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My thoughts

You can change the pain experience

4/17/2025

 
It's important to remember that you're not alone. There are strategies and techniques that can help you take control of chronic pain and live well, despite it.
 
Empower yourself by changing your perspective about pain, altering your emotional response to it, and adjusting your actions in its presence. This shift in mindset and behavior can significantly alter your experience.

My journey took a turn for the better when I embraced the reality of the pain, ceased the relentless pursuit of a cause and a cure, and discovered the power of self-management through a structured interdisciplinary pain rehabilitation program. This acceptance and proactive approach brought a sense of relief and control.
 
Learn more
  • A few things you may not know about chronic pain that have helped me recover and live well (02:02)
  • Control what you can control
  • Self-management skills and strategies to learn, practice, and adopt
  • How to Move Patients from Passive Management to Active Self-Management
  • The Journey to Recovery
  • My Time at the Mayo Clinic Pain Rehabilitation Center
  • Central Sensitization Syndrome (CSS) - Dr. Christopher Sletten (22:19)
 

Our lives can become negatively centered around chronic pain

6/5/2024

 
"In a word, describe how you feel right now."

I recently saw this question asked in a 99,000-member fibromyalgia support group.
 
Almost all the 377 answers just two days after the post had negative connotations. Words like exhausted, defeated, overwhelmed, afraid, lousy, anxious, depressed, painful, lifeless, restricted, broken, irritable, lost, done, and disconnected were shared.
 
The few positive answers included words like confident, grateful, proud, and hopeful.
 
The overwhelming percentage of negative words saddens me about the level of pain care and what people living with pain are experiencing.

My answer was confident. However, there was a time in my journey with chronic pain when my answer wouldn't have been as positive.
 
That was before I attended a pain rehabilitation program, accepted the pain, and learned to live well despite it using active self-management strategies.
 
We need to stop treating chronic pain as prolonged acute pain because it's not prolonged acute pain. It is its own condition. Clinicians need to empower people living with pain – shifting from a "find-it, fix-it" mentality to a "self-management" mentality.

Learn more
  • Thoughts are powerful: we aren't our pain 
  • How to Move Patients from Passive Management to Active Self-Management
  • Tame the Beast – It's time to rethink persistent pain - Lorimer Mosely (5:00)
  • How to Move Patients from Passive Management to Active Self-Management
  • Central Sensitization Syndrome (CSS) - Dr. Christopher Sletten (22:19) 
  • Strategies for Coping with Chronic Pain - Dr. Matthew Schumann (1:02:17)
  • The Truth About Managing Chronic Pain (w/Dr. Rachel Zoffness) - ZDoggMD (1:39:10) 
  • Five things I wish I knew earlier in my journey with chronic pain 
  • Are You Missing Two-Thirds of Your Potential Pain Treatment Plan? 

Not all pain management facilities are the same

9/8/2023

 
(updated 12/12/23)

Has your doctor referred you to pain management but you’re unsure where to go and what to expect?

With all the different names such as pain clinics, pain centers, pain management centers, pain treatment centers, pain institutes, pain management programs, and pain rehabilitation programs, it’s easy to get confused.
 
I’ve tried to separate the different types of treatment facilities below into broad categories based on their disciplinary approach and treatment focus with a chronic pain rehabilitation rating.
 
GOOD
Intradisciplinary interventional pain management: Pain management physicians (typically anesthesiologists) provide an individualized approach to evaluate, diagnose, and treat all different types of pain frequently focusing on the cause of pain, pain reduction or elimination, and specific pain conditions. They primarily offer passive interventional procedures such as medications, injections, spinal procedures, nerve blocks, radiofrequency ablation, Ketamine IV therapy, acupuncture, pain pumps, spinal cord stimulators, and surgery.

​Multidisciplinary pain management: Pain management specialists provide interventional treatment with access or referral to other specialties like physical therapy, psychology, neurology, surgery, orthopedics, acupuncture, nutrition, and pharmacy with treatment customized to each patient based on their condition. While these providers may work in the same facility or for the same employer, they often operate independently with their own modalities and therapeutic goals.

BETTER
Multidisciplinary pain rehabilitation: A core provider team ​from multiple disciplines (physical therapy, psychology, rehabilitation medicine, anesthesiology, nursing, and occupational therapy) with additional involvement from surgeons, neurologists, internists, physiatrists, psychiatrists, social workers, dietitians, and pharmacists use the biopsychosocial model of medicine and standardized treatment approaches to help manage pain. Featuring psychological and behavioral therapies, traditional medicine, physical reconditioning, and educational components, these multi-week programs are more comprehensive but can be combined with interventional pain therapies for specific pain conditions. Care may or may not be coordinated or integrated with shared goals.

BEST
Interdisciplinary pain rehabilitation: Features a diverse multidisciplinary team including physical and occupational therapists, psychologists, dieticians, pharmacists, nurses, and medical doctors at one location. The providers interact with each other and the person using a shared biopsychosocial approach to pain – working together toward a common and coherent goal of pain rehabilitation teaching skills to empower the person to help themselves and actively self-manage the pain with the goals of reducing fear of exercise and activity, increasing daily activity; improving physical reconditioning;  decreasing healthcare utilization, and improving quality of life with some but less focus on reducing pain. Generally lasting several weeks, these programs are often hospital-based (6-8 hours per day) and group-based offering behavioral therapy, physical therapy, occupational therapy, relaxation training, medication optimization/management, as well as some sort of family education and counseling. 

Conclusions/thoughts
  • A lack of common terms and definitions made it hard to categorize the types of pain management facilities as there are no clearly established guidelines for pain management that are uniformly followed by every provider. Offering different treatment goals and components, they don’t fit into nice little boxes when doing an internet search.
  • International standards and classifications for pain management should be established to improve care.
  • As pain transitions from acute to chronic, passive interventions are best used in a complementary role to provide short-term relief to allow the person to participate in an active self-management program.
  • Due to their focus on rehabilitation instead of interventional, and therapeutic treatments and their time commitment, interdisciplinary programs can be challenging for people, especially those expecting a diagnosis, passive treatment, and/or a cure.
  • Interdisciplinary pain rehabilitation programs patterned like the program I attended at The Mayo Clinic are the gold standard of comprehensive care. One key attribute of the Mayo program was social modeling—seeing other people with similar pain experiences develop the skills they need to succeed. Unfortunately, there’s limited availability and access to these types of programs.
 
It was my family doctor and a local surgeon who recommended I attend the 3-week outpatient Mayo Clinic Pain Rehabilitation Center instead of going through another risky surgery to try to fix the pain. The program changed my life.

Please discuss your medical situation with your healthcare team.
 
