure pain, but there’s no wrong way to keep track.
7. Get some fresh air, at least a little
Even with social distancing it’s still possible to get outside. Changing perspective by leaving the home can help check off other items on this list. Go for a walk (#3), talk to neighbors (#2), breathe in the fresh air (#1). Even getting out just for a drive and a change of scenery can be quite therapeutic.
You may have noticed that this list doesn’t include opioids. As studies have shown, opioids are not a magic cure-all. While opiates help relieve acute pain, they should be a temporary solution and discontinued or minimized if possible for chronic conditions. The risk of side effects and addiction can outweigh potential benefits, and add stresses to both patient and caregiver alike.
This emergency, the COVID-19 pandemic, has affected everyone. It also has given us the opportunity—some might say it’s forced us—to take another look at how we provide care. Perhaps you’ve learned that managing pain at home doesn’t have to mean being stuck at home in pain.
Hopefully, these seven tips for managing musculoskeletal pain at home are helpful. There are countless other options to consider. Who knows? Now that the pandemic is behind us, perhaps at-home pain management will be a better supported part of our new normal.
Source: RS Medical