HOW DOES RELAXATION WORK FOR CRPS?
When someone says you need to do some relaxation for your chronic pain condition like Complex Regional Pain Syndrome you most likely will think of long luxurious warm baths, lounging on the sofa, lying in bed late in the morning. Well we don’t quite mean those sorts of things, in fact there are many sorts of relaxation techniques that you can use as an alternative therapy or to use in conjunction with your pain management regime.
Relaxation is to calm yourself right down and also slow down your nervous system which will be working overtime because of your chronic pain. It should start to reduce the tension in your muscles, help make your pain medication to work better, help you sleep, lessen your anxiety and stress and also stop your pain from getting worse. So, when you get the pain spike or intense pain or flare up continue to your pain relieving management but also do some relaxation techniques to help it all work better. The actual pain that you have can also lead to stress and tension and the best thing to help it all is to break the constant ‘Catch-22‘ cycle by using relaxation techniques. Relaxation techniques are an integral part of the psychological therapy of chronic pain (Diezemann, A. 2011)
There are a few different styles of relaxation. First try to:
- Choose a quiet place for your relaxation
- Get yourself in a comfortable position either lying down or sitting up
- You can close your eyes
- Take 1 deep breath in
- Then keep breathing deeply and slowly
- Allow your shoulders to drop and relax your hands
- Continue with some slow deep breaths until you feel your body start to feel less tense
If you want to continue with the above you can then:
- Start to tense your various body muscles such as muscles in your legs, arms and then relax those muscles
- Once you feel your different muscles relax you can then begin to slowly open your eyes and bring yourself back to where you are and the present
This short exercise should take you around 10 minutes to do and if it works for you then try it at least once a day.
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NOW.. Some examples of some relaxation techniques:
- imagery which is when you concentrate on something that is not related to your pain so it could be a place you’ve been to on holiday or your children or a special dinner you went to with your partner, this is different to visualisation. Visualization and imagery techniques involve the induction of a relaxed state followed by the development of a visual image, such as a pleasant scene that enhances the sense of relaxation. These images may be generated by the patient or suggested by the practitioner. In the context of this relaxing setting, patients can also choose to imagine themselves coping more effectively with the stressors in their lives. (Vickers, A. & Zollman, C. 2001)
- there is muscles relaxation by relaxing and ‘letting go’ various muscle groups within your body
- gradual or progressive relaxation of different parts of your body starting from your feet up to the top of your head – this is where you concentrate on each area of your body, tense each area and then think that they are going limp and heavy beginning with your toes and work your way up your body and when you reach your head think that any pain left will leave or exit your body through the top of your head. This is technique best doing when you are lying down. According to Vickers, A. & Zollman, C. (2001) to learn how to do Progressive Relaxation you need to:
“…sit comfortably in a quiet room. He or she then tenses a group of muscles, such as those in the right arm, holds the contraction for 15 seconds, then releases it while breathing out. After a short rest, this sequence is repeated with another set of muscles. In a systematic fashion, major muscle groups are contracted, then allowed to relax. Gradually, different sets of muscle are combined. Patients are encouraged to notice the differences between tension and relaxation.”
- Body scan meditation – this is similar to the progressive relaxation but instead of tensing each are just focus your thoughts on that area and as you breathe think that your pain is leaving that particular area
- Breathing exercises that will help you relax to help your chronic pain (See the blog post for Breathing Techniques). However you try and breathe in and exhale slowly and try and let your muscles go loose every time you breathe out. If you suffer from any lung problems, please do see your doctor or specialist to check with them before doing any deep breathing
- Breathing whilst gently massaging near the area of pain, but please avoid any areas that are red, swollen or tender
- Mindfulness as relaxation – visit our MINDFULNESS post to learn more about mindfulness. However mindfulness is when you remain aware how you feel at that particular moment in the present both external and internal. If you remain focused and relaxed you can bring your pain levels down and as such bring your nervous system back down as well
- Biofeedback – Biofeedback measures your success in making changes to your body’s functions through activities such as guided imagery. Through hand-held machines that provide audio and visual information, biofeedback can measure changes in heart rate and muscle tension and relaxation (Bressert, S. 2015)
- Hypnosis – Hypnosis can distract people from pain or alter the perception of pain. People in severe chronic pain might try hypnosis as a form of distraction. For those in moderate pain controlled by medication, hypnosis can help them reduce their dosage and clear their minds. Hypnosis also can numb areas of the body where people experience milder pain. (Bressert, S. 2015)
- Relaxation CD’s
- Listen to some slow music using headphones – listen to some soothing sounds such as an example from a CRPS sufferer has given of ‘The Sounds of the Earth’ from Thunderstorm via Last FM. Available from: < http://www.last.fm/music/Sounds+Of+The+Earth/_/Thunderstorm+Out+In+The+Fields>
- Yoga and Tai Chi are 2 arts that are brilliant to help with your relaxation. Yoga involves a range of poses both moving and stationary and also combines deep breathing with the poses. Injuries can happen if you don’t practice Yoga correctly so the best suggestion is to learn by attending group classes or follow a Yoga DVD. Yoga teaches you to lessen your stress and anxiety and can improve your balance, strength and stamina. Yoga practice involves postures, breathing exercises, and meditation aimed at improving mental and physical functioning. Tai Chi is similar to Yoga but it has roots from martial arts. Just like meditation, you focus on your breathing and stay in the present. You use long flowing movements at your own pace. It has emphasis on relaxation, concentration, reducing stress, calming of the mind and the circulation of energy through the body. Tai chi is a gentle system of exercises originating from China. The best known example is the “solo form,” a series of slow and graceful movements that follow a set pattern. It is said to improve strength, balance, and mental calmness (Vickers, A. & Zollman, C. 2001)
- Qigong – Qigong (pronounced “chi kung”) is another traditional Chinese system of therapeutic exercises. Practitioners teach meditation, physical movements, and breathing exercises to improve the flow of Qi, the Chinese term for body energy. (Vickers, A. & Zollman, C. 2001)
You could also create a ‘Relaxation Journal‘ that helps you concentrate your mind by writing in your journal your relaxation method for that day, to enable you to vary what you do on each occasion you use your relaxation techniques. This is similar to writing a pain journal.
