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Understanding and Implementing Trauma-Informed Care for Clients in Pain: Summary 39
Exercises 1. The practice of somatics: Somatics is the exploration and experience of a story. Somatic practices provide the opportunity to be mindful of what is actually happening in the present. There might be several barriers than can reduce the effectiveness of somatic exercises: ○ Too much unprocessed trauma ○ Unsafe environment ○ Hormonal dysregulation ○ Fundamental or unconscious needs not met ○ Inflammatory diet ○ Not receptive • Reduce provoking or potentially provoking stimuli as much as possible • Following impulse: Allow the patient to get in touch with themselves a little better and encouraging patients to follow what feels right or good: ○ Example: ■ Learning to listen to appetite signals ■ Noting when their body and mind are tired • Body wake-up drill: This involves helping the client to get in connect with their body. It is also a great exercise as a general warm-up to exercise as it builds kinesthetic awareness and helps mapping/ remapping the brain: ○ 2-minute Body Wake-up Drill: ■ Stroke underneath the jaw bone, increasing stimulation from behind the skull to behind the ears to along the jaw line ■ Start by moving from the shoulder to the collar bone and sternum to the bottom of the rib bones: as if you were gently itching/ rubbing along the shoulder bone ■ Moving from the low back to the abdomen and from the hips to the navel with smooth strokes ■ Moving up and down between the sternum to the belly button • Fall matrix: Fall matrix is very helpful for those who experience chronic pain. It allows for being playful with movement and helps re-encourage positive sensation with movement. This is a more advanced exercise and not for all clients, especially for those who cannot get on and off the ground independently. Navigating appropriate exercises: If symptoms persist or increase with an exercise, consider the concepts of titration and minimal dose effect. Start small and slow, move gradually at the pace of their body by tracking their nervous system, and adjust from there. If that exercise is not a match for the client for any reason, identify what wasn’t working and consider choosing something else. These exercises are best done through a lens of curiosity and care. Feel free to tailor them according to your unique skills and clients.
Chronic Pain Chronic pain, or pain that persists for longer than 3 months, is a condition that impacts billions of people across the world. Chronic pain can be there all the time, or it may come and go. It can happen anywhere in your body. Chronic pain is one of the most common reasons people seek medical care. More than one in five adults experience chronic pain on most days or every day. Types: ○ Arthritis ○ Back or neck pain ○ Cancer pain
○ Headaches or migraines ○ Muscle pain (fibromyalgia) ○ Neurogenic pain
Symptoms: ○ Anxiety ○ Depression ○ Fatigue ○ Insomnia ○ Mood swings ○ Fear avoidance
○ Isolation Treatments: ○ Anticonvulsants for nerve pain ○ Antidepressants ○ Corticosteroid ○ Muscle relaxers ○ NSAIDs or acetaminophen ○ Topical products ○ Opioids ○ Sedatives ○ Medical Marijuana
LEARNING TIP! Chronic Pain Risk Factors: • Genetics • Obesity • Age • Previous injury • Smoking • Labor-intensive job • Stress and PTSD
The Institute of Medicine recommends an expansion and redesign of education programs, improved curriculum and education for healthcare professionals and an increase in the number of health professionals with advanced expertise in pain care. Additionally, the American Academy of Pain Medicine recommends addressing the fundamental concepts and complexity of pain, how pain is observed and assessed, collaborative approaches to treatment options, and application of
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