10 Self-Help Tips For Pain Management

Whether your pain has just come on or you’ve lived with it for years, these tried-and-tested self-help steps can bring you relief.


1. Get some gentle exercise. Simple, everyday activity like walking, swimming, gardening and dancing can ease some of the pain directly by blocking pain signals to the brain. Activity also helps to stretch stiff and tense muscles, ligaments and joints, which can lessen pain.
It’s natural to be hesitant if exercise is painful and you’re worried about doing more damage. But if you become more active gradually, it's unlikely you will cause any damage or harm. The pain you feel when you start gentle exercise is because the muscles and joints are getting fitter.
In the long term, the benefits of exercise far outweigh any increase in pain. Also, if you avoid exercise completely, the lack of activity could lead to other problems like stiff joints, weight gain, heart disease, osteoporosis, poor balance and falls.

2. Breathe right. Concentrating on your breathing when you’re in pain can help. When the pain is intense it’s very easy to start taking shallow, rapid breaths which can make you feel dizzy, anxious or panicked. Instead, breathe slowly and deeply. This will help you to feel more in control of the situation and will keep you relaxed and prevent any muscle tension or anxiety from worsening your pain.

3. Read books and leaflets. The Pain Toolkit is a free NHS-endorsed booklet packed with simple practical advice on how to live better with long-term pain. Download the booklet (PDF) or order a copy by telephoning 0300 123 100.  Quote 403298/Pain Toolkit.
You can also download and print out a free 2012 paintoolkit calendar packed with simple reminders or day-to-day pain management.
There is also a list of suggested self-help books and leaflets on The British Pain Society's website.

4. Stay positive. Pain can make you tired, anxious, depressed and grumpy. This can make the pain even worse, making you fall into a downward spiral. Be more kind to yourself. Living with pain isn’t easy and you can be your own worst enemy by being stubborn, not pacing your activities every day and not accepting your limitations. Some people find it useful to seek help from a counsellor, psychologist or hypnotherapist to discover how to deal with their emotions in relation to their pain. Ask your GP for advice and a referral, or read this article on getting access to counselling.

5. Distract yourself. Shift your attention onto something else so the pain isn’t the only thing on your mind. Get stuck into an activity that you enjoy or find stimulating. Many hobbies, like photography, sewing or knitting, are possible even when your mobility is restricted.

6. Share your story. It can help to talk to someone else who has experienced similar pain themselves and understands what you’re going through. Pain Concern, Action on Pain, Arthritis Care and BackCare all have telephone helplines manned by people with long-term pain, who can put you in touch with local patient support groups. The healthtalkonline and youthhealthtalk websites let you watch or listen to videos of other people’s experiences of pain.

7. Get some sleep. "Many people with chronic pain dread going to bed as that's when the pain is worst," says Heather Wallace from Pain Concern. But it’s important to try to stick to a normal sleep routine so you've got the best chance of sleeping through the night. Also, "sleep deprivation can worsen pain", says Heather. Go to bed at the same time each evening, and get up at a regular time in the morning and avoid taking naps in the day. If sleep problems persist, see your GP.

8. Take a course. The Expert Patients Programme (EPP) is a free NHS-based training programme for people who live with long-term chronic conditions such as arthritis to develop new skills to manage their condition (and any related pain) better on a day-to-day basis. Many people who have been on an EPP course say they take fewer painkillers afterwards. For further details, including how to find your nearest programme, visit www.expertpatients.co.uk. 

9. Socialise. Don’t let pain mean that you lose contact with people. Keeping in touch with friends and family is good for your health and can help you feel much better. Try shorter visits, maybe more often, and if you can’t get out to visit people, phone a friend, invite a family member round for a coffee or have a chat with your neighbour. Aim to talk about anything other than your pain, even if other people want to talk about it.

10. Relax. Practising relaxation techniques regularly can help to reduce persistent pain. There are many types of relaxation techniques, varying from breathing exercises to types of meditation. Ask your GP for advice in the first instance. There may be classes available locally or at your local hospital’s pain clinic. For more information, read this article on relaxation tips.

Causes Of Back Pain

Your back is a complex structure made up of bones, muscles, nerves and joints, so pinpointing the exact cause of the pain can often be difficult.
However, most cases of back pain are not caused by serious damage or disease but by sprains, minor strains, minor injuries or a pinched or irritated nerve.
Back pain can be triggered by everyday activities at home and at work, or it can develop gradually over time as a result of sitting, standing or lifting badly.

