From: Linda.Cummings@f34.n375.z1.fidonet.org (Linda Cummings)
Newsgroups: misc.handicap
Subject: Birmingham Pain Clinic
Date: 17 Apr 92 19:49:50 GMT
Reply-To: Linda.Cummings@f34.n375.z1.fidonet.org
Organization: FidoNet node 1:375/34 - Batteries Included, Montgomery AL

Index Number: 21239

[This is from the Spinal Injury Conference]

The following handout was given to me at the Birmingham Pain Clinic:

ACTIVITIES

Inability to pace activities wisely is one of the greatest
contributors to chronic pain.  Many people become quite inactive
because of their pain problems, fearing that activity will make
them worse.  Others become overly active, perhaps trying to over
compensate for their pain problems or show themselves and others
that they are the same person they always were.

With prolonged inactivity, muscles get weak and actually
deteriorate.  In addition, there is evidence that the brain does
not produce as much natural pain-relieving chemicals (endorphins)
when people are very inactive. Inactivity is also one of the surest
ways of becoming depressed, allowing all of your attention to be
focused on how miserable you feel.  In fact, almost anyone can make
himself or herself depressed by staying in bed and doing nothing
for a period of several days.

Overactivity, on the other hand, keeps the person from resting and
recovering and creates problems on its own, including re-injury and
increased stress and tension.  Increased muscle strain and
re-injury is especially likely if periods of inactivity alternate
with periods of overactivity.

While no sure answers can be given about what a person's proper
activity level is, the physicians and physical therapists can help
guide each individual. Some of the following points should serve as
guidelines as well:

    1.  Most chronic pain patients who have become very inactive
        as a result of their pain can benefit greatly from
        gradually increasing their participation in physical
        activities, if they do so in successive small steps.

    2.  It is generally helpful to gradually increase activity
        levels with day-to-day consistency rather than have one
        day of extreme activity and the next day of little
        activity.  Also, take frequent breaks for rest and
        relaxation when necessary.

    3.  A slight, temporary increase in pain may accompany
        increases in activity level, especially in the beginning.
        If an increase in pain level makes increasing activity
        level aversive, then make your increases more gradual,
        staying at each level for a longer period of time before
        the next increase.  Of course, major increases in pain
        should be reported to your physician before proceeding
        further.

    4.  In order to increase activity levels, there is a need for
        patience, persistence, determination and focusing on
        making slow, gradual changes.  It is very important to
        have a balance of activity and rest.  Difficult tasks
        (e.g., mowing the lawn) may have to be done in several
        segments with time for breaks and relaxation in between.

Many people in pain give up other activities such as social or
religious activities when they hurt.  By withdrawing from the
anxiety of such activities, they often cut themselves off from
others and feel increasingly depressed and isolated.  Some of the
important benefits from increased activities are:  an increased
sense of self-esteem and competence, improved mood, improved
physical health, more contact with people (less isolation and
loneliness), and, of course, long-term reductions in pain

Linda

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