Ahhh… Sweet Relief

Ahhh… Sweet Relief

From Chicken Soup for the Soul: Say Goodbye to Back Pain!

Ahhh… Sweet Relief

Healing your back takes time and patience. Many people with back pain will have nearly complete relief of their symptoms within two weeks. But, too often, the pain lasts much longer and is truly debilitating. One of the things that I spend a lot of time discussing with my patients is how in the old days doctors carried around black bags with their tools. I ask my patients, “If you had a black bag to control your pain, what would be the tools that are in the bag?” The idea of helping patients to develop their own “black bag” is really a metaphor for assisting them in identifying what tools they may be able to use at home if they have pain.

Many of my patients tell me that the worst part of having pain is not knowing how bad it will get and not having a way to control it. This worry is really fear about pain. In fact, there are a number of very interesting studies that have been done looking at how the fear of pain is often more disabling than the pain itself. So, as a medical doctor who treats a lot of people with back pain, I recognize that I need to treat not only pain but also fear.

This brings me back to my point about developing your own “black bag.” Having a black bag doesn’t mean that you don’t need to check in with your doctor. I always recommend that people get excellent medical advice, and in fact, your physician can contribute some tools to your bag. The goal is to try and not have “emergency” situations in which you are in severe pain and unable to control it. Having a black bag will not prevent every emergency situation, but it will help to prevent some of them and it will also help to reduce worry and fear about having uncontrolled pain.

Finding the Right Tools for Your Black Bag

I know from having many conversations with patients that it’s not always obvious which tools should go into your black bag. So, I start by asking them this general question: What tools do you have at home that may help you to control your pain? If they aren’t sure, then I ask them a series of questions about what has helped them in the past. Anything that helps, even a little bit, is something to consider putting in the bag.

Add a hot pack or cold pack. Moist heat, such as a hot bath or shower can also work well. Use either heat or cold or both — depending on your own experience with how these make you feel. Be careful, though, because both heat and cold can cause burns if they are used for too long or at too extreme a temperature.

Move your body. Safe movement is usually helpful to manage pain. Tools may include stretching exercises, yoga, Pilates, swimming or any other form of exercise (if it helps). Rest may also be a tool. However, it’s important to know that strict bed rest usually makes you feel worse, not better. Plus, it’s not good for the rest of your body. So, when it comes to rest, usually what doctors recommend is avoiding activities that make the pain worse, rather than going to bed and staying there for days or weeks.

Find a comfortable position during the day. Another component of avoiding exacerbating activities includes assessing what you do every day and how you might be able to get your body in a better position. For example, if you have neck pain, using the speakerphone or an earset is very helpful. If you have low back pain, a supportive chair at work and lumbar support cushion in your car is a good idea.

Find a comfortable position at night. Mattresses and pillows may make things better (or worse). The only way to know if a certain mattress or pillow will help you is to try it out. Back belts and neck braces are usually not a good idea to use as they promote stiffness and weaken the muscles that support the spine.

Lighten your load. This can mean lifting less weight (lighten your laundry basket, buy a half gallon of milk instead of a full gallon, and so on). Or, it can mean losing weight (if you are overweight). Two things that help support your “core” (your core is the middle of your body — where most neck and back pain originates) include:

1) lessening the work that the core muscles have to do to support your body by lifting less and/or losing weight; and

2) strengthening your core muscles so that they can better withstand whatever stress they need to tolerate.

Tap into your mind-body connection. Mind-body tools for your black bag may include relaxation techniques, conscious and controlled breathing, meditation, imagery, hypnosis and biofeedback.

Talk to your doctor. Your physician may recommend some tools for your bag, too. Of course, I’m talking about things that people have access to at home, so surgery or injections wouldn’t be tools for the bag, but over-the-counter and prescription medications count. You might find a TENS (transcutaneous electrical nerve stimulation) device helpful. TENS units may be used at home and are usually prescribed by doctors and physical therapists.

Take a minute to think about your own tools — you can even write down a list if you are so inclined. Sometimes it’s helpful to see on paper what interventions you actually have on hand to control your pain. Thinking about your black bag can be quite enlightening and also empowering.

Should you use heat or cold to relieve your pain?

The answer to this is — it depends. But, there are some general guidelines. First off, it helps to know what high or low temperatures do to your body. Heat acts as a muscle relaxant, so if your pain is due to muscles that are in spasm, warmth usually helps. Cold does two things — it decreases inflammation and provides an anesthetic effect (by numbing the area). So, if inflammation is a problem, then a cold pack may help. Also, it might just feel good because of the anesthetic effect. Try them both and decide which one works best for you. For the back and neck areas, it’s fairly safe to use heat as long as it’s not too hot (and causes a burn). Ice packs are fine to use for about 20 minutes, but should be taken off after that time and then reapplied several hours later if needed.

Tools that Might Be in Your Black Bag


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