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Chronic Pain

Pain management: relaxation and distraction

Many people that we talked to had used some sort of relaxation technique such as 'progressive muscle relaxation' or 'abdominal breathing' to manage their pain. Others used relaxation with a technique of distracting themselves known as 'visualisation'.

Some people used a combination of these techniques. Relaxation was thought to help reduce stress and muscle tension which could make the pain worse. One man had been taught relaxation and visualisation on a Pain Management Programme. He explained that they are also thought to help release natural pain-relieving chemicals into the brain.

 

Finds that deep breathing and relaxation reduce the stress and tension that can increase the pain.

Finds that deep breathing and relaxation reduce the stress and tension that can increase the pain.

Age at interview: 56
Sex: Male
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Well basically the breathing is the one that really works for me, you maybe take three big breaths but you put four out and that's you using your full capacity, your lungs, and that actually slows down your heart rate, so your tension, the tension eases, stress eases. 

Because if you get up tight, if you get angry, the tension, stress all goes to you so that when you get keyed up and people that suffer chronic pain when they get into that state their pain runs riot that is it at full swing. So you've got to try and cut out the tension and the stress, so if you get into your breathing it slows down your heart rate and your blood pressure so then your body is more calm and then it definitely lowers your pain level and its definitely one as I say works for me. 

If I've got the time I lie down and I listen to music, some people like listening to the tapes, sometimes they can drift away and visualise they're in Portugal or in their favourite place, and by doing that you're lowering the blood pressure, lowering the heart rate to what it probably should be, so then the tension and stress drifts away which definitely helps your pain, and I can't say it often enough but it definitely works for me. 

Once you sort of stop doing that, I mean the pain is still there but it's back to that sort of level that you can maybe call it your working pain because its there all the time, it's when you get that initial build up of this can give you tools to help you fight that, it's definitely worthwhile.

 

Was told on the pain management programme that relaxation and exercise produce natural pain...

Was told on the pain management programme that relaxation and exercise produce natural pain...

Age at interview: 61
Sex: Male
Age at diagnosis: 50
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They have other much more interesting and specific techniques, I can't remember what the technical term was but they taught us a sort of visualisation technique which you can, in which you can engage your brain yourself to produce a chemical called serotonin which is a natural painkiller. 

And so for example you can, they, one of the exercises we did every day, usually after lunch, we all lay on a mat on the floor and they'd play us gentle music and we were invited to imagine our pain as a something, say for example a bright light or a glaring sun or something, and imagine that is your pain and then if it's a bright light imagine that you've got control of the dimmer switch and you just dim it down, dim it down and it's quite amazing with practice that worked. 

You could actually learn how to use that technique. If it was a glaring sun well you could have imagine the sun was setting. I had a, because of this problem with my, the skin on my legs where I've got this burning sensation in my legs, I imagined in one of these exercises that I was standing in a clump of nettles and then I stepped out and, again with a little practice, you could make that work and it, it sounds fantastic. It sounds unbelievable but with training, with practice, you can make that technique work for you. 

And I go up now and lie on my bed and just, and just completely relax, imagine the pain away. And so that again is a clearly psychological technique but it is connected with actual physical mechanisms that exist in all of us but of course I was completely unaware. I didn't know what serotonins were. 

And another thing we talked about related to that is that the fact that the body produces something called endorphins and that exercise, when you exercise the body produces endorphins naturally and they are related to morphine. They are like a painkiller but it's produced by your body for your body so it's obviously completely natural and everything and exercise such as going for a long walk up the mountain produces a lot of endorphins and they have an expression, joggers high, when people go jogging and have a really good run and they feel very up and excited and happy and all the rest of it. That is from endorphins produced by exercise. 

So they, the whole process of pain management is a series of, it's immensely, practical, straightforward stuff that anybody can understand, but it's a constantly integrated approach of mental things and physical things that work together.

Some people had been taught how to think about or 'visualise' their pain as something that they could reduce or put away for example, putting the pain in a box, dimming a bright light or watching a hot sun set. One woman described visualising putting the pain from her thumb behind a glass screen and was surprised when it worked.
 

Was sceptical about visualisation but tried it and was surprised to find it helped relieve the...

Was sceptical about visualisation but tried it and was surprised to find it helped relieve the...

Age at interview: 56
Sex: Female
Age at diagnosis: 36
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We used to listen to tapes for relaxation, now I was very, very sceptical of anything like that, and we, you know you listened and there was a voice and it was taking you on a journey and that was fine, and I would sit there with my eyes closed and this particular Tuesday morning anyway my thumb, oh my god if I could've cut it off I would've done it. 

So this is called visualisation and we were taking this journey through a meadow to a glass building and then we're invited into the building and up to this other glass wall where you were asked if you wanted to put all your pain behind the wall or some of your pain behind the wall and then retrace your steps back and I remember thinking now who in their right mind would say 'oh well I'll just put some of my pain behind the wall, and I'll take the rest back with me'. 