Learn more
  • Is a Pain Clinic Right for You?
  • How to Move Patients from Passive Management to Active Self-Management (my article)
  • We Have a Chronic Pain Problem, not a Prescription Opioid Problem (my article)
  • Pain rehabilitation works (my blog post)
  • Interdisciplinary Rehabilitation Programs in Chronic Pain Management
  • Interdisciplinary Pain Rehabilitation Programs: Approach and Implementation
  • Interdisciplinary treatment for chronic pain: is it worth the money?
  • A Call for Saving Interdisciplinary Pain Management
  • The Demise of Multidisciplinary Pain Management Clinics?​
  • Mayo Clinic Pain Rehabilitation Center
  • My Time at the Mayo Clinic Pain Rehabilitation Center - published in HealthCentral
  • Find pain rehabilitation programs around the globe (my website)
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Do you talk about pain?

8/11/2022

 
It’s common for patients to talk about pain levels and treatments with family and friends. Although talking about pain can help us validate our experience, it can actually worsen our symptoms by adding more attention to the pain.

You can’t make positive steps in your life when surrounded by negativity 
Stay away from people who only want to complain about pain, and avoid sharing the pain with others unless there is a positive goal associated with the conversation. Talk instead about things you enjoy and find meaningful. Fill your life with joy and hope!

It’s natural for people to ask about the pain, but you have the power to change the discussion. Thank them for asking but explain that you’d rather focus on something else. Suggest a more life-affirming topic of conversation. Maybe say something like, “I live with chronic pain but have learned to live well despite it and prefer talking about other things that we both find more meaningful and enjoyable. Can we please change the conversation.”

I choose not to talk about the chronic pain I feel to myself or with others, including my doctors, unless there is a new symptom that needs acute treatment.

Learn more
  • Should You Stop Talking About Your Pain? (Dr. Evan Parks)
  • Reducing Pain Talk: Coping with Pain Series (Institute for Chronic Pain)

The importance of forgiveness and gratitude

8/4/2022

 
"Pain is physical AND emotional 100% of the time."
​- Dr. Rachel Zoffness

Pain is an experience with biopsychosocial factors, including our emotions.

Often times, people living with chronic pain can become angry and less thankful. There may even be some perceived misjustice, as was in my case.
 
It can be helpful to let go of the unpleasant emotions like anger, unappreciation, and blame as they can negatively affect the chronic pain experience, disrupt relationships, and worsen our symptoms – turning up the pain volume.
 
While being forgiving, kind, and grateful won’t magically make the pain disappear; they can help lessen the pain and suffering, foster better health, build self-efficacy, and make life more enjoyable.
 
Learn more and learn how
  • The power of forgiveness (3:28)
  • 13 Most Popular Gratitude Exercises & Activities
  • A Grateful Day with Brother David Steindl-Rast (5:22)
  • How to Forgive Someone Who Traumatized You 
  • Your 5-day gratitude challenge: 5 exercises to increase your gratefulness
  • How to Forgive in Six Steps
  • Jack Kornfield: 12 Principles of Forgiveness (13:42)
  • The power of forgiveness (3:28) - I saw this while as a patient at the Mayo Clinic Pain Rehabilitation Center
  • A Grateful Day with Brother David Steindl-Rast (5:22)
  • How to let anger out | Thich Nhat Hanh answers questions (9:18) - listen to what he tells a little girl how to deal with anger
  • Taking the Steps to Forgive Yourself
  • Forgiveness: Letting go of grudges and bitterness
  • Control anger before it controls you
  • 10-minute meditation: Loving kindness (10:07)
  • Practicing Gratitude Is More Important Now Than Ever
  • Your 5-day gratitude challenge: 5 exercises to increase your gratefulness
  • How Cognitive Control Can Boost Well-Being
  • Positive thinking: Stop negative self-talk to reduce stress
  • Doing What Matters in Times of Stress: An Illustrated Guide
  • The Pain Management Workbook - A book authored by Dr. Rachel Zoffness based upon Cognitive Behavioral Therapy ​
 
Read the research
  • Forgiveness is an emotion-focused coping strategy that can reduce health risks and promote health resilience: theory, review, and hypotheses
  • Forgiveness and chronic pain: a systematic review
  • Forgiveness and chronic low back pain: a preliminary study examining the relationship of forgiveness to pain, anger, and psychological distress
  • Associations between anger and chronic primary pain: a systematic review and meta-analysis
  • Loving-kindness meditation for chronic low back pain: results from a pilot trial

medical cannabis for chronic pain?

7/8/2022

 
Updated 3/27/24
​

Some people find medical cannabis helpful for chronic pain, especially in the short term, but there are questions about long-term effectiveness and safety.  Cannabis wasn’t recommended by Mayo Clinic when I attended their Pain Rehabilitation Center in 2018 nor is it recommended by the International Association for the Study of Pain.

A new systematic review and meta-analysis published November 28, 2022, in the Journal of the American Medical Association, suggests cannabis is no better at relieving pain than a placebo.  And relying on any sort of passive treatment like medicines and supplements can create dependence on the agent - producing a sense of helplessness and reminding the user of the pain.

I have found I don’t need medicine or supplements to manage my chronic pain. Of course, your experience may differ. I know mine did earlier in my pain journey. My relief came by changing how I think about, feel about, and behave around the pain with pain rehabilitation using self-management.
 
Learn more
  • Cannabis is no better than a placebo for treating pain – new research
  • Cannabinoid Non-technical Summary 2021 (International Association for the Study of Pain)
  • Cannabis for chronic pain: New research questions its effectiveness
  • International Review finds lack of evidence to endorse clinical use of medical cannabis for pain
  • Cannabis For Smart Consumers: What The Industry Does Not Want You To Know.
  • Cannabidiol (CBD) Products for Pain: Ineffective, Expensive, and With Potential Harms
  • What You Need to Know (And What We’re Working to Find Out) About Products Containing Cannabis or Cannabis-derived Compounds, Including CBD
  • Cannabis is no better than a placebo for treating pain – new research​
  • Labeling Accuracy of Cannabidiol Extracts Sold Online
  • Beware of supplements (my blog post)
  • We Have a Chronic Pain Problem, Not a Prescription Opioid Problem (my article)
  • The power of the placebo effect
  • How to Move Patients from Passive Management to Active Self-Management (my article)

Do you have back pain?

7/3/2022

 
Updated 05/01/2025
 
Did you know?
  • 84% of all adults will have low back pain.
  • 85% of elite athletes will have low back pain.
  • 85% of back pain is classified as non-specific.
  • Less than 1% of back pain is due to serious pathology.
  • 0% of disks slip.
  • 90% of herniated disks heal on their own.
  • Depression is more predictive of future low back pain than MRI results.
  • Most back pain will improve at home.
  • Recurrence of low back pain is very common, with more than two-thirds of individuals having a recurrence within 12 months after recovery (da Silva, et al, 2019). 
  • Back surgery can lead to failed surgery syndrome.

