Managing Chronic Pain

“Have compassion on me, Lord , for I am weak. Heal me, Lord , for my bones are in agony. I am sick at heart. How long, O Lord , until you restore me? Return, O Lord , and rescue me. Save me because of your unfailing love.”
Psalms 6:2‭-‬4 NLT

Deliberation by Mario Sanchez Nevado

For years my total body pain never went below a level 6, and many days it was higher. My “flare” meant that I had a level 9-10 pain for hours to days. Through much trial and error over two years, I learned to manage my fibromyalgia, endometriosis, and migraine pain. It took me a little over four years to be in remission from these conditions (symptom free and medication free).

My background as an Occupational Therapist and years of research on this topic, helped me to navigate this difficult process. I want you to share with you what I have learned, and what I wished someone would have taught me.

The following is how I treated “root” causes of systemic inflammation. In addition, is my trial and error approach to disseminating what kind of pain I was in, and how best to treat it. If I was unable to know what triggered my pain or to prevent it, then I had to put on my “band-aide” approaches.

Tip: I suggest getting a pain tracker app for a short period of time, as you are doing your trial and error testing to see if the treatments you implement help or make things worse. After you get some answers, I recommend deleting the app, as focusing on pain only heightens the sensation of it.

What Is Causing This Pain?

Many things can cause inflammation, such as sleep-wake disorders, stress and an overactive hypothalamic pituitary adrenal (HPA) axis in the brain, unresolved disease processes, and inflammatory foods. To treat pain fully, I needed a multifactorial approach (aka attack pain from every angle). I addressed all of these areas.  

Sleep-Wake Disorders

Sleep-wake disorders are common with people who have chronic pain. It is very important to address this (please see my article Managing Sleep Disorders). Dr. Ginevra Lipton of the Frida Center for Fibromyalgia believes that sleep is one of the most foundational triggers of fibromyalgia (Liptan, 2016). “Sleep deprivation in healthy individuals can cause symptoms of fibromyalgia, including myalgia, tenderness and fatigue, suggesting that sleep dysfunction might be not only a consequence of pain, but also pathogenic” (Choy, 2015).

Chronic Stress

Stress, chronic stress, anxiety, depression, and trauma need to be addressed in order to treat pain. Chronic stress and trauma actually change the brain (Gupta and Silman, 2004). It is important to remedy this, as it is a “root” cause. For years, I neglected this area because I didn’t think I had stress, and I buried my trauma (car accident, abusive relationships, and dealing with chronic illness). I only hurt myself by doing this and prolonged my own suffering. I highly recommend seeking out mind and body medicine practitioners or techniques (please see my Coping with Stress article).

Treating Co-Infections and Healing the Gut

It is important to treat the underlying conditions, if it is allergies or co-infections, such as epstein barr virus, lyme disease (bacteria), candida, SIBO, gut issues, etc. Until I really addressed root inflammatory issues, inflammation persisted no matter what changes I made. Please find an integrative or functional medicine MD or NP who listens to you, in order to address underlying disease processes.

Food is Medicine: Avoiding Inflammatory Foods, and Boosting Nutrition

As for diet, there is overwhelming evidence that certain foods can cause inflammation in the body. These include gluten and grains, dairy, legumes (soy), added sugar and artificial sweeteners, processed food chemicals, eggs, alcohol and coffee, nightshades, nuts and seeds; with gluten and dairy being two of the most offensive for many people with chronic illnesses (Ballantyne, 2013).

I suggest trying an elimination diet, such as the Autoimmune Paleo (AIP) and then slowly reintroducing foods to see which ones are triggering your symptoms. To do this, you would also need a system in place to track your food and symptoms, such as a food journal. This is a short-term process. The AIP diet isn’t just about removing inflammatory foods, but also maximizing nutrient dense foods into the diet to heal the body.  

The Science Behind the AIP Diet

The science behind this diet suggests that our stomachs become compromised over time, as a result of processed foods. This change in the stomach lining allows for small undigested food particles to filter through and enter our bloodstreams. This leads to systemic inflammation, which is believed to be the root many autoimmune diseases.

Note: Any therapeutic diet is meant to be a TEMPORARY means to facilitate and maximize healing. As I am improving and am symptom free, I can gradually add more foods back into my diet that aren’t causing any symptoms, such as nuts, chickpeas, occasionally rice and quinoa, etc. Overall, the AIP diet taught me to increase my vegetable intake and what foods contain the most nutrition.

