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LIFT WITH YOUR LEGS! Never lift with your back by bending over!!! Proper lifting techniques include bending your knees and squatting to pick up the object. Always keep your back straight, head up, lift with both hands, take short steps and hold the object close to your body. Avoid twisting your body while lifting. Tighten your abdominal muscles to help hold your back in a good lifting position and prevent excessive force on the spine. Finally lift with your legs not your back and try keeping your feet about shoulder width apart. Try to divide heavy loads into smaller parts, never strain, maintain good posture and body mechanics lift slowly and ask for help when you can. Push rather than pull when moving objects. Remember that pushing or lifting a heavy object can still cause strain on your knee joints, so be cautious. Wearing a back support belt may be beneficial when lifting, and using tools to get the task done isn’t a bad idea. NEVER TRY TO LIFT AN OBJECT THAT IS TOO HEAVY FOR YOU!

Often chronic pain makes it difficult for patients to keep active. This lack of activity along with medications such as opioids can decrease the levels of the body’s natural pain killers called endorphins. Your doctor may recommend you start a low impact aerobic exercises as part of your management tools. Exercises may include aquatic therapy, elliptical machine, and/or recumbent bicycling as tolerated, to improve cardiovascular function, core strength and flexibility. Aerobic exercises improve blood flow to and bring nutrients to painful structure. This can aid in healing, increase mobility, and decrease stiffness in painful joints and the back. When choosing which aerobic exercise is appropriate for you, you should choice low impact exercises which will not jar the spine or aggravate the joints. Always check with your doctor or cardiologist to make sure any form of exercise if appropriate for you to start especially if you have underlying heart disease. Example of Low Impact Exercises Include: Power Walking Stationary Bicycling: Recumbent bicycling it preferred over upright bikes as upright bikes can cause strain to the lumbar spine. Elliptical or Step Machines Water Therapy: Exercises in the water often allows one to be active will minimizing stress on ones back and joints, secondary to the buoyancy of the water which counteracts the affects of gravity on your body. Water therapy often allows patients to perform otherwise painful exercises. When performing an aerobic exercise you should exercise enough to increase your heart rate to the target zone which is often 20% higher than the baseline heart rate for at least 20-30 minutes. Target zone heart rates can vary widely from one person to another. It is best to start slow especially if you have not exercised regular prior and work your way up to your target zone and target time over a few weeks. Consult with your doctor to determine the appropriate level of exercise for you.

Welcome to My Pain Tools. I am Dr. Yogi. I hope you find this online patient education tutorial informative and entertaining. Knowledge is power and we hope we can inspire you to empower yourself into a happier and more functional life. So open your tool box, because we are going add a few new tools to it today.

This website is not indented for rendering medical advice or recommendations. The contents of this website and communications are provided for informational purposes only. This information should not be used as a substitute for a consultation with a qualified healthcare provider, who can meet your individual medical needs. Always consult a medically trained professional with questions and concerns you have regarding your medical condition. No patientphysician or patient-provider relationship is intended to be created by neither this website nor its creators by making this information available to you. Please read the full disclaimer before proceeding. The purpose of this online tutorial is to provide you, the patient, and your family members the tools and information needed to better understand and manage the chronic pain you or your loved ones suffer from. The economic impact of chronic pain is staggering. The annual total cost of pain from all causes is estimated to be more than $100 billion. Un-measureable is the cost and burden chronic pain places on those suffering from it. Although we may never be able to eliminate chronic pain, we can learn to live with it and overcome its limitations. You can empower yourself with the tools needed to achieve a happier and more functional life. We can only scratch the surface on some of the important topics that surround pain management. We hope that what you learn today inspires you to seek out more information. As you will learn shortly the power of laughter can be an important pain tool, and so we have tried to bring laughter and entertainment to you in this tutorial. We hope to keep you moving forward in life.

Chronic pain is a complex condition involving physical, psychological, emotional and environmental factors. A multidisciplinary approach to pain management has been shown to improve the quality of patient care, reduce the use of health care services, and overall cost of health care. A multidisciplinary team can include members from the fields of pain medicine, orthopedics, neurosurgery, neurology, rheumatology, oncology, palliative care, psychology, psychiatry, physical medicine and rehabilitation, physical and occupational therapy, social work, chiropractic care, acupuncture and alternative medicine, etc. Just as there can be many members to the multidisciplinary team, there are also many more modalities that are key to the multidisciplinary approach to pain management such as medication management, physical therapy, cognitive-behavioral therapy, nerve blocks, surgery, massage, counseling, biofeedback, support groups, spiritual wellness, and alternative treatments just to name a few. The main goals of pain management is to help you learn how to manage your pain by giving you the appropriate tools from the multidisciplinary approach to pain management, so you can achieve this goal.

A positive attitude may not solve all your problems, but it will annoy enough people to make it worth the effort. ~Herm Albright If you don't think every day is a good day, just try missing one. ~Cavett Robert It's so hard when I have to, and so easy when I want to. ~Annie Gottlier Every day may not be good, but there's something good in every day. ~Dr. Yogi The secret of having a positive attitude is not a new concept when it comes to dealing with chronic conditions, especially pain management. There have been numerous research studies showing over and over that those with a positive attitude have a greater response to treatments, report lower pain scores and show increase in function compared to those that do not. This is often difficult to maintain when dealing with chronic pain, which can often be debilitating. A positive attitude is a tool you must have in your tool box when dealing with chronic pain. Attitude is a little thing that makes a big difference. ~Winston Churchill.