Back pain can be scary, especially when an MRI finds something abnormal. While they can seem scary, structural findings on a diagnostic scan don’t always equate with pain or are the cause of the pain.

Abnormal MRI findings are normal in people without pain, especially as age increases. Over 50% of 30-year-olds with no pain show signs of disk degeneration increasing up to 80% at age 50 (
Brinjikji, et al, 2015).

And although chronic back pain is a common medical complaint, no specific cause is found in up to 85% of cases with central sensitization as a potential contributing factor (Sanzarello, et al, 2016) along with fear of pain and activity as maintaining factors.

Remember, all pain is biopsychosocial contributors Research has found that "when individuals with low back pain consider they have a flare, they do not always have greater than average pain, but have worse psychosocial features" (Costa, et al, 2021).

Read the World Heath Organization's guideline for non-surgical management of chronic primary low back pain.

Check out these back facts from OSullivan, et al, 2020:
  1. Persistent back pain can be scary, but it’s rarely dangerous
    Persistent back pain can be distressing and disabling, but it’s rarely life- threatening and you are very unlikely to end up in a wheelchair.
  2. Getting older is not a cause of back pain
    Although it is a widespread belief and concern that getting older causes or worsens back pain., research does not support this, and evidence-based treatments can help at any age.
  3. Persistent back pain is rarely associated with serious tissue damage
    Backs are strong. If you had an injury, tissue healing occurs within three months, so if pain persists past this time, it usually means there are other contributing factors. A lot of back pain begins with no injury or with simple, everyday movement. These occasions may relate to stress, tension, fatigue, inactivity or unaccustomed activity which make the back sensitive to movement and loading.
  4. Scans rarely show the cause of back pain
    Scans are only helpful in a minority of people. Lots of scary -sounding things can be reported on scans such as disc bulges, degeneration, protrusions, arthritis, etc. Unfortunately, the reports don’t say that these findings are very common in people without back pain and that they don’t predict how much pain you feel or how disabled you are. Scans can also change, and most disc prolapses shrink over time.
  5. Pain with exercise and movement doesn’t mean you are doing harm
    When pain persists, it is common that the spine and surrounding muscles become really sensitive to touch and movement. The pain you feel during movement and activities reflect how sensitive your structures are – not how damaged you are. So it’s safe and normal to feel some pain when you start to move and exercise. This usually settles down with time as you get more active. In fact, exercise and movement are one of the most effective ways to help treat back pain.
  6. Back pain is not caused by poor posture
    How we sit, stand and bend does not cause back pain even though these activities may be painful. A variety of postures are healthy for the back. It is safe to relax during everyday tasks such as sitting, bending, and lifting with a round back – in fact, it’s more efficient!
  7. Back pain is not caused by a ‘weak core’
    Weak ‘core’ muscles do not cause back pain, in fact people with back pain often tense their ‘core’ muscles as a protective response. This is like clenching your fist after you’ve sprained your wrist. Being strong is important when you need the muscles to switch on, but being tense all the time isn’t helpful. Learning to relax the ‘core’ muscles during everyday tasks can be helpful.
  8. Backs do not wear out with everyday loading and bending
    The same way lifting weights makes muscles stronger, moving and loading make the back stronger and healthier. So, the activities, like running, twisting, bending and lifting, are safe if you start gradually and practice regularly.
  9. Pain flare-ups don’t mean you are damaging yourself
    While the pain flare-ups can be very painful and scary, they are not usually related to tissue damage. The common triggers are things like poor sleep, stress, tension, worries, low mood, inactivity or unaccustomed activity. Controlling these factors can help prevent exacerbations, and if you have a pain flare-up, instead of treating it like an injury, try to stay calm, relax and keep moving up.
  10. Injections, surgery, and strong drugs usually aren’t a cure
    Spine injections surgery and strong drugs like opioids aren’t very effective for persistent back pain in the long term. They come to risks and can have unhelpful side effects. Finding low-risk ways to put you in control of your pain is the key.
 
Learn more
  • Surgery won’t fix my chronic back pain, so what will?
  • Endless pain
  • Spinal cord stimulation doesn't help with back pain, says new review
  • The chronic pain sufferers living with the impacts of failed spinal cord stimulators and surgery
  • WHO guideline for non-surgical management of chronic primary low back pain in adults in primary and community care settings
  • ANZBACK Public Lecture 2023: Rethinking How Low Back Pain is Treated (1:05:47)
  • RESTORE Clinical Trial for Back Pain
  • Pharmacological treatments for low back pain in adults: an overview of Cochrane Reviews
  • Dr. Peter O'Sullivan: Disabling Chronic Back Pain - The Mechanical Care Forum (47:32)
  • Systematic Literature Review of Imaging Features of Spinal Degeneration in Asymptomatic Populations (sourced in article)
  • Central sensitization in chronic low back pain: A narrative review (sourced in article)
  • Low Back Pain Flares: How do They Differ From an Increase in Pain? (sourced in article)
  • Psychological interventions for chronic, non-specific low back pain: systematic review with network meta-analysis
  • Back to basics: 10 facts every person should know about back pain (sourced in article)
  • 10 Facts every person should know about back pain. Presented by patients (4:15)
  • Patient Stories Behind the 10 Back Pain Facts Every Person Should Know (9:40)
  • Making Sense of Disabling Back Pain - Peter O’Sullivan Koadlow Lecture 2021 (1:30:29)
  • The Empowered Beyond Pain Podcast (includes several discussions about back pain and back pain myths/facts)
  • Communicating with people seeking help for lower back pain (a quiz for providers but also beneficial for patients)
  • Pain-Related Fear, Disability, and the Fear-Avoidance Model of Chronic Pain
  • Your Back Is Not Out of Alignment
  • Low Back Pain​
  • Central Sensitization Syndrome (CSS) - Dr. Christopher Sletten (22:19) 
  • 3 orthopaedic surgeries that might be doing patients (and their pockets) more harm than good
  • Benefits and Harms of Interventions With Surgery Compared to Interventions Without Surgery for Musculoskeletal Conditions: A Systematic Review With Meta-analysis
  • DIM SIM Therapy 
  • Back in Control (a resource center created by a retired spine surgeon)

​Research
  • https://effectivehealthcare.ahrq.gov/products/back-pain-treatment/clinician
  • https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6345455/
  • https://pubmed.ncbi.nlm.nih.gov/27062464/
  • https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9526366/
  • https://www.physio-network.com/blog/discs-dont-slip-dammit/
  • https://www.health.harvard.edu/pain/will-my-herniated-disc-heal-on-its-own
  • https://www.jospt.org/doi/10.2519/jospt.2011.3618
  • https://www.mayoclinic.org/diseases-conditions/back-pain/symptoms-causes/syc-20369906
  • https://www.ncbi.nlm.nih.gov/books/NBK539777/
  • https://pubmed.ncbi.nlm.nih.gov/31208917/

My thoughts about opioid therapy

6/22/2022

 
(Updated 06/10/2024)

My article published in Health Central (formerly Practical Pain Management)  "We Have a Chronic Pain Problem, Not a Prescription Opioid Problem" explored the efficacy and safety of opioids for chronic pain as well as the need for more pain rehabilitation programs.

