Summary of Pain Management Techniques – Brian Grady, Ph.D

Technique What Purpose Effect on symptoms When How long
1 Diaphragmatic breathing Deep and slow breathing, using the belly. Physical Relaxation

Calming

Pain reduction

Pain tolerance

High pain

High stress

Can’t sleep

Tension

During activity

While stretching

5 to 25 minutes, daily

Duration of high pain episode

2 Activity pacing Alternate difficult and easy activities Prevents pain flare-ups while increasing productivity Preventive

Conserves energy

Any task Duration of task.
3 Persistence / non-avoidance Keep doing an activity Learn not to let pain control activity Neutral When continuing will create no long-term problems While symptoms are manageable
4 Thought stopping Noticing persistent negative thoughts, halting them, and changing focus Calming

Decrease worry

Neutral Can’t sleep

Worry, uncertainty

10 seconds, repeated as needed
5 Sensory transformation Feel “itching”, “pressure”,”heat” or “numbness” instead of pain Makes sensations more bearable Pain tolerance Moderate to high pain 10 to 25 minutes
6 Progressive muscle relaxation (active) In sequence, tense, hold, and then release muscles with an out-breath Physical relaxation

Calming

Pain reduction Any level of pain

Emotional distress

Can’t sleep

Tension

Too tired to concentrate on another relaxation method

5 to 25 minutes
7 Progressive muscle relaxation (passive) In sequence, be aware of muscle groups, and soften with an out-breath Physical relaxation

Calming

Pain reduction Any level of pain

Emotional distress

Can’t sleep

Tension

5 to 25 minutes
8 Peaceful imagery Use all the senses to experience or recall a peaceful experience Physical relaxation

Calming

Pain reduction Any level of pain

Emotional distress

Can’t sleep

Tension

When able to concentrate

5 to 25 minutes
9 Be with pain Non-resistance. Don’t fight it. Just let it be there. Makes sensations more bearable

Reduces distress

Pain tolerance Any level of pain Any length of time
10 Self-hypnosis (imagery, counting) Deeply relaxed, absorbed in what you experience, while open to what may happen as you use images and suggestions for healing Pain relief

Calming

Relaxation

Building confidence

Making behaviour changes

Pain reduction Any level of pain

When able to concentrate

10 to 25 minutes
11 Quick-cued relaxation / debracing Using a cue previously connected with the relaxation response to relax quickly Relaxation

Calming

Pain reduction

Pain tolerance

Any level of pain

Stress

2 to 5 minutes
12 Defusing negative emotions Notice negative emotions building, and short-circuit them early Calming

Makes sensations more bearable

Pain tolerance As soon as stress begins to build 1 to 10 minutes
13 Exercise Strengthening

Stretching

Fitness

Build fit, flexible, strong body Long term pain reduction Daily routine 30 to 60 minutes
14 Biofeedback Getting feedback about a body function helps you control it Gain control over tension, breathing Long-term Pain reduction In office with clinician

Thermal: on own, daily routine, as part of relaxation practice

10 to 20 minutes
15 Stretching Stretching muscles, joints Relieve tension

Improve flexibility

Pain reduction (immediate and long term) Daily routine

With increases in pain

When tension is noticed

Before activities

2 to 20 minutes
16 Distraction Put mind on something other than symptoms Reduce distress, pain awareness Pain tolerance Any pain level

Can’t sleep

As long as necessary
17 External focus Focusing on environment around, not body Reduce distress, pain awareness Pain tolerance Any pain level As long as necessary
18 Positive self-talk Coaching oneself through stressful experience Reduce distress, improving coping Pain tolerance Moderate to high pain

Stress

Can’t sleep

As long as necessary
19 Cognitive rehearsal Preparing oneself to cope before a situation Reduce distress, improving coping Pain tolerance Before possibly painful or stressful experience. 5 minutes
20 Posture correction Maintain balanced posture and gait (walking pattern) Relieve tension and fatigue Pain reduction long term Daily, frequently. Ongoing.
21 Pressure point release Press classical acupuncture points Release tension

Increase energy

Calming

Pain reduction Tension

Pain

Can’t sleep

15 minutes
22 Micro & mini breaks 3 second to 30 second breaks in activity Release tension

Conserve energy

Re-establish circulation

Preventive During activities. Micro breaks every minutes, mini breaks every 5 minutes. Duration of activity
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