Some of the more common types of relaxation strategies include: ● Guided imagery: Is founded in the knowledge that the body and mind are connected (Elliott Patricolo, LaVoie, & Slavin, 2017). Though not well understood, it is believed that guided imagery may involve changing how the mind perceives pain (Elliott Patricolo et al., 2017). The client imagines a pleasant experience or a soothing environment; the mind becomes absorbed in this task rather than focusing on potentially painful and anxiety-producing stimuli. ● Deep breathing : Also known as abdominal breathing . A review of the literature suggest that pain influences Biofeedback Biofeedback is a treatment modality used to control breathing and heart rate. Clients can improve understanding of the mind/ body connection by making pain visible (Krishnan et al., 2018). An individual learns to control their body and relax muscles. With this control, the fear of pain decreases, which in turn reduces the stress caused by pain and finally, reduces the perception of the pain. (Krishnan et al., 2018). The three most commonly used biofeedback approaches are as follows: 1. Electromyography (EMG) : Which measures muscle tension. 2. Thermal biofeedback : Which measures skin temperature. Hypnosis Hypnosis is a noninvasive therapeutic technique where clinicians make suggestions that are designed to relax and focus them. In a recent study, Del Casale et al. (2015) proved that hypnosis has the ability to alter the perception of pain. These authors reviewed functional neuroimaging studies that looked at pain perception under hypnosis. While changes were seen in all areas of the brain and pain network, the anterior cingulate Cognitive behavioral therapy Working with mental health professionals such as psychologists and psychiatrists is an option for those with severe anxiety and phobias. CBT is one technique that is used and is supported in the literature. The mechanism behind CBT is changing a negative or harmful thinking pattern. Thinking is the cognitive part, and the clients actions are the behavior part (Ma, 2017). CBT is a psychotherapeutic approach that encourages the client Conclusion Pain is often mysterious and often misunderstood. Pain is challenging and offers no simple solutions. Clients with the same diagnoses will present differently and need a customized intervention approach. The healing process starts with attempts to compassionately understand all the factors that affect pain and the ways in which pain disrupts the client’s quality of life. Effective pain management requires a thorough understanding of pain neurophysiology, specific diagnoses, and symptoms. The journey of pain management concludes with identifying evidence-based, individualized, and collaborative treatments Resources Organizations ● American Academy of Pain Management A nonprofit association for pain physicians. See Patient Center for helpful links such as Get the Facts on Pain, Patient Education, and Position Statements on such topics as ethics and medication use. www.painmed.org/PatientCenter/Main.aspx ● American Pain Society The mission of the society is to bring together a multidisciplinary community to “increase the knowledge of pain and transform public policy and clinical practice to reduce pain-related suffering.” They provide continuing education services and advocate to improve the recognition and treatment of pain. www.americanpainsociety.org
respiration and paced, slow breathing is associated with reduced pain. The mechanisms underlying this effect however, are not well understood (Jafari, Courtois, Van den Bergh, Vlaeyen, & Van Diest, 2017). ● Progressive relaxation : Involves tensing and releasing successive muscle groups while focusing on the differences in sensation that occur (Charalambous et al., 2016). Once learned, this technique can be used to relax muscles at the first signs of tension. Progressive muscle relaxation has been found effective in controlling pain (Charalambous et al., 2016). 3. Neurofeedback or electroencephalography (EEG) : Which measures brain wave activity. While there is no conclusive evidence to support the effectiveness of biofeedback, there are data that support the analgesic potential of this intervention (Castelnuovo et al., 2016). Simple and affordable biofeedback devices can be purchased for home use or as a smartphone application. These devices typically measure temperature, heart rate, and breathing rate. A practitioner does not need to be certified in their use to incorporate these devices into an interventional or educational session. cortex was fundamental in modulating pain perception. There is some evidence to support the use of hypnosis with clients who experience chronic pain. Studies have been completed on pain associated with cancer, low back pain, and arthritis, and each has demonstrated a reduction in chronic pain symptoms (Pierce & Kristevski, 2016). to identify negative thoughts, stop negative thoughts, practice using positive thoughts, and develop healthy thinking to help break the pain cycle (Ma, 2017). In a systematic review of the literature, CBT is found to prevent pain from becoming chronic, to decrease the number of days absent from work, and to reduce the intensity of the pain when provided in both individual and group formats (Castelnuovo et al., 2016). that enable healthcare professionals to be more effective in treating pain. While individuals have the right to adequate pain relief, the decision to implement an individual client pain management plan is discretionary for each hospital, clinic, and health professional. However, the importance and practicality of ongoing communication and care of the client throughout the rehabilitation process is paramount. Taking the time and making the effort to incorporate such a plan can bring rewards by developing trust and lasting lifetime relationships with clients and their families. ● American Society of Pain Educators A nonprofit professional organization focused on the education and training of healthcare professionals to become certified pain educators (CPEs). Pain educators include multiple healthcare professionals (including occupational therapy practitioners) who provide pain education to clients, staff, families, and communities. www.paineducators.org/ ● International Association for the Study of Pain (IASP) A professional forum promoting the study of pain. Resources include pain terminology, FACES Pain Scale, and links to pain journals (including Pain, the official journal of IASP.) www.iasp-pain.org/ ● National Institute of Neurological Disorders and Stroke Chronic Pain Information Page
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