Self-management tools

What is Self-Management?

Are you under the impression that chronic pain controls your life? Given that medical science doesn’t yet have the best solutions or means to help you, self-management could help you manage and control your pain. Waiting for someone to take care of your condition is essentially putting your life on hold. Self-management strategies allow you to take control of your pain while also preventing an increase in your pain levels during these waiting times. These strategies help you modify your pain, which can help improve your day-to-day life.

“Self-management” means using strategies to come with chronic pain and to reduce its effects. It can help you take control and experience a better quality of life in spite of chronic pain. It also helps you take an active part in managing your chronic pain, rather than relying entirely on health are service providers to treat it.

Self-management teaches you to accept chronic pain as a part of your life and to learn to live with the condition. This means acknowledging the biological, social and psychological impact of chronic pain on your life and knowing that you have the power to improve your situation.

There are a variety of strategies and tools available to manage your chronic pain. Different tools can be used at specific moments in your life. Some, like stretching and relaxation exercises are performed on a regular basis to prevent intense pain flare-ups. Others, such as switching your internal dialogue and self-affirmations may help when pain levels start to rise. The goal of chronic pain self-management is to know how to use the tools at your disposal when you need them the most. These tools may help reduce pain and allow you take an active part in what is important to you.

When learning how to manage your chronic pain, you will focus on what you can do rather than what you can’t do because of your pain.

Why is it important to learn to accept your chronic pain?

Over the past 10 years, studies have shown that accepting chronic pain as a part of life reduces pain levels, pain-related disability and emotional distress.

Acceptance is an ongoing daily process that involves:

To acknowledge the need for help;
To get a diagnosis;
To acknowledge that there is no cure;
To acknowledge that it could be worse;
To redefine what is normal.

Dr. Diane Lachapelle and her colleagues studied 45 cases of women (aged between 23 and 75 years old) living with arthritis and fibromyalgia who wanted to understand the acceptance process of their chronic pain. These women did not like the word “acceptance”, because it meant for them to “abandon” or to “surrender”. They preferred terms such as ‘understand’, ‘coping with’ and ‘taking responsibility’. Participants described acceptance as taking an active part in life and taking control, despite their pain while still hoping that it will lessen, yet also realizing that the pain is chronic.

Different Types of Exercises

Occupational therapists and physiotherapists rely on exercise as part of the treatment plan. They may prescribe some specific exercises that may help improve:

Tissues healing;
Movement;
Strength;
Knowledge of one’s body;
Motor control;
Function;
Neurophysiological patterns that are related to movement;
Self-efficacy;
Weak or tired muscles;
Abnormal activation models.

Stretching

A therapist may prescribe exercises to stretch your conjunctive tissues and muscles. Specific stretching exercises may help reduce your fear of performing certain movements. Stretching exercises may also help counter the effects caused by old protective muscle responses.

Strengthening and Motor Stability

Some exercises help strengthen deconditioned or weakened muscles. Deconditioning may have occurred before or after the injury. Sometimes, as we experience chronic pain, the nervous system becomes sensitized. With sensitization, the smallest movement may produce or increase pain; this is known as the “protective response”. Therapists will usually adapt exercises to ensure they won’t create unwanted protective responses. Strengthening exercises help to desensitize the nervous system to strong muscular contractions. Motor stability exercises focus on deep muscle stability. People living with chronic pain may have inhibited muscles. Motor stability exercises require concentration. They force the nervous system to focus on the exercise, away from pain. As with most exercise programs, the motor control exercises are gentle at first. This way, if the nervous system is sensitized, it will not perceive the exercises as being dangerous to the affected muscles.

Functional Restoration

Functional restoration programs are usually workplace-related. They are conducted by a physiotherapist as well as a multidisciplinary team. Functional restoration programs are usually workplace-related. It usually entails a cognitive behavioural approach (switching your mindset and your behaviours) as well as intense physical conditioning. The latter improves you aerobic capacity, muscular strength, endurance and coordination.

These programs are usually designed for specific patient groups, such as those living with chronic low back pain. Such programs have been successful in improving function. And to a lesser degree they may also help reduce pain.

Feeling better despite the pain involves separating pain from suffering. “I’m still in pain, but I can move better now, and it’s not as limiting anymore”.

A functional restoration program involves the following:

Repeated formal assessments of physical problems to guide, customize and monitor progress;
Psychosocial and socio-economic evaluations. They help guide and customise programs as well as manage pain, deficiencies, behaviours and results;
Multiple deficiency management programs that use cognitive behaviour techniques;
Psycho-pharmacological interventions if toxic substances must be removed from the body. They also include psychosocial management;
Ongoing outcome evaluation. These evaluations are performed according to standard criteria. Structured interviews may also be used;
A team-based approach involving frequent supervised team meetings with a physiotherapist or a multidisciplinary team.

Studies have shown that functional restoration programs that provide all of these elements may reduce the number of days off taken by some workers with chronic low back pain.

Yoga

Yoga can help people with chronic pain; yoga is not only about stretching. It includes relaxation, body awareness, breathing, gentle movements, focus and meditation. When yoga is taught by a qualified teacher, it may help relieve several aspects of chronic pain.

Embracing Self-Management Techniques

You need to learn how to treat your own injuries, diseases and deficiencies. This is referred to as self-management. Several techniques may be used to teach self-management. They may include the following:

Bio-feedback techniques help reduce muscle tension They allow you to perform gentle, coordinated movements with less pain;
Relaxation and meditation. They can help you release stress and tension before beginning a physical activity or exercise. They may also help you remain relaxed during movements and exercises;
Guided Imagery and Mirror Therapy. These two techniques help change how your mind processes information about your body awareness. Mirror Therapy has helped some people with chronic limb pain. This therapy involves moving the limb in front of a mirror. The visual feedback of the weakened limb is replaced by the “reflected” strong limb. Mirror therapy combines motor rehabilitation and sensory feedback;
Motor Imagery works just like Guided Imagery and Mirror Therapy, however it does not involve any initial movement.