Try different methods for relaxation because 1 way may be good for 1 person but not for another but whichever relaxation exercise you do, it will take practice, so don’t worry that it may not have helped the first few times – keep going and try a relaxation exercise at least once every day!! There are no studies to say which method is better than another it is all about preference and what works for you not for everyone else.
Your pain levels will generally alter every day and so will your ability to relax, so one thing you don’t want to do is to force your relaxation to happen. If you do try and force yourself to relax it will become harder and harder until you give up, which is not what we want. If any of the relaxation techniques make your pain worse or you think is not helping you must stop straight away and always contact your GP or pain specialist let them know what exercises you have been doing and ask them for alternative relaxation exercises.
According to the NIH website (2014), there have been studies done on the effectiveness of relaxation exercises for chronic pain. The research has found promising but not conclusive evidence that guided imagery may relieve musculoskeletal pain (pain involving the bones or muscles) and other types of pain.
Some people use VISUALISATION to help with the relaxation techniques. This is where people can reduce their pain by visualising something lessening it. Some people also call this guided imagery. Some say that is like traditional meditation so you don’t just use your vision but your smell, touch and taste. This can involve:
- get yourself in a comfortable position either standing, sitting or lying down
- you can choose to sit in silence, listen to a relaxation CD or whilst listening to some slow music. If you are thinking yourself to be at a beach or near the sea you can listen to the sounds of waves
- think about whatever place is most restful and calming, for example picture yourself on a tropical beach, in your favourite childhood spot or even in a forest – visualise this image, think about sounds, smells, feelings as well as what you see
- enjoy the feeling of relaxing in this place
- when you’re relaxed and ready, slowly open your eyes and allow yourself to come back to the present
ANOTHER VISUALISATION EXERCISE:
- get yourself comfortable either lying down or sitting
- listen to some slow music or to the sounds of waves crashing on a beach or simply sit in silence
- try to visualise / see your pain, think about how it feels, what it could look like if you could see it
- now think about reducing your pain in some way e.g. burying your pain in the sand, putting the pain in a box, putting the pain behind a glass door or screen or setting a hot sun on the pain.
- Be as visual as you can be, you never know it may work for you! Don’t just pick an image because it has been mentioned as it must be personal to you
- when you are ready slowly open your eyes and let yourself come back into the present
It is not a problem if you have a feeling that you’ve lost track of time or you’re not sure of where you are for a moment, this is a normal response.
- Diezemann, A. (2011) ‘Relaxation techniques for chronic pain,’ Schmerz. 2011, August. Vol 25(4) pp 445-453. Available from: <http://www.ncbi.nlm.nih.gov/pubmed/21818724>
- Hospice.net ‘Relieving Pain Without Medicine‘ Available from: <https://www.hospicenet.org/html/without_meds-pr.html>
- NIH website (2014) ‘Relaxation Techniques for Health,’ NCCIH website. Last Updated December 2014. Available from: <https://nccih.nih.gov/health/stress/relaxation.htm>
- Vickers, A. & Zollman, C (2001) ‘Hypnosis and relaxation therapies,’ Western Journal of Medicine. 2001, October. Vol 175 (4) pp 269-272. Full text available from: <http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1071579/>
Learning the art of relaxation for CRPS and chronic pain is important on many different levels as you have read, so why not give it a go? Post your thoughts about the exercises below in the comments box or share the blog on Social Media! What is your favourite relaxation technique? How do you try to relax? Let us know!
Last Updated: 07/03/2016