11 Tips for Living With Chronic Pain

1. Learn deep breathing or meditation to help with chronic pain.

Deep breathing and meditation are techniques that help your body relax, which eases pain. Tension and tightness seep from muscles as they receive a quiet message to relax.

Although there are many to meditate, the soothing power of repetition is at the heart of some forms of meditation. Focusing on the breath, ignoring thoughts, and repeating a word or phrase -- a mantra -- causes the body to relax. While you can learn meditation on your own, it helps to take a class.

Recommended Related to Pain Management

Chronic Pain: Does Vitamin D Help?

Not getting enough vitamin D in your system may be linked to chronic pain. Over the past 10 years, several researchers have found an association between extremely low vitamin D levels and chronic, general pain that doesn’t respond to treatment. Many Americans are running low on vitamin D. A study published in the Archives of Internal Medicine in 2009 showed that vitamin D levels have plummeted among all U.S. ages, races, and ethnic groups over the past two decades. But does not having enough vitamin...

Deep breathing is also a relaxation technique. Find a quiet location, a comfortable body position, and block out distracting thoughts. Then, imagine a spot just below your navel. Breathe into that spot, filling your abdomen with air. Let the air fill you from the abdomen up, then let it out, like deflating a balloon.

2. Reduce stress in your life. Stress intensifies chronic pain.

Negative feelings like depression, anxiety, stress, and anger can increase the body's sensitivity to pain. By learning to take control of stress, you may find some relief from chronic pain.

Several techniques can help reduce stress and promote relaxation. Listening to soothing, calming music can lift your mood -- and make living with chronic pain more bearable. There are even specially designed relaxation tapes or CDs for this. Mental imagery relaxation (also called guided imagery) is a form of mental escape that can help you feel peaceful. It involves creating calming, peaceful images in your mind. Progressive muscle relaxation is another technique that promotes relaxation.

3. Boost chronic pain relief with the natural endorphins from exercise.

Endorphins are brain chemicals that help improve your mood while also blocking pain signals. Exercise has another pain-reducing effect -- it strengthens muscles, helping prevent re-injury and further pain. Plus, exercise can help keep your weight down, reduce heart disease risk, and control blood sugar levels -- especially important if you have diabetes. Ask your doctor for an exercise routine that is right for you. If you have certain health conditions, like diabetic neuropathy, you will need to be careful about the types of activities you engage in; your doctor can advise you on the best physical activities for you.

4. Cut back on alcohol, which can worsen sleep problems.

Pain makes sleep difficult, and alcohol can make sleep problems worse. If you're living with chronic pain, drinking less or no alcohol can improve your quality of life.

5. Join a support group. Meet others living with chronic pain.

When you're with people who have chronic pain and understand what you're going through, you feel less alone. You also benefit from their wisdom in coping with the pain.

Also, consider meeting with a mental health professional. Anyone can develop depression if they're living with chronic pain. Getting counseling can help you learn to cope better and help you avoid negative thoughts that make pain worse -- so you have a healthier attitude. Asking for help is a sign of strength, not weakness.

6. Don't smoke. It can worsen chronic pain.

Smoking can worsen painful circulation problems and increase risk of heart disease and cancer.

7. Track your pain level and activities every day.

To effectively treat your pain, your doctor needs to know how you've been feeling between visits. Keeping a log or journal of your daily "pain score" will help you track your pain. At the end of each day, note your pain level on the 1 to 10 pain scale. Also, note what activities you did that day. Take this log book to every doctor visit -- to give your doctor a good understanding of how you're living with chronic pain and your physical functioning level.

My link to free pain diary:
http://www.docstoc.com/docs/30680755/Pain-Diary-Worksheet

And a second one:
http://www.painknowledge.org/physiciantools/PALogB698/PainandActivityLog_B698_FINAL.pdf

8. Learn biofeedback to decrease pain severity.

Through biofeedback, it's possible to consciously control various body functions. It may sound like science fiction, but there is good evidence that biofeedback works -- and that it's not hard to master.