In order to truly prevent pain, or to have it fully disappear like mine has, you need to address sleep, stress, underlying diseases, and diet or nutrition.

My Experience with Medications

I was unable to tolerate any of the traditional “fibromyalgia” medications. I took Gabapentin (long-term use is linked to dementia), which worsened my fatigue, and gave me nystagmus and severe dizziness. I also tried Lyrica (very expensive), which worked initially but then stopped working after six months. When the dose was increased, I had the dangerous side-effect of suicidal ideation. My experience with Cymbalta was that it didn’t work at all, and it gave me depression. I tried several other medications that didn’t work at all to alleviate the pain.

Medication That Did Work With Little to No Side-Effects

My integrative NP prescribed me Low-Dose Naltrexone (LDN) in 4.5mg for fibromyalgia. I was on that for two and a half years. It really helped to control pain and to sleep at night, without side-effects (research on Low-Dose Naltrexone and fibromyalgia). This drug can be harder to get, if a doctor isn’t educated it about it. It also needs to be filled at a compounding pharmacy. Insurance doesn’t cover LDN (around $70 for a month supply).

How I Used Opioids

About 1-2 times a month, I would also take a ½ or one Vicodin 5-300mg. I only did this if a pelvic cysts burst, if I had above a level 8 pain for over 4 hours, or a massive migraine. I would not have survived without Vicodin! I remember countless times being so delirious from pain. I knew if I went to the ER, no one would help me. They would think I was “drug seeking.” So I lay there, sweating, panting, and wanting to die, so the pain would stop. It’s by the grace of God that I survived it, and Vicodin.

I’m In Pain, Now What Do I Do? (Band-aid Approaches)

Step 1.) Distinguish what kind of pain you are in. What is the sensation of your pain? We are trying to determine if the pain is primarily nerve or muscle pain, as we treat them differently. I do not address joint pain in this article, as I was diagnosed with fibromyalgia (although some tips would help: sore joint rub, cold, and active movement). I recommend trying to find a PT or OT that knows how to do physical manipulations for pain, such as myofascial release, craniosacral therapy, feldenkrais, etc.

Step 2.) Apply one of the following tips. Keep a record of what worked and what didn’t.

Nerve pain will feel like: stabbing, burning or hot, tingling, or shooting. This could also be a tendonitis, which may need to be ruled out by your doctor.

Tips to alleviate nerve pain:
1. Cold– If the pain is localized, or in one spot, hold an ice pack wrapped in a towel on the location. Leave it on for no longer than 8 minutes depending on how cold it is, and if it is tolerated. You can rest for 10-15min and apply again, if you felt that it helped you. I personally can only tolerate about 3 minutes, because I have Raynauds. Please use your best judgment…if you are going numb or the pain increases, take the ice pack off.  

2. Hypericum Perforatum pellets by Boiron- are awesome for full body on fire sensations. You can buy this at Walmart, Amazon, or any health food store. It comes in different doses, and I used the strongest one of 30c. I used this as an alternative to Lyrica and Gabapentin, which I had horrible side-effects to. Click here for research on this ingredient and nerve pain.

3. Chiropractor– can help with nerve pain, including headaches and migraines. I
have muscle spasms in my neck, and I ask that my chiropractor does not adjust
that area. Instead he uses a tool called an Activator on my neck, which I like.

4. Reiki– a really gentle way to decrease heightened arousal and pain. After I
fractured my spine in an auto accident, a friend performed reiki on me weekly. It
really helped not only with the pain, but also the trauma of the accident. I would visualize angels or Jesus healing me during this time, and find it very peaceful.

5. Craniosacral therapy– helped me a lot with migraine pain, nerve pain,
dizziness, and nausea. I was lucky, in that I found a Physical Therapist named Dr. Sylbie Hodas (in Buffalo, NY) who could take my insurance to perform this technique on me. You could also try it using a CranioCradle.  

6. Nerve glide exercises– perform with ease and move slowly..DON’T OVERSTRETCH

Sciatic and hamstring glide

Arm and neck glides

Cat-Cow Pose for the spine

Avoid: heat and overstretching (can pull on already tight nerves or tendons)

FYI: I have had times where a bath made it worse and times it made it better, but I would try other things first.  

Muscle pain will feel like: aching, ripping, throbbing, tight, stiff

Tips to alleviate muscle pain:
1. Heat– using a heating pad, or bath is great for this kind of pain. I also include a cup of Epsom salts with doTERRA therapeutic essential oils (7 drops of lavender, 5 drops of rosemary, and 2-4 drops of peppermint).