So, but that was the day we called it the miracle of [CP01's] thumb, because believe it. And I mean I could hardly believe it and yet I was the one that was suffering the pain with this thumb and by the time the visualisation exercise we had gone into it with the deep breathing and preparing and all the rest of it and we had gone on this journey and we came back again, as we just got back into the flow of a meeting again, you know, like you were so relaxed and then you just come out of the relaxed state, you come back in with your eyes wide open and I could not believe that I had no pain in my thumb. 

Others found it helped to visualise a relaxing experience such as walking along a beach or sitting by a waterfall. Some people listened to relaxation tracks to help them with the visualisation, which they found helpful. Although one woman pointed out that to get the most benefit you had to use them regularly.

A few people found visualisation difficult but had found that a technique called 'progressive muscle relaxation' helped. Others had not found specific relaxation methods helpful and preferred to relax by listening to music, watching the television or reading a book. These were also good methods of distraction.

 

Finds guided visualisation difficult and prefers to use progressive muscle relaxation.

Finds guided visualisation difficult and prefers to use progressive muscle relaxation.

Age at interview: 47
Sex: Female
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Have you tried things like relaxation at all?

Yeah. I've done relaxation tapes and I find it very hard to do that because of the pain, when they say, you know 'Well just imagine you're on a beach and all you can see is the blue sea and the golden sand' I can't do it. I just cannot see that in my mind and I think that is just because the pain is there all the time, you know.  

But I'm not very good at visualising things with my eyes shut. But yeah, I'll do the, you know, the relaxation where you know you think of your fingers and then you think of your arms and you relax them as you go up your body, I can do that. But I'm no good putting a picture, and I used to be able to do that, I could do that but I can't do that anymore.  

Being able to distract the mind away from the pain by immersing themselves in another activity was a valuable self-management skill for some people who had taken up a new hobby such as woodwork or sewing which they found a good distraction. Others found it helpful to concentrate on a piece of work or solving a problem. Day to day activity such as spending time with the family, thinking about grandchildren or even driving could be a good distraction technique.
 

Has taken up cross-stitch and finds that this and her grandson a good distraction from the pain.

Has taken up cross-stitch and finds that this and her grandson a good distraction from the pain.

Age at interview: 47
Sex: Female
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The only thing I think that helps the pain is distraction. Just somehow find something that will distract you from the pain. Nothing makes the pain go away. Whatever you do, nothing makes my pain go away. Yeah perhaps you can say oh well you can ease it if it's something warm or something cold, but then that's something different and I think that is because you're thinking about 'Well will this work or won't it work?'  So you think 'Well perhaps it does feel a bit better like that' but no I truly think you've just got to distract yourself from it somehow and find something that will do that.

What do you find is the best distraction?

Probably, I started doing cross-stitch, which I didn't do before all this, but I find with that I can pick it up, I can put it down if I'm doing a good, big project or something, then I'm eager to get back to it and see it, you know, evolve and then to see people's faces when it's finished. That's very satisfying, that's something that, you know, I can, that I can do now, that I get the same sort of feeling as doing something well at work.  

You know, it's something that I am proud of and I will say that, I am proud of, you know, what I do and it is good. But then I like to, I've always liked, I can't fail, I'm not, I hate failing, and I know I can do that well and so, you know, that does distract me from the pain. 

And the family, if my grandson comes round then yeah you're obviously thinking about them. But that's the only, the pain doesn't go away, it never, ever, ever goes away. So just try and distract yourself from it.

Many people pointed out that although it is good to hear what works for others, not all techniques of distraction and relaxation suit everybody and it is important for each person to find out for themselves what is most helpful.
 

Relaxes by flooding his mind with a colour and distracts his mind from the pain by solving...

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Relaxes by flooding his mind with a colour and distracts his mind from the pain by solving...

Age at interview: 54
Sex: Male
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Now if you've got any other mental stimulus like your job, like your family, like your wife, you've either, you've got to somehow dump that problem on somebody else or get rid of it. Realise it is not a primary problem because you are so busy trying to deal with the pain in your head you have not got the mental ability to deal with anything else. 

And the only real ways I've ever found of dealing with that is some sort of relaxation and meditation and I deal with it by trying to flood my mind with a single colour and breathing and I end up really calm and drift off and you think 10 seconds has gone past and actually half an hour's gone past where you've just been nice and blank and calm and it does work. 

I also set myself solving mathematical problems as well which distracts me, so I start wondering you know, how somebody thought about differential calculus and how they went about it and I start trying to do that myself and I find that also helps me, but it could be anything. I mean it could be thinking about whatever you're practiced in. Not as a big problem but just an interesting thing to solve because in my case I've always found if I can get to sleep its better.


Since these interviews were recorded, techniques such as ‘mindfulness’ are increasingly used to help with chronic pain. The aim in mindfulness is to be more aware of the present moment, including your feelings and thoughts, your body and the world around you. The idea is that this can positively change the way you feel about life and how you approach challenges. Mindfulness combines various meditation practices (including a method called 'body scan') with modified yoga exercises and mind-body education (a form of Tai- chi) which all emphasise awareness of breathing techniques and relaxation.

Last reviewed August 2018.
Last updated May 2015.

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