Back pain causes include:

• Bending awkwardly
• Lifting, carrying, pushing or pulling incorrectly
• Slouching in chairs
• Standing or bending down for long periods
• Twisting
• Over-stretching
• Driving in a hunched position
• Driving for long periods without taking a break
• Overuse of the muscles, usually due to sport or repetitive movements (repetitive strain injury) 

Sometimes the pain develops suddenly for no apparent reason. Some people just wake up one morning with back pain and have no idea what has caused it.

Risk factors

Some risk factors increase the risk of developing back pain. These include:

• Being overweight – the extra weight puts pressure on the spine. Use the healthy weight BMI calculator to find out if you need to lose weight. 
• Smoking – this could be due to tissue damage in the back caused by smoking or the fact that smokers tend to have unhealthier lifestyles than non-smokers. Get help quitting. 
• Being pregnant – the excess weight of carrying a baby can place additional strain on the back.
• Long-term use of medication that is known to weaken bones, such as corticosteroids.
• Stress – it is thought that stress can cause tension in the muscles of the back, which can result in back pain.

Depression – back pain can make people feel depressed, which can sometimes result in weight gain leading to more severe pain and worsening depression.

Nick"As part of my back protection regime I always lift with slightly bent knees,if the object that I'm lifting is quite large I find that holding it close to my chest,almost hugging it, and leaning back slightly, also helps,I also find that if I have to stand relatively still for a long period,that bending my knees slightly also helps prevent any undue stiffness developing in my lower back."

Back Care At Work

Back Pain

About 9.3 million working days were lost due to work-related back pain and other musculoskeletal disorders in 2008/9. The main causes of it are poor posture or an awkward twisting movement (bending or reaching), or a combination of the two.
In most cases, the best treatment is to stay active and, if necessary, use over-the-counter painkillers. You may feel like going to bed, but this won’t help and could make things worse. The longer you stay immobile, the weaker your back muscles will become and the more they'll hurt in the long term. For tips on keeping a healthy back,  read more HERE



Sitting

If you spend a lot of your time at work sitting at a desk, make sure you're sitting in the right position in relation to your computer. If you're unsure about correct posture, ask your line manager for a workplace assessment.
If you work on a computer a lot, it's important to take regular breaks. That means for every hour at your keyboard you should rest for at least 5 to 10 minutes.


Lifting

One of the biggest causes of back injury, especially at work, is lifting or handling objects incorrectly. Learning and following the correct method for lifting and handling objects can help prevent back pain.

Here are some key points to lift safely:

• Think before you lift.
• Start in a good position.
• Keep the load close to your waist.
• Avoid twisting your back or leaning sideways.
• Keep your head up.
• Know your limits.
• Push, don't pull.
• Distribute the weight evenly.

For more information on correct lifting techniques and safe manual handling, read our guide to lifting safely.HERE

Dealing With Back Pain Out And About

When You're Shopping:

• Don't shop until you drop - take regular rests or make several short trips
• Don't overload your trolley and use a high 'tray' trolley rather than a large deep one
• Distribute your shopping evenly between both hands or hold a bag in front of you, or use a small backpack (not large or over-filled)
• Wear comfortable shoes

In The Car:

• Adjust your seat properly so your arms have a slight bent at the elbow when your hands are on the steering wheel
• Support your lower back with a small cushion or rolled up towel
• Take regular breaks on long journeys and get out of the car for a stroll and a stretch

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Dealing With Back Pain At Home

The best way to sit down is to do it without bending your back. Stand in front of the chair with one foot behind the other, almost under the chair. Bend your knees, and at the same time place your hands on the arms or seat of the chair. Lower yourself gently into the seat. A chair with arms makes this much easier.

The following can also help back health in the home:

• Make sure work surfaces are a comfortable height so you don't have to bend your back
• Use a ladder or stable chair when painting or cleaning - don't stretch too far
• Squat or kneel when cleaning the bath or reaching low shelves
• Use an upright vacuum cleaner and keep it close to your body
• Ensure easy access to each side of the bed so you don't have to stretch when making it, and kneel or squat to tuck in sheets and blankets.
• Take regular breaks from time-consuming tasks

If you have children, make sure you:

• Bend your knees to pick up a baby - don't twist
• Kneel down to talk to toddlers rather than picking them up
• Adjust the height of the cot so you don't need to bend, or choose one with drop sides
• When unloading a pram's shopping tray, always bend from the knees
• When getting into bed, sit on the edge, lower your body on to one elbow and shoulder and draw up your knees and then feet. Reverse the procedure to get out.

The wrong sleeping arrangements can put additional strain on your back. If you're experiencing back problems, you might want to try the following:

• Replace a sagging mattress
• Lie on your back with a pillow under your knees or on your side with a pillow between your bent knees
• Don't have too many pillows - they support your neck, not strain it
• When buying a bed, try any you are considering for as long as you can. Your bed should allow ease of movement but mould to the contours of your body. Don't assume a bed marked 'orthopaedic' is what you need - the word can sometimes be used as a marketing tool.

