Use Your Head to Break the Rheumatoid Arthritis Pain Cycleby Marianna Paulson, B.Ed., B.P.E.-O.R. Patient Advocate
When you're floundering with the pain of an RA flare, you might turn to your medicine cabinet to find relief. There's another place to go, and it's free. There's a growing body of evidence to support using your head to help manage the pain you feel in your body.
I remember flares that were so bad that I couldn't dress myself. I would tense up, even with the anticipation of movement of any kind. I was like a steam engine trying to build up enough energy to move forward, even if it was only from sitting to standing. I'm so thankful that I rarely experience those types of days. I may have RA, but it doesn't have me thanks to some of the following strategies that I regularly use.
A change in career led me to become Auntie Stress, a move that enabled me to realize that there was something I could do for the emotional, mental, and physical pain I was feeling. By committing to a regular practice of addressing my stress, a magical thing began to happen. I had less pain, and I was better able to manage the pain when I did have it. The change was almost unnoticeable because my focus had shifted to things other than my pain.
When you are stressed, your brain receives signals indicating that you are under an attack of some sort. Regardless of the reason, real or imaginary, your system is flooded with chemicals, complete with side effects that can include an unappealing smorgasbord of symptoms such as heart disease, high blood pressure, high cholesterol, aches and pains, poor gut health, and increased inflammation.
The process to feeling better is gradual. Start with the following steps and add more with time:
Pay attention to your breathing. Are you huffing and puffing like a steam engine, using the muscles in your neck and chest to breathe? Instead, imagine sending the breath down to your hips, which will engage your diaphragm, instead of overusing those tired (and sore) neck and shoulder muscles.
Pay attention to how you are feeling emotionally, mentally, and physically. Then, make the connection with how you are breathing. Being mindful of this is a first step in making a change.
Oh, those neural pathways!
You don't remember learning to walk, but I'll bet you remember learning to drive. It involved a great deal of practice and a lot of focus on the mechanics of driving and the rules of the road, all the while paying attention to the actions of others who shared the road with you. Gradually, you became more comfortable driving, to the point where you now talk and drive without giving those beginning efforts much thought.
Think about the other things you have done effortlessly through repetition such as writing, speaking a foreign language, and using technology. Thanks to the brain's plasticity, repetition/practice helps to strengthen neural pathways so you don't continually have your own “Groundhog Day” when you learn something new.
Think about your habits, both desirable and undesirable. How often do you find yourself doing the very thing you swore you wouldn't do? A well-worn neural pathway equals a default to an unconscious behavior. Change requires learning a new strategy — in other words, creating a new neural pathway.
To dull the effects of pain, it's important to use your head and follow a different pathway — one that leads to gradually feeling better.
I play The Painless Game, which includes changing how I look at my health. Rather than itemizing what is wrong with me, I shift my focus to what is right. I then stoke feelings of gratitude for what I can still do. It can be easy to think and feel myself into feeling worse. That “stinkin' thinkin'” not only triggers the stress response, which contributes to inflammation, but it also keeps the focus on my pain. For the same reason, I limit the amount of complaining about my pain, when I do have it.
You don't have to catch the first train that comes along
Your train of thoughts, especially if you think you're at the beginning stages of a flare, come rumbling in like a train to the station. But do you really want to reach that destination? Wouldn't it be better to wait and take the next train? The pause gives you time to reassess your situation, rather than immerse yourself in worried thoughts. Perhaps it's morning stiffness. Maybe you overdid it the day before. The pain and stiffness you feel does not always lead to a major flare.
Remember, stress (negative thinking and feeling) can contribute to the inflammatory response.
“Researchers discovered that when study participants were asked to ruminate on a stressful incident, their levels of C-reactive protein, a marker of tissue inflammation, rose,” reported an Ohio University study in Science Daily.
I've learned that it is helpful to change my perception from: “Oh no, not a flare!” to “Let's wait and see” Dampening the fear helps to dampen the flare.
Pain is greedy
Pain is greedy, robbing you of the small joys in life. Pain can prevent you from fully participating in all that life offers, including family time, work, travel, and socializing. The goal of RA treatment is to prevent damage, reduce inflammation, and thus, control pain.
My goal is to be as proactive in my health as possible in order to achieve the same goals. The process of pain management is a choice I will continue to work on for the rest of my life. I am motivated for the simple reason that I feel better! If and when there are times when I slip up, I always find my way back to them.
Do you use strategies to manage your RA pain?