Below is some of the original content I submitted that didn't make the published version of the article which helps provide some additional context.


The rise of prescription opioids
In the 1990s and the next two decades, opioid prescriptions became the quickest and least expensive treatment option for chronic noncancer pain.

Their rise in popularity was due to a mix of factors, including:
  • Good intentions to improve pain management.
  • Pain is positioned as the 5th vital sign with a focus on pain intensity.
  • Aggressive, if not, fraudulent pharmaceutical company marketing.
  • incentives based on patient satisfaction.
  • The desire for a quick and easy fix.
  • The structure of our healthcare system and insurance reimbursement.
  • A reduction of interdisciplinary pain rehabilitation programs.

With the increase in opioid use came an increase in opioid use disorders and opioid deaths.  Then came a hard push to reduce opioid prescriptions following the 2016 Centers for Disease Control (CDC) guidelines for prescribing opioids.

The 2016 CDC guidelines indirectly led to many chronic pain patients being forced to lower their medicine doses or to stop them completely. Often with little or no tapering and no alternative treatments offered or covered by insurance. Pushing patients to undergo invasive procedures like injections or surgery. And labeling patients as “addicts” for wanting pain relief. Which all led to increased tension between patients and providers, more patient suffering, illegal drug use, or, even worse, suicide.  

Opioid users don’t know what they don’t know – “try it, you may like it”
Unfortunately, there isn’t a crystal ball when it comes to pain treatment. There's no way of knowing how a patient will respond to any specific type of therapy. And tapering can be hard. Chronic pain patients can be weary of tapering opioids for fear of increased pain and the general fear of the unknown. 
 
Patients need to accept the possibility of worse pain and other symptoms during a taper. It’s also important for providers to remember to treat the entire person in pain and not just manage the taper.
 
Transitioning to self-management built around pain rehabilitation takes time. It’s a marathon, not a sprint, and requires work from both the provider and the patient. It’s like the old joke “How do you get to Carnegie Hall? Practice, practice, practice.”
 
Opioid treatment is a decision between the provider and patient
The use of opioids is a shared provider-patient decision based on risk and reward including the history and needs of the patient and should be applied on a case-by-case basis.
 
If the decision is to reduce or stop opioid therapy, tapering should be done with education about the benefits of opioid reduction and provider oversight. If the decision is to use opioids, they should be prescribed at the safest lowest dose. Either decision should include pain rehabilitation and self-management strategies.
  • Read this latest research: Does opioid therapy enhance quality of life in patients suffering from chronic non-malignant pain? A systematic review and meta-analysis
  • Read my article for clinicians about transitioning from passive treatment to active self-management
  • ​Read my blog post about pain rehabilitation
  • Find pain rehabilitation programs around the globe (my website)
  • Read about my experience at the 3-week Mayo Clinic Pain Rehabilitation Center
  • Learn more about opioids, pain management, and the Compass Opioid Stewardship Program
  • Listen to my Compass Opioid Stewardship program interview

Personal note
My chronic pain recovery started after I accepted the pain and stopped doctor-shopping to find pain relief and a medical cure (many praises for the Mayo Pain Rehabilitation Center). Through pain rehabilitation, I learned how to self-manage my condition. This process led me to stop the use of medicines including opioids, benzodiazepines, anticonvulsants, muscle relaxers, amphetamines, beta-blockers, antidepressants, and over-the-counter analgesics as well as other passive interventions like supplements and injections for my pain.

Be kind to yourself

6/15/2022

 
There's still a core you despite the pain.

What you can do
  • Write down your positive qualities and accomplishments – what’s good about you. Sometimes we can be own worst critics.
  • Balance expectations.
  • It’s okay to not be perfect – everything doesn’t have to be in place.
  • Say “no” if you need to.
  • Accept help.
  • Forgive yourself (sometimes we are our own worse critics).
  • Eat healthy.
  • Sleep better with these tips.
  • Talk with your loved ones about your needs and challenges without complaining. We don’t want sympathy, we want understanding.
  • Reward yourself and celebrate your successes, no matter how small.
  • Check out these helpful self-compassion exercises and practices from Dr. Kristin Neff.
  • Read this article "The Role of Self-Compassion in Chronic Illness Care".
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Beware of supplements

6/13/2022

 
Updated 6/5/25

Do you know?
  • Not intended to treat, lessen, prevent, or cure disease
  • Supplements aren’t regulated by the FDA.
  • Comes with risks related to contamination with toxins, interactions with conventional medicines, unwanted side effects, and health problems
  • There isn't high quality evidence regarding diet supplements.
  • Products labeled natural aren’t necessarily safer.
  • Can create dependence on the agent - producing a sense of helplessness and reminding the user of the pain

​Editor’s note: This article was written based on my experience and what I have researched about the topic.  Everyone is different. The decision to use supplements should be a decision between you and your doctor.

Many people use supplements as part of their pain treatment plan, often as substitutes for prescribed medication that aren't often effective or well, tolerated.

However, supplements come with risk, including contamination with toxins, health problems, unwanted side effects, and interactions with conventional medicines. 

Unlike prescription or over-the-counter drugs, which must be approved by the Federal Drug Agency (FDA) before they can be marketed, the FDA doesn’t review supplements for safety and effectiveness before they are sold.
 
We don’t know where the products are made, how they are made, what is in them, and if the dosage is appropriate.
 
Safety is left up to the manufacturers and distributors of the supplements.  

Taking pills can reinforce the pain

besides the safety concern, each time you take a pill or supplement, you're reminding yourself you're in pain - reinforcing the neural pathways and keeping you in the pain cycle.

My experience
As part of the multi-day Mayo Clinic fibromyalgia program I attended in 2016, I met with a pharmacist to review the long list of prescription medicines, over-the-counter medicines, and supplements I was taking at the time. My medicine cabinet looked like a GNC store.
 
I was instructed to bring the actual bottles with me to the appointment, so I packed the bottles into a gym bag (yes, I was taking a lot of medicines and supplements) and went to see her.
 
I was surprised as she read each bottle, making comments and recommendations about each pill – including product quality, labeling issues, ingredient safety, and dosing.  
 
