Pain management session two

Pain Cycle

This weeks pain management programme was great. It was nice to get out and have some company. The attendance was slightly smaller but still good.
We started with a Recap of pain and pain processes which was useful as I’d ‘fibro fogged’ it last week without even realising it. Doesn’t take much these days to forget something, words just go in one ear, get jumbled into oblivion and come out the other ear. So I wrote it down this week. aha!

The subject, given by the physio, was long and short term pain. She talked about long term pain and how we become more sensitive to pain with decreased inhibition to movement etc. She described decreased precision, which is the concept of pain moving around. i.e. You may have back pain on the right side which then migrates to the left side as well. Much of this rang true and judging by the discussion, it did for everyone else as well. It’s nice to know that there has been thought and research put into this and theories have been developed. Its also nice to know that everyone else has the same problems. Although I wouldn’t wish it on anyone.

We then talked about the pain cycle. I tried to insert a nice design but I’m still learning. Anyway this is another well researched theory and although the pain cycle diagrams are all slightly different it goes something like this.

You get a pain > activities reduce >you get weaker and stiffer with more pain> so you do less activity >you get more pain.

She then went into detail about the boom and bust theory. we all do this, without realising or without intention. On a good day you do everything you can because you don’t know when your next good day will be. Then, the next day you are in pain and severely fatigued so you do nothing to recover and hope you have another good day soon.

So the theory is, do less on good days and more on bad days. The idea is to become time focused instead of task focused. In other words, set a time for activity instead of just your normal full task.

To do this you set a tolerance level by working out your baseline [Baseline= normal amt of time it takes to do a task ÷ 2 then reduced by 10%]

For instance, on a good day I walk the dog for 40 mins, therefore I divide it by 2 which gives me 20 mins and reduce by 10% or 2 mins. Therefore on both good and bad days I should walk the dog for 18 mins.

I should then stick at the tolerance level until there is no rebound and then step up in 1 or 2 min increment trials. Being a logical person, this makes perfect sense and I have started doing this already. It’s only been two days, so I’ll let you know how it goes.

We had a group session to discuss Planning, prioritising and pacing in relation to activities such as going to the cinema, which I think was very useful for some people. People seem to band these expressions around but I’m not sure that it is a well understood concept. Recently my thresholds have reduced and pain has increased due to several factors which I have talked about in my blog. This maybe because I didn’t fully understand it myself until recently.

Our exercise session was very gentle with varying degrees of difficulty. There was advice about the benefits of exercise on a Physical, psychological and social level.

I’m looking forward to the next session.