Coping by definition is often referred to as “purposeful efforts to manage the negative impact of stress” With chronic pain this often refers to the efforts made to live through the pain and maintain activity and function despite the pain. Using the mind along with other pain management therapies can be very powerful in increasing your sense of control and learning to live with pain without it interfering in your well-being. Try not fight against the pain as this can be counter-productive, self-defeating, and a reflection of one's lack of acceptance of one's condition. Rather than trying to fight the pain, manage it, cope with it, and acknowledge other areas of your life you have control over. Using a coping skill is something you can control, it may not "control" your pain, but in choosing to use a coping skill, it may indirectly decrease your pain by making you feel more empowered, energetic, accomplished, etc. When trying to develop your own set of coping tools try to incorporate some key techniques that are described next. Relaxation Techniques There are many different ways to put yourself in a relaxed state of mind. One option is to place yourself in an isolated dark and quiet room, then shut your eyes while you focus on slow deep breaths. Do not let your mind wander. Find a relaxation technique that works for you. Some examples include: biofeedback, deep breathing, meditation, Zen yoga, muscle relaxation, power napping, pranayama, visualization, hypnosis, etc. Imagery Techniques Again there are many different ways to apply imagery techniques to your coping tools. Often this technique involves imagining your pain or injury as a certain physical form with size, shape and color, then changing that physical form and controlling its movements and actions. Once you get the sense of control over that object, then you can discard it, destroy it or have it fly away through the power of your imagery. Age progression/regression is a type of imagery technique. This technique involves mentally taking yourself forward or backward in time to a state where you are or were pain free and focusing on that pain free state of mind as if it were true and your reality. Diverting Focus Focus on a non-painful part of your body and then alter a sensation in that part of your body, such as focusing on your big toe and making it feel cold. This can take your mind off the sensation of pain from your primary area of pain such as your back. Optimistic View/Attitude Focus your attention on what you can do rather than on ways in which your pain limits you. As well as on what your want to do and believe you can achieve that goal despite the pain. This is a very important tool, as how we perceive our pain will reflect greatly on how we experience both psychological and physical pain and will have an impact on our quality of life. Always remember the glass is half full not half empty. People who are optimistic tend to have higher levels of endorphins which are the body’s natural pain killers. Biofeedback Although not a coping skill by definition, biofeedback is a very important treatment modality. There have been many advances in the field of biofeedback. Biofeedback “is the process of becoming aware of various physiological functions using instruments that provide information on the activity of those same systems, with a goal of being able to manipulate them at will.” There are any processes that can be controlled including: heart rate, respiratory rate, brain activity, muscle tone, skin temperature and conductance, as well as pain perception. This technique is best performed with the help of a professional such as your psychologist. The above were just a few of the tools that can be helpful when trying to cope with chronic pain. One of the hardest things to do, yet very important is persisting despite the pain. Persisting Despite The Pain We often look at function as a more important measurement of quality of life rather than pain scores in the management of chronic pain. This is because physical function and one’s ability to perform daily activities correlates more closely to quality of life than individual pain scores. It is important to set goals to move you towards increasing your function even in the face of increasing pain. It is often difficult not being able to do the things, due to pain, that we once could do. When we start pulling away from the things we love to do and start avoiding actives because of the fear of pain, we find ourselves worse in the long run. This can be the most difficult task when trying to find the balance between increasing function and activities while not increasing the pain or injuring oneself. Always check with your doctor to make sure the activities you choose to persist through are appropriate for you. Other tools to coping include proper sleep, exercising and diet. We will talk more about these topics further along in this tutorial. Like learning anything new, it will take time and practice to master these techniques. Practice them for about 30minutes 3-4 times a week. With persistence you will master the tools to coping and improve your quality of life.

Depression and chronic pain are closely intertwined. As with many other issues, depression increases pain and pain increases depression in a viscous cycle. Patients often forget to address their moods when they are trying to manage their pain. It is important to discuss your mood such as depression and anxiety with your doctor during your physician visits. Many of the pain medications available today can be helpful both in the treatment of depression while helping manage a chronic pain condition. Review your medications with your doctor and together you two can determine if adjuvant pain medications that address pain and depression are an appropriate addition to your regimen. A valuable tool for chronic pain patients with or without depression includes developing a relationship with a psychologist and/or psychiatrist. They can offer valuable insight and coping tools that should be part of the overall management of your chronic condition. Please seek immediate medical care if you ever experience any suicidal or homicidal ideations.

It has been repeatedly shown that smoking cigarettes is linked to many diseases including chronic pain. Smokers report on average 3 times more pain such as in back pain than nonsmokers. Studies have shown that woman who smoke are even more likely than men to develop back pain. Smoking increases pro-inflammatory substances increases your risk of osteoporosis, decreases nutrition to the body and leads to poor circulation, all of which can cause disc damage and increase back pain. Nicotine and carbon monoxide are just two of the many harmful substances smokers are exposed. Both of which deprive disc cells of vital nutrients and cause disc degeneration. The road to a smoke free life may be a bumpy one, however the long term benefits make the journey worth it. There are many programs and tools to help those who want to stop smoking. However the first step is making that decision yourself to quit. Talk to your doctor today to decide the best game plan to get you to a smoke free and pain free life.