When the appointment ended, my medicine and supplement list was much shorter with her recommending stopping most of the supplements and my gym bag much lighter – throwing away the pills was going to stop taking. I kept only one supplement - Vitamin D, which I no longer use.

Bottom line
You assume all risk when using supplements. While some may be helpful, many aren’t and some may even be harmful. And they can become a unhelpful pain behavior - reminding you of the pain.

Review any supplements with your medical team to help you make an educated decision.
 
Learn more
  • American Roulette — Contaminated Dietary Supplements
  • Supplements: They’re Not As Safe As You Might Think
  • The role of diet and non-pharmacologic supplements in the treatment of chronic neuropathic pain: A systematic review
  • Harmful effects of supplements can send you to the emergency department
  • Natural supplements can be dangerously contaminated, or not even have the specified ingredients
  • Hundreds of Dietary Supplements Are Tainted with Prescription Drugs
  • Herbal Medicine for Pain Management: Efficacy and Drug Interactions
  • Dr. Pieter Cohen Explains Dietary Supplements and Regulations
  • Cannabidiol (CBD) Products for Pain: Ineffective, Expensive, and With Potential Harms
  • What You Need to Know (And What We’re Working to Find Out) About Products Containing Cannabis or Cannabis-derived Compounds, Including CBD
  • Central Sensitization Syndrome (CSS) - Dr. Christopher Sletten (22;19)
  • Medical cannabis for chronic pain? (my blog post)
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cognitive behavioral therapy for pain

6/5/2022

 
​Updated 09/23/2023
Our thoughts, emotions, and behaviors can make pain worse or more manageable.
​​
We can change the chronic pain experience and retrain our overprotective pain systems by changing how we think, feel, and behave using a form of biopsychosocial treatment called Cognitive Behavioral Therapy (CBT).

CBT reprograms our minds and bodies to help us feel safe and confident in our ability to manage pain and do the things we enjoy — improving the body’s natural pain relief mechanisms, increasing function, and breaking the chronic pain cycle.

.CBT is based on the core principles that our thoughts, emotions, and behaviors interact together with the pain; that we can become trapped in unhelpful thoughts, emotions, and behaviors; and that we can modify our thoughts, emotions, and behaviors to make our experience more manageable. 

It's what changed my pain experience and my life by giving me tools to:
  • Accept the pain and live in the present.
  • Identify, challenge, and change unhelpful negative thoughts and behaviors.
  • Actively self-manage the pain.

Best yet, CBT is a do -it-yourself therapy. You can use it anytime. You don’t need help from anyone once you learn it. And there are no negative side effects.

I learned CBT while attending the prestigious 3-week interdisciplinary Mayo Clinic Pain Rehabilitation Center.  

Find a CBT pain therapist
It can be hard to find psychologists trained in cognitive behavioral therapy for pain. Ask them about their approach to treatment. You might want to use the content from my pain truths to see if their practice beliefs matches the latest pain science. There are links to therapist search tools and pain rehabilitation programs below.

Learn more and do more
  • What is CBT?  (McGovern Medical School)
  • Cognitive Behavioral Therapy for Chronic Pain (4:29)
  • ​A Magical Cure for Pain? No – it’s just Cognitive Behavioral Therapy 
  • Managing Chronic Pain: A Cognitive-Behavioral Therapy Approach​ 
  • Reframing unhelpful thoughts
  • How To Use CBT Thought Records To Change The Way You Feel
  • How to recognize and tame your cognitive distortions​
  • 15 Cognitive Distortions To Blame for Negative Thinking
  • Cognitive Restructuring Worksheet
  • Replacement Thought Examples
  • The Pain Management Workbook
  • American Association of Pain Psychology​ - offers a search feature to connect with a pain psychologist
  • Psychology Today - offers a search feature to connect with a psychologist (be sure to look for a provider familiar with chronic pain and CBT)
  • Find a pain rehabilitation program - links to programs around the globe. 
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Image courtesy of McGovern Medical School

Don't count spoons...Recharge!

5/29/2022

 
(Updated 5/16/25)

INSTEAD OF STARTING YOUR DAY WITH A LIMITED NUMBER OF SPOONS, YOU HAVE THE ABILITY TO SELF-CHARGE THROUGHOUT THE DAY TO BOOST ENERGY AND IMPROVE MOOD.
​

Christine Miserandino's spoon theory has become popular with people with chronic pain to explain their pain and plan their days so they don't over-extend themselves..

The theory assumes people with chronic pain have only so much emotional and physical energy each day to do the things they want to do. You start each day with a finite number of spoons. Each spoon represents a unit of energy. As you use up your energy, you take away a spoon. 

The problem with the theory: there isn't a way to add more spoons (energy) or to make each spoon last longer than expected.

Therefore, it can be self-limiting - focusing on what we can’t do instead of the things we can and leading us to avoid activities that could make us feel worse but may very well help us in terms of giving us more energy and improving our mood. For instance, we may choose to save spoons by not joining our friends for lunch or going on a much-needed walk.

Recent research "demonstrated that on mornings when patients catastrophized more than usual about their pain in the day ahead, they spent more time in sedentary behavior and engaged in fewer minutes of moderate to vigorous physical activity that day. Cross-day lagged analyses further showed that the effect of morning pain catastrophizing on subsequent sedentary behavior extended to the next day. More time spent in sedentary behavior, in turn, contributed to greater pain catastrophizing the next morning" (Zhaoyang et al 2020). 

Another idea: Think of your day like a battery system in a car.

If you don't use a car or if you leave on a car's lights or radio without the engine running, the car battery will eventually run out of energy. But if you drive the car, the alternator will recharge the battery as you drive.
​
Just like a car's battery system, we can add more energy to our days by doing things like:
  • Changing how we think about pain to not be so afraid of it and minimize the suffering.
  • Incorporating activities like deep breathing, tai chi, mindfulness, yoga, and muscle relaxation.
  • Playing games and doing hobbies.
  • Laughing - Watch a funny movie or TV show and give yourself permission to be silly.
  • Getting outside for a walk and enjoying nature.
  • Listening to music - Music has an analgesic effect to help us feel better.
  • Modifying and moderating activities to make things easier, not harder.
  • Spending time with people who don't drain our energy with pain talk, negativity, and complaints.
  • Being grateful - Focusing on what you have, not what you’ve lost.

Check out 50 ways to live well, despite chronic pain. 

Note: This is just another tool to add to your chronic pain toolbox. If the spoon theory or another approach works for you, please continue using it. 

PACING ISN’T AN EXCUSE TO AVOID ACTIVITY AND PAIN

5/28/2022

 
People with chronic pain often do too much when they’re having good days and not enough when they’re having bad days.