To test if a bed is giving you the correct level of support, lie on your back and slide your hand, palm down, between the small of your back and the mattress.

If you can:

• Work your hand through with some resistance, the bed support is probably about right
• Slide your hand easily through a large gap, the bed is probably too hard (or saggy)
• Hardly force your hand through at all, the bed is probably too soft

If you're in pain, the easiest way to turn in bed is to bend your knees, bringing your heels up towards your buttocks. Let your knees fall to one side and as the weight of your legs takes you over, bring through your hip and shoulder - don't twist.

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Stay Mobile & Keep Working

If you have long-term pain, it's important to keep active. If your body stiffens up it can make the pain worse, so resting is not always the best way to deal with pain.

Things You Can Do

Painkillers:
If painkillers help you, take regular pain relief. Use paracetamol as it's safer than anti-inflammatory drugs such as ibuprofen, unless you have a clear injury that occurred in the past few days. Pharmacists can advise you on pain relief and what to do if you're having side effects.

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Exercise:
Try to do gentle stretches, movements and warm-up exercises throughout the day. Take care not to overdo it. Ask your GP about Exercise on prescription schemes. Your GP can refer you to a fitness instructor at a local leisure centre who will design a fitness programme that is adapted for you.

Pace Your Activity:
Do something active every day instead of only on the good days when you're not in so much pain. This may reduce the number of bad days you have and help you feel more in control.

Osteopaths And Chiropractors Specialists:
May be able to help with short-term pain relief, but it's not recommended that you use these treatments in the long term. It’s important to be able to manage the condition yourself.

See A Physiotherapist:
Physiotherapists use a wide variety of treatments for pain. They also help with posture. For instance, if you have a painful condition, you may lean away from the site of the pain (for example, using a stick or crutch). The longer you lean away, the more difficult it is to get upright again. This can put pressure on the other side of your body and cause problems there. It’s important to use your muscles rather than relying on collars, braces, corsets, tubigrips and wrist splints.
You need a referral from your GP to see a physiotherapist. Physiotherapists are often based in hospitals, but some are available in GP surgeries.


Occupational Therapy Occupational Therapists (OTs):
These are specialists who work with people with long-term pain and give expert advice on how to carry out day-to-day activities in spite of pain. They can assess your home to identify whether devices such as stair rails could help you lead an independent life. They can also advise you on how to get back to work gradually. They can produce a 'graded return-to-work' plan for you and liaise with employers.

Work

It's important to try to stay in work. Research shows that people become less active and more depressed when they don't work. This, in turn, leads people to take even more time off. If your employer is not sympathetic you may need a letter from your GP explaining your condition.
If you've been off work, you could go back to work gradually. This is called a 'graded return'. You may start with one day a week and gradually increase the time you spend at work.
When you do go back to work, take care not to overdo it. Change your position at regular intervals and take proper breaks.

Go On A Course

The Expert Patients Programme is a six-week course for people with chronic or long-term health conditions. You'll work with health trainers who themselves have long-term health conditions. They will help you relax, develop new life goals and work on ways of building up your stamina. Together with the tutors you will develop a plan to help you live with your pain.

When To See Your Doctor

Back pain: When To See Your Doctor

Many people with back pain never need to see their doctor. But you should feel able to call or visit your GP if you're worried about your back or feel unable to cope with the pain. As a general rule, people with back pain are advised to contact their doctor if the pain is no better after about a week.

You should certainly see your GP as soon as possible if you have any of these symptoms:

• Difficulty passing urine, or if you are passing blood
• Numbness around the back passage or genitals
• Numbness, pins and needles or weakness in the legs or arms
• Pain running down one or both legs
• Unsteadiness when standing

These are associated with uncommon conditions, but ones that need treatment immediately.

Back Pain At Work

Back pain is the second most common cause of long-term sickness in the UK after stress.
About 9.3 million working days were lost due to work-related back pain and other musculoskeletal disorders in 2008/09.
The most common causes of back pain are strained muscles or ligaments, wear and tear, bad posture and stress.
Most of us will have back pain at some point in our lives. Although painful, back pain isn't serious in most cases. The pain generally lasts from a few days to a few weeks. It usually clears up after about six weeks.

Treating back pain

In general, the best treatment is to stay active and, if necessary, use over-the-counter painkillers. You may feel like going to bed, but this won’t help and could make it worse.
The longer you're immobile, the weaker your back muscles will become, and the more they will hurt in the long term.
The best ways to deal with pain and help your back to recover are to maintain your mobility, based on your usual activities, and return to work as soon as possible.
Any exercise that strengthens your legs, back and stomach will help to keep your back healthy. Read exercises for back pain for more information.