Here's how it works: You wear sensors that let you "hear" or "see" certain bodily functions like pulse, digestion, body temperature, and muscle tension. The squiggly lines and/or beeps on the attached monitors reflect what's going on inside your body. Then you learn to control those squiggles and beeps. After a few sessions, your mind has trained your biological system to learn the skills.

9. Get a massage for chronic pain relief.

Massage can help reduce stress and relieve tension -- and is being used by people living with all sorts of chronic pain, including back and neck pain.

10. Eat a healthy diet if you're living with chronic pain.

A well-balanced diet is important in many ways -- aiding your digestive process, reducing heart disease risk, keeping weight under control, and improving blood sugar levels. To eat a low-fat, low-sodium diet, choose from these: fresh fruits and vegetables; cooked dried beans and peas; whole-grain breads and cereals; low-fat cheese, milk, and yogurt; and lean meats.

11. Find ways to distract yourself from pain so you enjoy life more.

When you focus on pain, it makes it worse rather than better. Instead, find something you like doing -- an activity that keeps you busy and thinking about things besides your pain. You might not be able to avoid pain, but you can take control of your life.

http://www.webmd.com/pain-management/11-tips-for-living-with-chronic-pain

Alternative Therapies for Fibromyalgia

Herbs and Supplements for Fibro Pain

At some point during your fibromyalgia treatment, you may decide to try a complementary or alternative fibromyalgia treatment. Herbal remedies and dietary supplements are some of the many complementary and alternative treatments people use to relieve the symptoms of fibromyalgia.

Herbs and supplements as fibromyalgia treatments may not work for everyone, although some people find them very effective. If you decide to try an herb or supplement as a fibromyalgia treatment, be sure to talk with your doctor first to make sure it’s safe for you. Even though they're often labeled as "natural" products, herbs and supplements can cause serious side effects and interact with other drugs you may already be taking. Unlike drugs, herbs and supplements don’t have to receive FDA approval for safety or effectiveness before they can be sold.  In addition to talking with your doctor, it’s important to learn as much as you can about any alternative therapy before using one.

Although studies about the effectiveness of herbs and supplements are limited and overall evidence has been inconclusive, researchers are beginning to research them more. Some small studies have been promising, but many study results have been mixed.

Research is ongoing, but here are just a few of the herbs and supplements that may be helpful in treating fibromyalgia symptoms:

Anthocyanidin. This supplement is a type of flavonoid found in red-blue fruits like red cherries, blueberries, raspberries, and purple grapes that has been used to treat other types of chronic diseases. In one small study of people with fibromyalgia, researchers found that anthocyanidins helped improve participants’ quality of sleep. Researchers found no improvement in the patients’ pain or fatigue. The side effects were minor, but included nausea, indigestion, and nasal congestion.

Capsaicin. Capsaicin is an extract of chili peppers that is applied to the skin in a cream. In a small study, capsaicin was found to significantly relieve tenderness in patients with fibromyalgia. However, it didn’t help improve pain or quality of sleep. The only side effect was a slight stinging or burning on the skin.

Magnesium and malic acid supplements. Some studies have found that people who have fibromyalgia have too little of a substance called ATP in their body. ATP is a substance that helps provide energy to your body and muscles. Some researchers believe a lack of ATP may cause the muscle pain associated with fibromyalgia. Because magnesium and malic acid help the body produce ATP, taking these supplements may help increase ATP levels and decrease pain.

SAM-e (S-Anenosylmethionine). SAM-e is a substance that occurs naturally in the body. It has been studied in many clinical trials over the past 20 years in patients who have joint pain and osteoarthritis. These studies have found that SAM-e may be as effective in relieving pain as nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen and aspirin. SAM-e is used as a drug in Europe, where many of these studies have been done. One U.S. study in patients with osteoarthritis found that SAM-e reduced pain and improved joint function as effectively as Celebrex, a type of NSAID. In addition, new research has found that SAM-e may also help reduce the symptoms of depression, another common fibromyalgia symptom. SAM-e may interact with some medications for depression, so be sure to talk with your doctor about drug interactions before trying it. Other reported side effects include upset stomach and dizziness.

