Self-help for chronic pain and fatigue

There are many different conditions that cause chronic pain and fatigue, such as fibromyalgia, inflammatory arthritis, and ME to name a few. If you live with one of these conditions, you’ll already know how limiting these symptoms can be. It’s also really easy to get into a cycle of pain and fatigue limiting your activities, leading to feeling weaker and lowering your mood and therefore making you less able to be active. It’s therefore really important to have lots of small ways you can help reduce the pain and fatigue so you can cope better and be more active.

As always, before starting any new advice it’s best to check with your doctor to make sure it’s suitable for you. I hope I can provide a few ideas to help you reduce your pain and fatigue…

Hot/Cold Therapy.

Using heat or cold to help reduce pain can be really effective. Hot water bottles and electric heating pads are the best way to apply heat, just be sure to take regular breaks to avoid over-doing it. Ice packs wrapped in a towel or using a topical gel are perfect for targeting particular painful areas. Be careful to avoid ice burns by applying the ice for short periods and using a towel to protect the skin.

There’s a lot of conflicting evidence about hot and cold, so go with what you feel works best for you. For acute injuries though, always go for cold and get advice from your local osteopath or your doctor.

Massage.

Massage can be great at loosening tight muscles, improving blood flow to an area and also giving your body a different sensation and therefore distracting from the pain. If you can’t get regular massages with a qualified massage therapist, there are lots of tools available for you to use at home.

Spikey massage balls can get into small areas of tight muscles. I recommend gently leaning on the ball against a wall and moving around to massage an area (think of how a bear scratches it's back on a tree!) It’s better to do little and often, so you don’t overdo it or cause an injury.

Foam rollers are very popular because of their ease of use. You can either use the foam roller like a rolling pin, or place it on the floor and use your body weight to apply the pressure. Beware of overdoing it, this can be intense, so gradually build the amount of pressure over time.

Relaxation Techniques.

It’s natural to feel stressed when you experience a lot of pain and fatigue, but that stress can often exacerbate the problem. Unfortunately we all go through stressful periods in our lives and people with chronic pain conditions often find these aggravate symptoms. Even when you can’t affect the cause of your stress, you can limit the physical impact of it with some techniques.

Mindfulness and Meditation.

There are lots of different ways you can approach mindfulness and meditation. Some people find guided meditations through apps and youtube videos. Others find just listening to some calming music and focussing on your breath can work wonders. Experiment with different techniques and find what works for you.

Prayer.

Depending on your faith, prayer or even just expressing yourself out loud can be very therapeutic. Sometimes the worst thing we can do when stressed is to keep things bottled up, so let it out in the way you feel most called to do!

Deep Breathing.

Breath is incredibly powerful and important. Obviously breathing is one of the essentials of life, but it can also be a great way to promote relaxation. Try this exercise:

• Sit or lie comfortably and start focussing on the sensation of your breath.
• Gently take a breath in, counting up to four and focussing on drawing your breath right into the bottom of your lungs and into your belly area.
• Gently breathe out, counting up to four.
• Continue this until you feel calm and relaxed.
• Ensure you don't tense your neck and shoulders while doing this exercise.

This exercise can be difficult at first, so alter the timing as you feel comfortable; the faster you count to four, the quicker your breath, so gradually slow your counting down as you get more experienced with the exercise. If you have any kind of respiratory condition, it’s best to check with your doctor before performing exercises like this.

Progressive Muscle Relaxation.

• Lie down comfortably and cover yourself in a blanket if you’re cold.
• Start focussing on your breath and let your breathing slow naturally.
• Then, bring your awareness to the top of your head. Imagine all the muscles in the top of your head slowly relaxing and releasing.
• Then, bring your awareness to your forehead and do the same with these muscles.
• Gradually progress all the way down your body, focussing on a new area and moving to the next when you feel relaxed.

Distraction.

If you’re feeling overwhelmed with tiredness and pain, it can be useful to distract yourself with a positive or mindful activity. Everyone enjoys different things, but some things you could try are:

• Reading or audiobooks.
• Listening to music.
• Listening to podcasts.
• Talking with friends or family.
• Journaling.
• Colouring, such as the mindfulness colouring books.
• Arts and crafts.
• Watching a positive film.
• Puzzles.

Counselling or CBT.

Counselling can provide a valuable outlet for your emotions associated with your health. Trained counsellors should also be able to put you in touch with other health professionals if you require any other help. Cognitive behavioural therapy (CBT) is really good at providing coping techniques and can help your mental/emotional health long-term.

UCLH provide a great online resource for more information about pain management with all sorts of different techniques.

Joint supports.

Joint supports can be really useful, especially while building strength up in an area, but they should be recommended by a trained health professional such as your doctor or osteopath. Usually supports are used in conjunction with exercises to build strength, but sometimes supports are recommended for longer periods of time.

Taping.

