From the Archives: Fall 2009 issue of Lupus Now
Moving Past the Pain: Tried-and-True Alternatives to Relieve Chronic Pain
by Jenny Thorn Palter
Sharp and stabbing or dull and aching, burning or numbness or prickly tingling, a minor inconvenience or completely disabling -- whether you’re new to lupus or were diagnosed years ago, you’re probably familiar with pain, one of the most challenging symptoms of lupus to measure, as well as to manage. Pain from the inflammation lupus causes inside the body is often the first symptom people with lupus remember experiencing.
Keep It Moving
Lois Backscheider, 60, of Duluth, MN, was diagnosed with lupus nearly four years ago, although, like many people with lupus, she had sought a diagnosis for years prior to that. In 2008 she fell and broke her foot, making pain management critical. To make matters worse, she developed chronic back problems due to the fall. Backscheider also experiences pain from rheumatoid arthritis and fibromyalgia. The problem? She has allergic reactions to pain medications. The solution? Instead of becoming less active, she’s done the opposite -- and has benefited from her efforts.
Her exercise routine includes back-strengthening physical therapy, hula-hooping, and walking one to three miles daily, either outside or with a video exercise routine inside, keeping her doctors informed about each new addition. “And yoga is absolutely wonderful,” she says. “I complete an hour and a half to two hours of exercise at home before I go out and start my day. I get relief from the pain, and I can go out and get things done. It also helps combat my fatigue.”
Backscheider also takes advantage of her local Curves fitness center, where the 30-minute exercise circuit combines strength training, cardiovascular activity, and stretching. In fact, her commitment to staying active is working so well that Backscheider says she’s actually increasing the amount of exercise she gets. Twice a week she teaches a Bone Builders exercise class at a local senior living home. “Now I’m afraid not to work out every day -- if I stop, I might never move again!”
But passive bodywork also has a positive effect on her lupus, Backscheider believes. “Acupuncture can be for specific areas of pain, so since I have kidney issues with my lupus, my practitioner concentrates on that area. It’s very relaxing; when it’s over, it feels like I’ve had a massage!”
“I like the idea of taking control of my pain, rather than letting my pain take control of me,” she says.
Combining Old and New
Allan Platt, Jr., P.A.-C., faculty member and co-coordinator of the Physician Assistant Program at Emory University in Atlanta, co-wrote a book on pain called Overcoming Pain: What It Is, Why It Is, and Successful Ways to Treat It. His co-authors are his wife, Susan Platt, M.D., a physician of internal medicine for the Department of Veterans Affairs in Atlanta, and Cathy Hedrich, a registered physical therapist.
Platt says he feels fortunate to be at Emory, where the medical college curricula reflect the changing view that successful pain management must take a comprehensive approach.
“I think there is a happy medium between using medications and also using other techniques,” he says. “For example, acupuncture and chiropractic look at the whole person and offer a holistic approach to treating pain. St. John’s wort and feverfew are two herbs that have been found to provide pain relief. Deep breathing, biofeedback, meditation, behavioral changes, work, and play therapy: All of these methods can work side by side with prescribed medications and over-the-counter products.”
He says many excellent patient-oriented resources are available and that a daily pain diary, as well as pain assessment charts, will be helpful to share with treating physicians.
Platt recognizes that a comprehensive pain center can be hard to find, especially because these services don’t tend to be well reimbursed by insurance plans. He also acknowledges that it can be difficult to recognize the difference between good and bad care until you start receiving good care. But he urges anyone with chronic pain not to give up. “You can find health care providers who understand comprehensive pain management. If the pain care you’re getting is not working, then you should look for better care.”
Find consumer-friendly articles describing research in pain management treatment and therapies at Painmedicinenews.com.
Health.com offers a handy list of the five important things to track in your personal pain diary at health.com/health/condition-article/0,,20189785,00.html.
The when, where, and why of pain
Allan Platt, Jr., P.A.-C., of Emory University in Atlanta, recommends keeping a daily pain diary and a pain assessment chart that you can share with treating physicians.
“Pain can come from many sources as a warning message from your body,” he explains. “Tell your doctor if you are having your ‘typical’ pain you know is from your medical condition. If your pain is new or atypical, let your doctor know right away. You can help your doctor sort out the cause(s) by describing the seven key aspects of the pain, and a mnemonic to remember these seven aspects is ‘L-O-C-A-T-E-S.’”
- L is for Location. Where is the pain? Does it travel to another part of your body?
- O is for Other symptoms that come with your pain, like nausea, blurred vision, and swelling.
- C is for Character of the pain. Describe how the pain feels: sharp, dull, achy, burning, etc.
- A is for Aggravating and Alleviating. What makes the pain better, and what makes the pain worse?
- T is for Timing. When did the pain start? Is it constant, or does it come and go (intermittent)? If intermittent, how long does it last?
- E is for Environment. Where are you and what are you doing when the pain starts? Are you holding still or moving?
- S is for Severity. Choose a number from zero to 10—with zero being no pain and 10 being the worst pain ever—to describe how severe the pain is.
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