St. John’s wort. This herb may not help with your fibromyalgia pain, but it may help ease the depression that many people with fibromyalgia experience. Studies have shown that St. John’s wort may help improve mood and reduce the insomnia and anxiety common to depression. Some studies have found St. John’s wort as effective in treating mild to moderate depression as antidepressant drugs. However, it may not be as effective in treating more severe depression. St. John’s wort can interact with many other medications, so be sure to check with your doctor or pharmacist before using it.

Valerian. Some researchers believe valerian root may help with sleep and ease fibromyalgia pain. One small study showed that people who took valerian for 28 days reported better sleep and an improvement in their general quality of life.

Vitamin D supplements. Well-known for supporting bone strength and bone health, vitamin D is also being studied for its use in treating other conditions, including fibromyalgia. Some small studies showed that people with fibromyalgia were more likely to be deficient in vitamin D. Other studies have shown that there is no connection. Vitamin D is generally safe in recommended amounts for most people and rarely causes side effects when taken in recommended amounts.

WebMD Medical Reference

Reviewed By Louise Chang, MD

Fibromyalgia and Vitamin D Deficiency Link

Chronic Pain and Vitamin D Deficiency Linked Long Ago

by Laura Owens

Multiple studies link vitamin D deficiency to chronic aches and pains, muscle fatigue or weakness, and other disorders including immunity and some cancers (Holick 2003b; ODS 2008; Plotnikoff and Quigley 2003; Reginster 2005; Tavera-Mendoza and White 2007; Vieth 1999).

A study presented at the American Society of Anesthesiologists 2007 Annual Meeting reported that about one in four patients with chronic pain also have inadequate blood levels of vitamin D. Patients with insufficient vitamin D also needed higher doses of morphine for longer periods of time.

According to study author W. Michael Hooten, MD, medical director and anesthesiologist at the Mayo Comprehensive Pain Rehabilitation Center in Rochester, Minn., researchers have long known that inadequate levels of vitamin D can cause pain and muscle weakness.

“The implications are that in chronic pain patients, vitamin D inadequacy is not the principal cause of pain and muscle weakness,” said Hooten for a press release, “However, it could be a contributing but unrecognized factor.”

The jury is still out on the exact connection between vitamin D and chronic pain but scientists believe it may begin with lower levels of circulating calcium (hypocalcemia) due to inadequate vitamin D. A cascade of biochemical reactions then occurs that hinders bone metabolism and health. Low levels of calcium elevates parathyroid hormones which impairs proper bone mineralization causing a spongy matrix to form under periosteal membranes covering the skeleton.

This gelatin-like matrix can absorb fluid, expand, and cause outward pressure on periosteal tissues, which generates pain since these tissues are highly innervated with sensory pain fibers (Holick 2003b; Shinchuk and Holick 2007; Yew and DeMieri 2002).

Fibromyalgia and Vitamin D Deficiency

The association between low levels of 25-hydroxyvitamin D and non-specific musculoskeletal pain, including fibromyalgia syndrome remains controversial.

In one study, Israeli researchers found no association between women with fibromyalgia and low levels of vitamin D (Tandeter et al. 2009). Yet researches in an earlier study in the Middle East found a significantly greater prevalence of low D concentration in women with fibromyalgia compared to women without fibromyalgia (43% vs 19%).

Yet researchers in the Middle East found that 90% of patients diagnosed with fibromyalgia and/or non-specific musculoskeletal pain treated with vitamin D improved.(Badsha et al. 2009).

One reason for the conflicting evidence is researchers have yet to adequately measure patients' response to different formulations, doses, and durations of vitamin D. In addition, scientists believe vitamin D receptors have different genetic make up and activity so individuals may respond differently to vitamin D therapy. (Kawaguchi et al. 2002; Videman et al. 2001).

Vitamin D Dose For Pain Relief

Dr. Cannell, Executive Director of The Vitamin D Council recommends supplementing with Cholecalciferol (vitamin D3). D3 is the naturally occurring form of vitamin D and is made in large quantities in skin when sunlight strikes it. Dr. Cannell explains that Calcidiol is the only blood test that should be drawn. Doctors can order calcidiol levels although labs will know calcidiol as 25-hydroxyvitamin D.

