Robins’ health pros offer practical tips for chronic pain management Published Sept. 30, 2016 By Holly Logan-Arrington Robins Public Affairs ROBINS AIR FORCE BASE, Ga. -- Occasional aches and pains are part of life as people age. But, chronic pain – the kind that impacts one’s ability to perform daily activities – can be difficult to endure without help. Robins Air Force Base’s health professionals in the 78th Medical Group are offering the following insight and tips on chronic pain and its effective management. Psychology of Chronic Pain Management Capt. Louis Pagano, a base Mental Health Clinic clinical psychologist, said there’s more to pain than some might think. One example of psychology’s influence in pain management is the Gate Control Theory of Pain, supported by years of research. “Things that open the pain gate and make you feel pain are: stress and tension, depression and anxiety, and lack of activity or excessive activity,” he said. “Things that close the pain gate and help you feel better are: mindfulness skills, engaging in hobbies, using coping skills and moderating or pacing your activity.” Behavioral Health Treatments that modify one’s sense of physical comfort and psychological well-being – closing the gate – may change activity and processing in the sensory cortex and limbic system, which then offers patients an increased sense of successful pain management. Pagano said Acceptance and Commitment Therapy, often called ACT, uses a set of interventions to explore one’s life direction which when someone is in pain, may be viewed as impossible. People with normal pain often believe that once symptoms are removed or decreased, they will be able to continue on with their life – which usually happens, Pagano said. Chronic pain sufferers, however, often put valued life directions on hold for a long time. Pagano said in therapy people are invited to use these life directions as a compass to both direct and motivate for the challenging work of treatment. “ACT can help you respond to painful thoughts, feelings and physical sensations about pain by helping you stay actively engaged with things that give your life meaning that chronic pain has previously taken from you,” Pagano said. Pagano said ACT helps foster a mindful and willing posture pain so that you struggle with CP less and live your life more fully. Physical side of chronic pain Capt. Cody Butler, a 78th MDG physical therapist, said physical therapy and fitness can help with chronic pain management. “Instead of striving to be completely rid of back pain, one should focus on a functional task, such as simply performing daily household chores or performing weekly fitness routines, without intense pain,” he said. Manual therapy, manipulations, massage, electrical stimulation and mechanical spinal decompression are tools to help decrease pain, albeit short-term for the most part, to help people move better, Butler added. A newer tool that’s becoming more popular is trigger point dry needling. “It’s a procedure where tight or knotted muscles are found, and a thin needle – similar to an acupuncture needle – is inserted into that muscle, causing that muscle tension to be released. A person is then able to do more movements with less pain,” Butler said. “By increasing motion and endurance, it encourages blood flow, and with that, nutrition to tissue,” he said. “For some, land-based exercises are either too painful or their bodies have become deconditioned or hypersensitive and even simple movements are extremely painful.” In those circumstances, Butler said water based aerobics could be the answer. It allows an individual to perform exercises with the help of buoyancy that they just couldn’t accomplish using weights or machines in the gym,” he said. Butler said people who have chronic pain should find exercises that work for them. Low-impact cardiovascular exercise, including biking, elliptical or rowing, followed up by a strength training program, which should target eight-10 muscle groups, especially the core is ideal. Finally, a stretching routine to maintain flexibility is crucial for improved function, Butler said. Nutrition: An ingredient for chronic pain management What people put in their bodies plays a significant role in the treatment and management of pain, said Marita Radloff, Robins Health and Wellness Center registered dietitian nutritionist. “Research shows that a balanced diet can decrease inflammation and other responses that cause pain,” she said. “However, a diet that is lacking nutrient-rich food can worsen pain symptoms and chronic pain continues.” Most anti-inflammatory diets are based on the same principles and will include the familiar markings of a balanced diet. “To manage chronic pain, it’s important that you eat an adequate amount of calories throughout the day,” Radloff said. “That helps your body maintain energy levels and a healthy weight. Extra weight puts added pressure on the joints and requires organs to work harder. Maintaining a normal weight will help you manage your chronic pain.” Spices can also help manage pain, Radloff said. “Turmeric is a spice that has been shown to be comparable to taking 200 to 400 milligrams of ibuprofen since it reduces inflammation and pain in the body,” she said. “In patients with osteo-arthritis, research has shown that signs and symptoms of the disease were decreased, inflammatory markers were lowered, and walking performance increased when turmeric was taken daily.” “Swelling, joint pain and stiffness have also been shown to be reduced when taking turmeric daily,” she added. Another spice with anti-inflammatory properties similar to turmeric is ginger, and it can be added to many foods in the form of a spice or directly from the root. For pain relief, take ginger in supplement form of 100 to 200 mg per day, Radloff said. If on a blood thinner, people should check with their doctor prior to including ginger supplements in their diet. Robins’ health and nutrition professionals agreed the management of pain is unique to each person. Proactively taking control of pain by addressing it through interventions other than the standard pain medication/narcotics, people can get on the road to a more productive, enriched quality of life.