5 Steps to Start Managing Your Pain


How are you doing? This is week 2 of our wellness series on the topic of pain management or "how to better understand how to prevent or/and heal chronic pain and injuries". Why should you care? Well, if you are anything like me, super active all the time, you may be on the look out for extra pockets of energy. In fact, my number 1 personal health goal is to be high energy because when I bursting with vitality and energy, I am unstoppable. I get things done and it feels amazing. Now what are the two biggest energy suckers you wonder? PAIN/DISEASE and DIGESTION. Yep. That is why this month we look at pain and next month, at digestion. If you missed last week's article on the cycle of chronic pain, you can find it HERE.

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So you have some chronic pain or injury to heal, or you have recovered successfully, and want to make sure that knee, rotator cuff, hip or lower back and sciatica pain does not come back, what do you do? Here are five tips to get you started on managing your pain and to create a team around you to support your journey into recovering your health. I sat down with my own teammate (in my personal team of healthcare pros) an amazing Chiropractor named Rob Pape (http://www.nycbodymechanic.com), to hear his words of wisdom:

Step 1: Get an initial evaluation from someone you can trust
This first step is like the wide opening of a funnel. It helps to determine whether you are seeking help from the right expert. When you complain about pain to your healthcare professional, he will begin to assess whether it is a musculoskeletal issue (a muscle, joint issue or structural issue), and whether the pain is associated with certain movements or activities. It may not be. For a smaller percentage of people, the pain felt is due to nervous system issues and can be spotted with numbness and tingling for instance.

Seek that first evaluation from someone you trust, someone with a broad view of health and a broad referral network of quality professionals like a functional doctor, a good chiropractor with a broad range of experiences and education or a holistic health professional/coach. This person should evaluate you with the underlying ever present question "Am I the right person to help you out?"

Rob Pape, DC, has a list of red flags, i.e. signs that would call for a proper medical referral. If the answer to the question below is YES, he would refer the client to another medical professional:

  • Is it a fracture?
  • Is there ligament disruption?
  • Is there spinal cord injury?
  • Is there a loss of bladder and bowel control?
  • Is there loss of sexual function?
  • Is there unrelenting and severe pain non-associated with a particular movement?
  • Is there unresolved swelling for several weeks?
  • Are there organic issues, if so, hands on work and corrective training would start after the organs healed.
A good practitioner will ask many questions and perform tests to try to understand the WHY (the root cause) in order to make a proper diagnostic and determine the right course of action.
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Step 2: Start treatment
You won't get better unless you start treatment. Adherence to treatment prescription is incredibly low in the US. It is 70% for treatments prescribed at facilities, so imagine how much lower it is when the treatment is to be performed by ones self at home... Unless you start and stick to your treatment, don't expect to heal.

Healing pain is a holistic process. Trust me! I've been there (correction: I am there). It takes professionals from multiple backgrounds. Anyone who tells you they got it all, can fix everything on their own, without other practitioners, especially at the beginning of your treatment is likely mistaken. Stay away.

Because the body is an integrated system but medicine is segregated by specialty areas it takes a village: a doctor, a specialist (OBGYN, orthopedist, etc.), a nutritionist, a lifestyle coach, a personal trainer, a physiotherapist, etc.
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Step 3: Commit your resources
Once you've started, finishing requires to commit your resources in terms of time, energy and money (i.e trade-offs). Such a project requires a budget, especially because it tends to be long term: after the acute and sub-acute phase, there is a chronic phase of management. I have a health budget because I am obsessed with making the most out of my short life (see commitment continuum above) and I cannot make the most of it unless I radiate vibrant health, and live pain free. I have allocated resources for:
  • Auxiliary healing procedures monthly (acupuncture, chiropractic, massage, etc.)
  • A weekly food and supplements budget (more on this topic in two weeks)
  • A daily allocation of time for corrective exercise, stretching and exercise (60 min before sunrise and 60 min at the end of the work day) and finally,
  • A reorganization of my schedule around my sleep. No healing and repair can take place without extra zzzz. Human Growth Hormone is especially created in the first few hours of the night, before midnight. Consider napping when you can as well.
Step 4: Measure and re-evaluate progress
While pain management and situation of chronic injury treatment tend to be a long term project, you want to make sure that the treatment is working and correcting the problem. You should see progress after every session. "Every session or every couple sessions is an opportunity for decision points, Rob says, especially in the beginning of treatment there should be changes occurring after each session. If during the beginning of treatment progress (improved range of motion, mobility, decreased pain) isn't being seen at least every couple of sessions, the practitioner should be reevaluating, changing his or her approach, and deciding whether a referral is appropriate)."

During the acute phase, your health practitioner should see you as often as possible, several times a week for a couple weeks depending on the severity of the matter. When I started in June 2015 an 8 weeks project to dig into the 3 decades root cause of my back issues, I was visiting him 3 times a week for 2 weeks, then once or twice for 2 more weeks and then once a week for a few more weeks.

During the chronic phase, the visits frequency depend on the body's ability to process treatment, absorb and integrate the change on its system. Moving too fast may be uncomfortable. It's like dental braces really, it takes time...!

It also takes a team of experts as we said earlier. Rob advises that if the chronic issue is not an organic issue (liver, kidneys, etc.), corrective exercise should complement the hands-on work.

After each session with Rob where we broke down old scar tissue and realigned my body, I performed corrective exercise training immediately following treatment to "seal the deal". I was teaching my body how to move correctly in its new alignment (proper recruitment of the kinetic chain) and create new neurological pathways between my brain and my muscles to correct and prevent faulty movement patterns and create new correct ways of holding my posture and moving. I focused on correcting muscles imbalances, accumulated over years of compensation (although not visible to the eye), increase flexibility in some places and strength in others and increase neurological efficiency.

One sign you have the bad team: Progress stalls for 2-3 weeks at a time and the treatment protocol s not changing or no-one is asking questions (and I am assuming you are doing your homework right?)

Step 5: Take ownership of the healing continuum
Finally, years in management consulting at PwC taught me that for a change management project to be successful, there needs to be great leadership and ownership. The leader and owner of the project, make no mistake, is YOU. Not your primary care physician, not your super talented chiropractor, not your personal trainer or your holistic health practitioner. It is YOU. You make the plan and execute that plan, you engage the team, you draw the status report, the lessons learned, negotiate and hold the resources, you ask the questions. In order to live pain free it requires great commitment to this project and direct ownership on your part which means you are ultimately responsible for the success or failure of the project. If treatment does not work, you are responsible to question the team and ask for a different course of action.

This leadership attitude needs development. What my pain management journey taught me was how to become that better leader and owner of my own health and my healing process. I learned how to be disciplined, committed, understand my body, say yes to what is good for me and no to what is not. That leadership permeated throughout all other areas of my life and enabled me to feed success as described in my Feeding Success book.

And what about you, what are your top tips to manage your pain? Let me know in the comments below!

To your health,

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