At your desk

Sitting badly in front of a computer for hours on end is storing up trouble. The body can tolerate being in one position for only a short period of time before you feel the need to adjust.
Workstation factors that can affect your back include:

• seating posture
• computer screen position
• chair height
• keyboard position
• mouse position
• desk equipment layout

If you work in an office and use a computer, you can avoid injury by sitting in the right position and arranging your desk correctly. Get tips on how to sit correctly.
If you're not sure about your seating position and workstation, ask your manager to arrange a workplace assessment for you.
Good posture when sitting at a desk can help prevent repetitive strain injury (RSI), which is a cause of back pain. Sit up straight and make sure that your lower back is supported.

Adjusting your chair

By law, workstation chairs must be stable. The standard office chair has five legs in a star shape.
The seat height must be adjustable, and the back rest must be adjustable in height and tilt. Ideally, the back rest should move independently of the seat to allow for a more comfortable position.
When you’re sitting, your thighs should be at right-angles to your body or sloping slightly down.
If your chair is properly adjusted, your feet should be firmly on the floor, but if it’s more comfortable, use a footrest. The basic rule is to plant your feet on the floor and support your back.


Take regular breaks

Don’t sit in the same position for long periods. Make sure you change your posture as often as is practicable.
Frequent short breaks are better for your back than fewer long ones. It gives the muscles a chance to relax while others take the strain. This can prevent you from becoming stiff and tense.
Most jobs provide opportunities to take a break from the screen, e.g. getting a drink, going for some fresh air, filing or photocopying.

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Stay Active

Stay Active!

The best way to deal with back pain is to stay active and continue doing regular exercise.

“The advice 20 years ago was to rest, but research has shown that inactivity only makes things worse,” says Dries Hettinga of BackCare, a charity that offers support and information to people with back pain.
“When you’re in pain you may want to stay in bed and not move around, but that results in further [loss of mobility] and will only prolong the pain.”
Staying active means continuing with regular day-to-day activities to avoid becoming sedentary. Examples include walking to the shops rather than taking the car, getting off the bus one stop early, gardening and taking the dog for a walk.
If you experience moderate pain, take painkillers that are available over the counter from your pharmacist or supermarket. Your pharmacist or GP can advise you on how to use your medication effectively.

Exercise Programme

In addition to maintaining an active lifestyle, try to exercise. You can do any activity that gives your body a good workout.
“It’s important to pick an exercise you enjoy,” says Hettinga. “If you do something you enjoy, you’re more likely to stick with it. There’s no quick fix for back pain so you need to work at it.”
Ideally, your choice of activities should involve elements of endurance, strength and flexibility. Examples include walking, running or jogging, cycling, dancing, swimming, hydrotherapy (exercising in water) and aquarobics.
Consider a variety of exercises as part of a weekly exercise programme, which could include yoga, t’ai chi, working out in a gym and sport in general.
Hettinga says exercise programmes are most effective if performed regularly and over prolonged periods of time.
Aim for at least three to five sessions a week (approximately 30 minutes each session). You may want to build this up over a number of weeks.
Hettinga says an individually designed exercise programme gives the best results. A physiotherapist or exercise professional can help you with this.

Manual Therapy

Hettinga suggests combining an exercise programme with a course of manual therapy, especially when the pain is persistent. Manual therapy is provided by chiropractors, osteopaths and physiotherapists.
“Evidence suggests manual therapies can be effective. Your back is examined to see if any joints need to be freed up.
"They can do it with a gentle massage, mobilisation or manipulation. It’s especially helpful if your back is stiff and flexibility is an issue," she says.
Manual therapists are also qualified to advise you on the type of exercises that will be most effective at dealing with your type of back pain.
“You should see improvements after a few weeks,” says Hettinga. “If the pain hasn’t disappeared after a few weeks of treatment, seek further medical advice to explore alternatives.
"There is always something that can be done about back pain, but it requires some work and dedication from you.”

Nick"I can not stress enough the benefit of keeping active when you have back problems,I mention this in various post though out this site,not because I have nothing else to say,but,because it's so important.Laying down can be an excellent way of getting relief from the symptoms of your pain problems ,and indeed I do this myself,(I find laying on my back with my feet shoulder width apart and a pillow supporting the back of my neck/head gives me almost total relief) but only as a way of relaxing.I suppose in some respects I'm fortunate, being on my feet all day and walking as far as I do as part of my job, I don't have to make any special effort to keep moving,but walking is just a part of my back care regime,I stretch, incorporating a few simple T'ai Chi moves,and as I've already mentioned I use the excellent Bodi Tek BackMagic"