Sports tape has mixed research currently, but I’ve found it useful myself and recommend it to patients to see how they personally find it. It’s non-invasive, non-pharmaceutical and as long as you don’t have an allergy to the adhesive or tape itself, it can provide support to an area.

Exercise.

Gentle exercises to strengthen and stretch areas of your body can include:

• Walking.
• Nordic walking.
• Swimming/hydrotherapy/aqua aerobics.
• Cycling.
• Yoga.
• Pilates.
• Tai chi.

As always, it’s essential you check with your doctor before starting a new exercise to ensure it’s safe and beneficial for you. Start slowly and gradually build up over time. If you have to stop your exercise routine for a few days, then take care to gradually build up again.

Pacing.

It’s really important to pace yourself and monitor your activities when living with chronic pain and fatigue. In fact, usually your body won’t give you any choice in the matter! If you overexert yourself, you may experience a kickback of symptoms that force you to rest and recover. A fantastic way to explain this to people who have never experienced it is using The Spoon Theory by Christine Miserandino.

Creating a daily routine of self-care activities can help you manage and limit your symptoms. If there are some activities that always help you, keep them as ‘non-negotiable’ that you do every day. Don’t make them difficult or energy consuming, they should be things that feel beneficial to you, such as applying a heat pad to problematic areas before going to bed every night or doing a particular stretching routine before you get up in the morning.

Over time you can gradually set small goals to increase your activity, but building it gradually over time to avoid burnout. It’s normal that symptoms will fluctuate, so always take that into account and don’t push yourself too hard or punish yourself if you don’t meet your goals. It’s all about finding the right balance; it’s always a work in progress and changes day to day.

Practice Gratitude.

A beautiful way to cultivate positivity in your life is by writing down three positive things that have happened during your day. I try to practice this, but I will admit that I forget sometimes and have to keep reminding myself! Things I write down can include simple things like speaking to a friend, seeing a pretty sunset, having a nice cup of coffee, making something, realising an exercise is getting easier… you can be really creative with your choices! During days when it’s difficult to find a small positive, it’s really nice to look back over previous days, both for inspiration and for appreciation.

Nutrition.

Cooking and maintaining a healthy diet is really difficult when you’re low on energy and in pain, but it can help your symptoms and quality of life in the long-term. If you need specific advice then your GP should be able to refer to a dietician or you can speak to a naturopath like myself. I’ll give you a few simple ideas you can easily incorporate into your day, but if you have any digestive problems please exercise caution with any changes and speak to your doctor first:

• Drink plenty of water. When you feel hungry, have half a glass of water first and wait ten minutes. Often our body misinterprets thirst as hunger.
• Limit caffeine and alcohol as much as possible.
• Have healthy snacks with you such as nuts, seeds, carrot/cucumber sticks and humous.
• When you’re feeling up to it, make food in bulk and freeze in portion sizes to have when your energy is low.
• You can buy prepped vegetables for days when peeling and chopping is too much. Obviously these aren’t quite as good as fresh, but they’re much better than a ready meal.
• Take a look at my previous post about healthy breakfast ideas.

Sleep Health.

Sleep is essential for healing and rejuvenating, but often chronic pain can keep you awake at night. This itself is a problem, but it then also leads to stress and apprehension. Try to create a restful sleeping environment, free of stimulants like phones and televisions.

Create a bedtime routine to help your mind wind down and prepare for sleep. Don’t look at bright lights (like phones) for 30-60 minutes before bed, dim the lights if you can, play relaxing music, take a hot bath if that relaxes you and perhaps have a nice lavender essential oil room spray/candle/diffuser.

Try to keep the same time for going to sleep and getting up. This helps to keep your sleep and wake hormones in a natural cycle and make sleeping easier and more restful. If you need to nap during the day, then feel free to!

It can be really horrible when those nights come around where no matter what you do, you can’t get to sleep. If that happens, try to calm your mind by reassuring yourself that although you're not sleeping, you're still resting and helping your body. I know you’d rather be sleeping, but rest is still beneficial for your body.

Osteopathy and Naturopathy.

The principles behind osteopathy and naturopathy stress that health doesn’t just mean a healthy body, the mind and emotions are equally as important. This is why I trained in naturopathy as well, to be able to support people and share information to improve all aspects of their health. I've written about naturopathy on my blog previously.

I’m especially passionate about helping people with chronic health conditions, because I live with a couple myself. When you live with a chronic condition it can be really difficult to manage symptoms while living the life you want to. I use lots of these techniques to manage my physical and mental health, enabling me to then help other people. I hope these tips help you, please let me know if they do or if you have any other suggestions. We’re all different, so different things work for different people! If you’d like any more information, please get in touch.

Zoë Clark is a registered osteopath trained at the British College of Osteopathic Medicine in London. Practicing in Howe near Norwich (01508 558373) and Burston, near Diss (07543 557746), Norfolk.

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www.zoeclarkosteopathy.co.uk