Chronic pain can cause us to overprotect ourselves. Our natural reaction to pain is to avoid activities that worsen our discomfort or increase our perceived risk of further damage. When we become overly fearful and stop doing things in anticipation of pain, we can make things worse.

Inactivity reduces our functional ability and decreases our strength and stamina. It also prevents us from getting involved in the social, leisure, and work activities we enjoy.
 
Pacing/moderation has become a helpful tool for people living with chronic pain to help provide them with balance. It includes setting time limits, slowing down (start low, go slow), breaking up tasks, and taking frequent short breaks.
 
But be careful not to let pacing become an excuse for not being active or avoiding pain. Doing so can add more focus to the pain, worsen symptoms, and reduce physical stamina.

Pacing should instead be used to gradually increase what we can do, despite the pain. Stay consistent with your activity. 
 
The difference is in the goal and execution. Keep moving forward.
 
Learn more and do more
  • Activity pacing: moving beyond taking breaks and slowing down
  • The role of avoidance, pacing, and other activity patterns in chronic pain
  • Activity Pacing
  • Pacing and Goal Setting
  • Tools for recovery – Boom or bust vs pacing
  • Pacing For Pain
  • Chronic pain self-management: Pacing and goal setting
  • Goal Setting for Pain Rehabilitation​
  • Pacing – how to manage your pain and stay active
  • What Goals Have You Set Recently? 
  • Effect of Pain Reprocessing Therapy vs Placebo and Usual Care for Patients With Chronic Back Pain
  • Activity Pacing is Associated With Better and Worse Symptoms for Patients With Long-term Conditions​
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Cooper, Booker and Spanswick, 2003

Resilience is important

5/22/2022

 
I just watched a great TEDx Talk from Dr. Trung Ngo about resilience that everyone who lives with chronic pain or treats chronic pain should watch.  

He talks about how there are three types of people:
  1. Those who are victims
  2. Those who are catastrophizers
  3. Those who are resilient

I can identify with all three types during my personal journey with pain. Early in my journey, I was the victim. It was the surgeon's fault for the pain. I was set on making that doctor pay for his mistake and make the pain go away.

As the pain continued, I became the catastrophizer. It quickly became gloom and doom. I become fearful of the pain. I worried about all the terrible things that might happen because of the pain. And I worried about my future and the future of my family. 

Fortunately, my mindset changed to resiliency. Many thanks to the Mayo Clinic Pain Rehabilitation Center for helping me transition to that stage.

How to be resilient
According to Dr. Ngo, the keys to being resilient:
  • Be interdependent
  • Prioritize your own well-being
  • Let go
  • Take ownership

 Learn more
  • 10 Habits of Highly Resilient People
  • How to Build Resilience and Boost Your Mental Health

* Ojala, T., Häkkinen, A., Karppinen, J., Sipilä, K., Suutama, T., & Piirainen, A. (2014). Chronic pain affects the whole person – a phenomenological study. Disability and Rehabilitation, 37(4), 363–371. doi: 10.3109/09638288.2014.923522

Take control

4/28/2022

 
Pain doesn’t have to determine your life.

I love this metaphor I first heard when I attended the Mayo Clinic Pain Rehabilitation Center:  Imagine being in a car with chronic pain. Where is the pain?  Who’s in control? Is pain behind the steering wheel - determining where you go and what you do in life? Or are you driving? Put pain in the back seat, or even better yet, the trunk.

Things you can control - Focus on these
  • Understanding how pain works
  • Changing how you think and feel about pain, and how you respond to it
  • Accepting the pain
  • Not being afraid of the pain
  • Being aware of what you listen to, read, and watch to avoid negativity and drama
  • Being kind to yourself and others
  • Taking active responsibility for your care
  • Not verbally expressing or complaining about the pain
  • Not wallowing in the pain
  • Not placing blame for the pain
  • Staying away from people who only want to complain about pain
  • Not sharing your pain with others
  • Reducing stress
  • Eating right
  • Moving more and increasing your activity level
  • Moderating what you do
  • Modifying what you do
  • Being grateful – focus on what you have, not what you’ve lost
  • Developing better sleep habits
  • Preparing for a flare in advance so it doesn’t overwhelm you
 
Things you can’t control - Don’t focus on these
  • Pain
  • Imaging test results
  • Past medical interventions
  • Past painful experiences
  • What other people say or do
  • Weather
  • Cultural and family norms
  • Socio-economic background
  • Demographics (sex, age, ethnicity, etc.)
  • Genetic make-up

25 tips to get the best treatment

3/29/2022

 
My article originally published December 30, 2019 in National Pain Report. Edited March 16, 2023
Chronic pain appointments can be difficult for both doctors and patients. 

For patients, doctor visits can be intimidating and create anxiety.  We want validation of our pain, empathy, answers, and support.  
 
For doctors, chronic pain patients can be more challenging to treat than other patients.  We can be demanding of their time, attention, and patience.
 
While they genuinely want to help, doctors often have limited training (typically only 11 hours of pain education in medical school); limited time (typically only 15-20 minutes per appointment); limited options due to government, health system, and insurance guidelines; and limited internal resources to treat chronic pain patients.
 
So how do you make the most of your appointment time and get the best treatment when you visit the doctor?
 
Below are 25 suggestions to help maximize the patient-doctor experience (thanks to the many ideas provided by members of the Chronic Pain Champions – No Whining Allowed Facebook support group):
 
 
In general

  1. Don’t bring any bad experiences you may have had with other doctors in the past to your appointment.  You don’t want to muddy a new doctor relationship.
  2. Go with a stated purpose but don’t go with any pre-conceived expectation about getting a certain treatment or continuing a specific treatment, like opioid therapy, or a specific diagnostic test, like an MRI.  Unfortunately, there isn’t an easy answer for chronic pain.  It’s not like prescribing an antibiotic that will cure an infection.  Most chronic pain doesn’t have a cure.  You may not be able to be fixed.
  3. Let your doctor determine the best course of action.  That is why you’re there.  To get the help you need, not necessarily the help you think you need.  Be open to any suggested treatment recommendations.  Any treatments should be a shared-decision.
  4. Ask your doctor about arranging recurrent appointments (quarterly, etc.) just for pain management as well as scheduling extra time, if needed, for those appointments.
  5. If you’re seeing the doctor about other medical conditions unrelated to your regular chronic pain, don’t talk about pain.  Keep it for your regular pain visits.
  6. Confirm your doctor is up-to-date with the latest pain science, and treatments.  They should be able to correctly answer the questions from my pain quiz.
  7. Reduce your reliance on doctors and use of the medical system as your self-management skills grow.
 