Take enough vitamin D3 to get 25(OH)D levels above substrate starvation levels, 50 ng/mL or 125 nmol/L. Current recommendations for adults and children are inadequate to maintain optimal health and certainly to treat chronic pain conditions and illness.

Dr. Cannell suggests people supplement with vitamin D before getting their blood tested, then adjust their dose so their 25(OH)D level is between 50–80 ng/ml during both the summer and the winter. These are conservative dosages explains Dr. Cannell. People who avoid the sun, and nearly all dark-skinned people need to increase their dose if their blood levels are still low, even after two months of the above dosage, particularly during the winter months.

Exact levels are difficult to determine because requirements vary by age, body weight, percent of body fat, latitude, skin coloration, season of the year, use of sun block, individual variation in sun exposure, and how sick someone is.

“If you use suntan parlors once a week,” says Dr. Cannell, “or if you live in Florida and sunbathe once a week, year-round, do nothing.” However, if you receive very little UVB exposure the Council recommends the following dosing levels of D3 (maintenance level):

• healthy children under the age of two - 1,000 IU per day*
• healthy children over the age of two - 2,000 IU per day*
• adults and adolescents - 5,000 IU per day.

*The American Academy of Pediatrics recommends 400 mg per day for children.

While the exact relationship between vitamin D and chronic pain syndromes like fibromyalgia isn't fully understood, most researchers agree that vitamin D deficiency contributes to muscuskeletal pain. Patients and practitioners should consider including vitamin D supplementation in their therapy for patients suffering with chronic pain syndromes.

Further Reading:

Swine Flu Deaths in Healthy Children & Vitamin D

Sources:

"Vitamin D Inadequacy May Exacerbate Pain," American Academy of Anesthesiologists, Press Release, October 15, 2007.

Tandeter H, Grynbaum M, Zuili I, Shany S, Shvartzman P., "Serum 25-OH vitamin D levels in patients with fibromyalgia." Israeli Medical Association Journal, 2009.

Badsha H, Daher M, Ooi Kong K. Myalgias or non-specific muscle pain in Arab or Indo-Pakistani patients may indicate vitamin D deficiency. Clinical Rheumatology. 2009.

Leavitt, Steward, B. MA, PhD., "Vitamin D: A Neglected ‘Analgesic’ for Chronic Musculoskeletal Pain: An Evidence Based Review and Clinical Practice Guideline," June 2008, http://Pain-Topics.org/VitaminD.

"Vitamin D for Pain: Update of Research Evidence," Pain Treatment Topics, Accessed: January 10, 2010.

Arvold DS, et al., "Correlation of symptoms with vitamin D deficiency and symptom response to cholecalciferol treatment: a randomized controlled trial," Endocrine Practice, 2009 May-Jun.

Armstrong DJ, Meenagh GK, Bickle I, Lee AS, Curran ES, Finch MB., "Vitamin D deficiency is associated with anxiety and depression in fibromyalgia," Clinical Rheumatology. 2006 Jul 19.

Vitamin D

Vitamin D

What It Is: A fat-soluble vitamin created within the skin when exposed to sunlight; also present in cod liver oil, fortified milk and, in limited amounts, in butter and egg yolks

What It Does:

• Helps the body absorb and use calcium to strengthen bones and teeth
• Low levels have been associated with a higher risk of death; deficiencies may play a role in heart disease and several types of cancer
• Deficiencies have been linked to a number of other health conditions, including multiple sclerosis, Parkinson’s disease and depression

Usage Notes: Subclinical deficiencies are not uncommon; current RDA of 400 IU, thought by many scientists to be too low, is under official review; 5,000 IU believed to be more in line with actual need

Shocking!!

Current research has implicated vitamin D deficiency as a major factor in the pathology of at least 17 varieties of cancer as well as heart disease, stroke, hypertension, autoimmune diseases, diabetes, depression, chronic pain, osteoarthritis, osteoporosis, muscle weakness, muscle wasting, birth defects, periodontal disease, and more.

This is very common in people with Fibro. Next time you go to your doctor, have your Vitamin D levels checked. I did and mine was almost non-existent! Now I take 2000 IU a day. I have heard of people able to get off their pain meds once their Vit. D levels are up again. Something to ponder and it can't hurt.