As a doTerra Wellness Advocate, I can give you information about how essential oils can impact your overall health, and guide you to meet your wellness goals. If you are interested, please contact me HERE!

2. Massage, massage, massage!!! I was often too weak or fatigued to massage myself, and didn’t always have someone to help me.

FYI: Buffalo, NY friends, I saw an amazing massage therapist, Melissa, once a month. She is located in the South Towns.

Below are some suggested tools that I have used. You can control how much pressure or force you apply.

3. Badger Rubs– I used these rubs every night on my entire body for four years. I would not have been able to sleep without them! I preferred the cayenne and ginger, sore joint rub. It decreases muscle pain immediately! (Use with caution if you have nerve pain too!)

Sore Muscle Rub

Sore Joint Rub

5. Arnica montana pellets by Boiron- for systemic inflammation. These are found in
Walmart, Amazon, or any health food store. It comes in different doses. I use the
strongest 30c. I didn’t leave the house without this!

6. doTERRA Deep Blue- is a combination of Wintergreen, Camphor, Peppermint, Ylang Ylang, Helichrysum, Blue Tansy, Blue Chamomile, and Osmanthus therapeutic grade essential oils. I would use this for muscle pain acute and chronic. (Tip: start by applying a light layer of the cream to see if it is well tolerated, or if using the oil make sure to dilute it with a carrier oil like coconut oil). Can shop HERE!

7. Lifewave Icewave patches– use phototherapy to treat pain. They come with a
booklet on where to apply patches for different pain locations: whole body,
headache, etc. These are very gentle. They were hit or miss on effectiveness for
me. If I caught a migraine fast enough, they were awesome!

8. CBD (internal) oil– I personally did not get any pain relief from various internal
CBD oils that I tried. However, that doesn’t mean it won’t work for you, and it is
definitely worth a shot. I would recommend Kat’s Naturals, which uses organic
hemp. I still use their Relax liquid bottle to help with stress and insomnia (which indirectly helps with pain). I would also recommend Charlotte’s Web CBD, which is
what my doctor has given me, and is a well respected brand for high quality.   

CBD (topical) capsaicin cream by Kat’s Naturals– So freaking awesome! Takes
muscle pain away rapidly.

9. Physica Energetics Inflamma Life Force
This product is great for daily use to decrease systemic inflammation. I used it for
years, as prescribed by my doctor. I used it in place of NSAIDS (Advil), which destroyed my stomach over the years.

 10. Acupuncture

11. Repositioning, Posture, and Strengthening– Muscles can become sore from lack of use or muscle weakness. It is important to continually move throughout the day
so that they don’t become stiff, be aware of your posture to decrease neck and
back pain, and to work to incrementally strengthen your muscles. Weaker
muscles can result in overstraining and misalignments, and is common with
injuries (ex. throwing your back out).  

12. Cold Laser Therapy– I saw a Physical Therapist (in Buffalo, NY), Dr. Susan Bennett, who uses this device to reduce inflammation to nerves, muscles, and joints! It is awesome!

Avoid: Cold can increase muscle tension, aggressive massage (only do what is tolerated), sitting or lying down for long periods of time, or over exerting yourself.

Tools for Coping

Freedom from pain is possible!
  1. It sounds simple, but the poem “This Too Shall Pass” by Helen Steiner Rice helped me to cope with severe pain. The truth is that even if the severe pain lasts for days, there is usually a day or time where it will let up. That is what I focused on.
  2. Breathing exercises help to decrease the HPA overactivity and mantras (please see Resource Guide).
  3. Positive and uplifting music really helped me on the days, when my symptoms were severe. Please see Soul Food to get my playlist “Going to war over suffering.”

References

Ballantyne, S. (2013). The Paleo Approach: Reverse Autoimmune Disease and Heal
Your Body.
Las Vegas, NV: Victory Belt Publishing.

Choy, EH. (2015). The role of sleep in pain and fibromyalgia. Nature Reviews
Rheumatology, 11(9), 513-520. doi:10.1038/nrrheum.2015.56

Gupta, A., & Silman, A. J. (2004). Psychological stress and fibromyalgia: A review of the
evidence suggesting a neuroendocrine link
. Arthritis Research and Therapy, 6(3),
98-106.

Liptan, G. (2016). The Fibro Manual: A complete Fibromyalgia Treatment Guide for You and Your Doctor. New York, NY: Ballantine Books.

Copyright @healingfaithfully 2019.

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