 
Before the appointment

  1. Make a prioritized list of topics/questions you want to cover at the appointment.  That way you won’t forget things and you’ll stay on topic.  You might also want to practice going over the list and what you want to say to help capitalize on your discussion time at the appointment. 
  2. Draft an alphabetical list of medications (including over-the-counter medications/supplements).  Include the medication name, the dose (such as 5MG), how many pills you take and how often you take them, as well as the name of the doctor who prescribed them.  Include any allergies on this list.  Download this free template.
  3. Put together a medical summary of major health events, medical conditions, surgeries, and special treatments related to your pain condition.  Make it easy to read and keep it short, one- or two-pages so the doctor can get a quick snapshot of your history. Download this free template.
  4. Arrange for a family member or other trusted support person to go with you to the appointment to be a second set of ears and take notes.
 
 
At the appointment

  1. Arrive early with your insurance card and payment method.
  2. Bring your prescription list.  Give this list to the nurse at the beginning of each appointment to help them reconcile your medicines.
  3. Bring copies of your prioritized list of topics you want to cover at the appointment.  Share with your doctor and support person at the beginning of your visit. 
  4. If visiting a new provider, also bring your medical summary and any relevant x rays, CT scans, MRIs, ultrasounds along with their radiological reports.
  5. If you heard something you think might be helpful in your diagnosis or treatment, take time before your appointment to look at evidence-based scientific research that may support it (try searching on Google Scholar) and bring a copy of the research with you to share with your doctor. Be prepared to talk about it.  Don’t say you Googled some information.
  6. Stay non-emotional, calm, and factual.  No drama, whining or catastrophizing about the pain.  And don’t get angry or be rude.  
  7. Talk to your doctor about what is happening in your life and how your chronic pain is affecting it.  Pain isn’t just a number on a pain chart.  It’s a biological, psychological, and social experience.  Talk about your emotions, your ability to work, your relationships, and your ability to do daily activities.
  8. Be specific when describing your pain symptoms.  Tell the doctor when the pain started and how it started, what kind of pain you’ve been feeling (aching, dull, throbbing, sharp, burning, radiating, pins and needles, electrical, numb, etc.),  how often you experience the pain, where the pain is located (lower back, head, etc.), what you’ve done to help reduce the pain (ice, heat, analgesics, etc.), and how successful those treatments have been.
  9. Talk to your doctor about treatment goals.  Once pain becomes chronic, the goal of treatment is often increasing functional ability and quality of life, not pain elimination.
  10. Talk to the doctor about the psychosocial components of pain and recommended treatment.  Opioid pain medicines and other medical interventions aren’t always the best or only treatment options.  Explore comprehensive multidisciplinary pain management and rehabilitation.  Ask about other treatments.  If there isn’t a cure, how can you manage the pain?
  11. Clarify and confirm.  Ask questions if you don’t understand something.  Repeat what you heard to make sure you heard it correctly.
  12. Be respectful.  Listen to what the doctor says and do what they recommend, even if they may involve behavioral changes or other treatments you may have already tried or don’t think are valuable.  If you want them to listen and respond to you, you need to do the same to them.
  13. Be patient as a patient.  It may take several doctor visits and/or different treatments before you recognize improvement.
  14. Be grateful.  Thank the doctor.
 
 
Bottom line
To get the best treatment from your doctor, be prepared, calm, engaged, insightful, and open to self-management.  It’s harder for doctors to treat patients who are negative or expect the doctor to fix all their problems.
 
I hope you find these tips helpful.

what goals have you set recently?

3/12/2022

 
Chronic pain can make it easy to feel overwhelmed, reduce our activity levels, and become isolated.  Goals help restore a sense of order, build self-efficacy and sense of control, improve mood, and provide direction by helping with planning daily activities.
 
One of the tools we learned at the Mayo Clinic Pain Rehabilitation Center was goal setting to help us plan our days and keep us on track. We set goals each day. They didn't have to be massive, but they had to be SMART - specific, measurable, achievable, relevant, and time-bound.
​
  • Specific – What do you want to do?  What action will you take?
  • Measurable – How will you track progress and know when you’ve reached the finish line.
  • Achievable – Is it something you can do? Do you have the necessary skills and resources?
  • Relevant – Why is it important to you?
  • Time-bound – When do you want to accomplish it?

Some SMART goal examples:
  • Increase my step count by end of week to 5,000 steps a day.
  • Do deep breathing for three minutes three times each day for the next week.
  • Read three articles about cognitive behavioral therapy by end of the week.
  • Plan a social event to visit in-person with friends and family this week.
  • Lose 4 to 8 pounds of weight in the next 30 days.
  • Volunteer 10 hours a week at the community center for the next month.
 
Did you notice none of the goal examples included pain reduction?
Our focus should be on reducing stress, improving our quality of life and increasing functional ability and activity, not pain reduction. Focusing on pain reduction is an easy trap to fall into - leading to frustration and depression.  Just as the homepage of my website says - we can live well, despite the pain. 

Celebrate!
While it's natural to celebrate big goals, be sure to celebrate milestones along the way, as well as smaller victories. These celebrations keep us motivated along the way and help instill confidence.

Resource
  • Goal Setting for Pain Rehabilitation​

Hurt doesn't always mean harm

3/10/2022

 
Pain is the body’s alarm system.  It’s designed to protect us from danger just like a home security system or a smoke detector.  It’s the body’s normal response to acute tissue damage or injury and heals in normally 3-6 months.
 
But what happens when pain doesn’t go away?
 
Once pain persists beyond the normal healing time, it becomes chronic - losing its warning function and becomes its own disease/condition.  It’s an abnormal response (with or without obvious pathology). 
 
Although all pain hurts, not all pain indicates damage. We know what to expect from our pain by the very nature of it being chronic or ongoing.  It’s not like getting burnt, twisting an ankle, or getting stung by a bee that needs protection until the injury has heals.  Of course, any unexpected new pain should be investigated.
 
Learn more
  • Central Sensitization Syndrome (CSS) - Dr. Christopher Sletten (22:19) 
  • Understanding pain & what to do about it in less than 5 minutes - VA (5:00)
  • A Tale of Two Nails 
  • How your brain creates pain – and what we can do about it
  • Tame the Beast – It's time to rethink persistent pain - Lorimer Mosely (5:00)
  • Are You Missing Two-Thirds of Your Potential Pain Treatment Plan?  (my article)
  • The Truth About Managing Chronic Pain (w/Dr. Rachel Zoffness) - ZDoggMD (1:39:10) ​
  • Pain-related fear is more disabling than pain itself: evidence on the role of pain-related fear in chronic back pain disability
  • Fear-Avoidance Beliefs and Chronic Pain

calm the mind. calm the body.

3/1/2022

 
Pain, stress, and tension are closely related. Muscles tighten and put pressure on nerves resulting in even more pain.

It’s possible to activate your body’s natural relaxation response to help reduce the tension using mind-body tools like:
  • Deep breathing (also called diaphragmatic breathing, abdominal breathing, and belly breathing) – easy to learn and can be done anywhere.
  • Yoga and tai chi – can be modified, if needed, to accommodate individual needs, like chair yoga or tai-chi chih (a simplified version of tai chi).
  • Mindfulness and meditation – require you to redirect your attention.
  • Passive muscle relaxation – mentally relax your muscles from head to toe.
  • Progressive muscle relaxation – actively tense and relax your muscles from head to toe.

Helpful videos
  • Deep Breathing Exercises for Beginners
  • Breathe to Heal | Max Strom | TEDxCapeMay (18:32)
  • Mindfulness
  • ​Passive Muscle Relaxation to Manage Anxiety and Stress (12:40)
  • Progressive Muscle Relaxation to Manage Anxiety and Stress (15:00)
  • ​Tai Chi Chih - Joy Through Movement (50:08)
  • Yoga For Chronic Pain | Yoga With Adriene (25:33)

Free Apps
  • Bellybio
  • Breath2Relax
  • Mindfulness Bell
  • ​The Breathing App
 
FIND MORE TOOLS AND APPS
 

Pain rehabilitation works

2/15/2022

 
Updated 3/1/24

Pain rehabilitation goes beyond medicine and medical interventions – and crosses different disciplines. It doesn’t just focus on removing the pain.  It focuses on the patient and how they can play a role in their own pain management - giving them control over the pain instead of letting the pain control them..
 
It’s a proven approach based on the biopsychosocial model of medicine – benefiting patients while reducing costs and reliance on the medical system.  
 
In addition to their general efficacy, these types of programs using interdisciplinary chronic pain rehabilitation can be effective at weaning patients off opioid therapy with long-term improvements in pain, mood, and function.
 
I was fortunate to be able to attend the 3-week interdisciplinary Mayo Clinic Pain Rehabilitation Center – not just once, but twice.  It was both a game-changer and lifesaver for me.  I highly recommend the program to anyone interested in taking an active role in managing their own care.  Read about my Mayo experience in this article.
 
More programs like this are needed to shift the current reliance on biomedical therapy towards a greater reliance on provider-supported patient self-management and true biopsychosocial treatment. .
 
Availability is important but so is accessibility. These programs aren't cheap, and insurance can be hesitant the pay the price tag. What payors need to remember is that these programs are cost-effective with a 68% reduction in medical cost spending.
 
Find links to rehabilitation programs in the U.S. and around the globe.

 
What to look for in a program
A pain rehabilitation program should focus on you as a person, not just your pain.  

Interdisciplinary pain rehabilitation programs that take place in the same facility with health care providers working together with open communication and shared objectives are the gold standard of comprehensive care outperforming medical pain services and less coordinated multidisciplinary programs.
 
A comprehensive pain rehabilitation program typically includes:
  • Medication management – To find the right combination of medicines and taper/stop any unnecessary medications along with better monitoring of patients who are prescribed opioids.
  • Pain education – To help patients better understand the purpose of pain and how best to respond to it – reducing any fears that pain is a symptom of a serious health issue, and that activity will cause more damage.
  • Lifestyle changes – To improve diet and sleep.
  • Psychosocial intervention – To change self-limiting thoughts and provide coping skills using acceptance commitment therapy and cognitive behavioral therapy.
  • Physical therapy/exercise – To build strength and endurance while reducing fear of exercise and activity.
  • Occupational therapy – To modify and moderate daily life activities.
  • Relaxation training – To reduce stress on the mind and body – easing the pain experience.
  • Family therapy – To teach loved ones how to help/not help those in pain – encouraging self-efficacy and reducing pain behavior.
 
Learn more about pain rehabilitation
  • Not all pain management facilities are the same (my blog post)
  • Patient Perspective: We Have a Chronic Pain Problem (my article)
  • What is a Chronic Pain Rehabilitation Program?
  • On Can't and Able
  • Interdisciplinary Rehabilitation Programs in Chronic Pain Management
  • Interdisciplinary Chronic Pain Management: Past, Present, and Future
  • Focused Review of Interdisciplinary Pain Rehabilitation Programs for Chronic Pain Management
  • Interdisciplinary Chronic Pain Management: International Perspectives
  • Interdisciplinary Chronic Pain Management: Overview and Lessons from the Public Sector
  • Economic Analysis of a Comprehensive Pain Rehabilitation Program: A Collaboration Between Florida Blue and Mayo Clinic Florida
  • Chronic pain affects the whole person – a phenomenological study
  • IASP Pain Management Center – a series of chapters
  • The Resurrection of Interdisciplinary Pain Rehabilitation: Outcomes Across a Veterans Affairs Collaborative
  • A Call for Saving Interdisciplinary Pain Management
  • Evaluation of an interdisciplinary chronic pain program and predictors of readiness for change
  • Predicting Readiness to Attend an Interdisciplinary Pain Management Program: What’s better for Clinical Decision-Making? Clinical Judgment or a Patient Self- Report Questionnaire?
  • Has your doctor referred you to pain management but you’re unsure where to go and what to expect?
    ​
Learn more about the Mayo Clinic Pain Rehabilitation Center (PRC)
  • Program information
  • My experience at the PRC
  • Dr. Christopher Sletten explains pain, central sensitization syndrome, and what they do at the PRC (22:19)
  • Dr. Jeannie Sperry explains how the PRC can help those suffering with chronic pain (9:44)
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Picture

WE CAN LEARN A LOT FROM A PRO GOLFER

1/22/2022

 
Pro golfers use visualization when they play. They picture the precise shot they want to hit before taking the club back – the trajectory, shape, roll and finish. This puts a positive image in the mind; the body then makes the motions needed to turn the image into reality.

We can do the same with our pain.

We can visualize a different way to view our pain and respond to it. We can visualize living well despite the pain. And we can visualize the pain leaving our bodies or the pain taking a smaller role in our lives.

Try these exercises
  • Audio Meditation - Visualize your Pain​ (9:54)
  • Guided Imagery for Pain Relief (9:55)
  • Guided Imagery Practice For Pain (9:43)

Find links to these and other self-management tools.

My Compass Opioid Stweardship interview

1/5/2022

 
I was recently honored to be a guest on the Compass Opioid Stewardship Program podcast hosted by Dr. Rachael Duncan, PharmD. and Dr. Don Stader.

I'm so grateful for the opportunity and blessed to be able to share my story with clinicians. I'm also thankful for the generosity of Dr. Stader. You'll find out what he offered me at the end of the podcast. It brought me to tears.

You can listen to the podcast episode on Apple, Spotify, and Libsyn via the links below:
  • Apple
  • Spotify
  • Libsyn

Check out the entire podcast series. 

Learn more about the Compass Opioid Stewardship Program.

​

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