by Lynne O’Connor
The Opioid-Free Pain Relief Kit: 10 Simple Steps to Ease Your Pain is written by Beth Darnall, PhD. Dr. Danall is a clinical associate professor who has over fifteen years experience in chronic pain treatment. Living in Palo Alto, California, and working in the division of pain medicine at Stanford University, she brings a personal experience of chronic pain to her recommendations for finding relief from pain while reducing your pain medication.
Those of us who suffer intense chronic pain, no matter the cause, often find it necessary to turn to opioid medicines – a treatment option that is becoming more controversial and more difficult to obtain. Dr. Darnall (Beth) doesn’t espouse a point of view that opioid prescriptions are all bad or that chronic pain patients who use them are addicts. She recognizes that there are side effects of opioids and other pain medications that can be reduced or even avoided when chronic pain patients learn how to contribute to their pain treatment by improving the practice of her recommended steps to ease pain.
Having suffered from chronic pain for over 25 years, I thought that I had heard it all, so I was curious to see if Beth had anything new to contribute to my personal tool box of non-prescription pain management techniques. I was very pleased to see a blend of methods that I already use (augmented by some suggestions that I had not yet tried) and a few new methods that I could add to my mix.
This book is easy to read and, even though it was authored by a very knowledgeable doctor, it feels like it was written by a friend who knows what we go through as pain patients. Each of the chapters covers one of the ten steps in simple language that describes the reason why these techniques are worth trying. There are activities such as worksheets and logs to help you put these new tools to the test and incorporate them into your personal pain relief kit.
Step 1 – Quiet Your “Harm Alarm”
This first chapter explains how your body naturally responds to pain in a set of nervous system reactions, the “harm alarm,” that are designed to get you to escape from the cause of pain. When you cannot escape the pain, the continuous alarm can become distorted and make you less able to deal with the pain. Dr. Darnall offers access to an online audio file that you can download and listen to on the device of your choosing. It is designed to help you to calm your nervous system and quiet the pain alarm.
Step 2 – Understand Your Pain: It’s More Than it Seems
This chapter explains how pain is a combined physical and psychological experience. That’s not to say that “it’s all in your head,” but you can learn how to moderate your pain experience by controlling your thoughts and emotional reactions to the pain. It’s not as easy as you would hope but, with practice and using the suggested methods, it might be more within your reach than you can imagine.
Step 3 – Harness the Hidden Power of Your Thoughts
In step three, we learn more about how negative thoughts can actually increase our perception of pain and how calming our thoughts can help to break that cycle. A simple quiz gives you a numerical score that reflects the degree to which your thoughts are working against you in managing your pain. Through examples and stories, you will learn how to identify negative thoughts and replace them with calming thoughts and positive statements.
Step 4 – Pain Relief Actions for Right Now
Step four is all about creating your pain relief action list. When you’re deep in a pain flare and can barely think straight, having this list handy can help you get back on track with the pain management tools that you have found to be most successful.
Step 5 – The Power of Daily Mind-Body Medicine
I really like the analogy that Beth uses in this chapter to describe the benefit of a daily practice of mind-body methods that can help you to change your perception of pain. She describes how watering a plant is similar to the cumulative affect of a consistent, daily effort to develop these new skills. You won’t always experience immediate relief but, if you trust in the process and be persistent, you will see the benefits over time.
Step 6 – Sleep and Activity are Pain Medicine
How many times have you heard it from the medical profession? Get more sleep. Exercise more. When you’re in so much pain that you can’t sleep and hurt so bad that you can barely move, how can someone suggest that you can do better by sleeping more and moving more? Beth offers several tips to make these changes, but the best one that I can stand behind is “start small.” If all you can do is deliberately wiggle your toes on those bad days, then give yourself credit for trying.
Step 7 – Preventing Pain Flares
The pain flare prevention suggestions are activity, calming, and self-care. Beth includes tips to help you to learn how to recognize your pain warning signs and head them off by deploying your tools to calm your nervous system. You can avoid “pain hangovers” by moderating your activity when you’re having less pain to prevent a deluge of pain after you overdo on a good day. We can’t be perfect all the time so, when you realize you’ve done something to contribute to a pain flare, recognize what you can learn from the mistake and ensure that you will be less likely to make it again.
Step 8 – Stress Relief = Pain Relief
Several years ago, I had moved to a new town and needed to find a doctor because I was developing new systems. I got lucky. The new doctor told me, “You’re under so much stress that I can’t clearly see what is going on with you. Also, you’re going through menopause and I don’t think that you realize that.” He was right. The stress of the move, the new job, and caring for a sick friend was intense and I didn’t know that several of my new symptoms were related to menopause. He advised me to go home, learn about the changes that were going on in my body, and come back when I had reduced my stressors and better managed my stress levels. He couldn’t have given me better advice. I made some significant changes in my life and began practicing better stress management – skills that I continue to improve upon to this day. If you don’t know how to take those steps, Beth offers some excellent suggestions in this chapter.
Step 9 – Pleasure is Pain Medicine
Where pain contributes to a negative physical and emotional response, pleasure can have the opposite effect and contribute to a positive physical and emotional response. The tips and suggestions in this chapter can help you to identify activities and thoughts that give you pleasure so that you can ease your suffering when you’re feeling badly. Learn how to identify those things that bring you joy so that you can get the most out of “pleasure medicine.”
Step 10 – All Together Now: Your Complete Pain Relief
This final step helps you to put together all of the things that you have learned about in the previous steps. The worksheet in this chapter helps you to assemble a daily program of pain-relieving activities that include calming your nervous system, thinking positive thoughts, performing soothing actions, achieving an activity goal and a sleep goal, and giving yourself some pleasure medicine.
One Last Chapter
There is one more chapter in this book that is not part of the ten steps to ease your pain, but it is an important one to help you to understand the role that pain medication can play in preventing and increasing the severity of your pain. You may already know about some of the side effects of the pain medications that you take, but you might feel resistant to the thought of reducing your dosages and trying new methods of pain management. If that’s you, I suggest that you read this last chapter first.
Beth doesn’t present this information, or any of the ten steps, in a judgmental tone as if you are knowingly and deliberately harming yourself. She speaks from experience and as a medical professional and genuinely wants to share with you the positive improvements that she and other chronic pain patients have seen by making small but significant changes in the way that they think and feel and act in response to pain.
Even if you, like me, think that you have a good set of tools to manage your pain without opioids or with lower doses of other pain medicines, chances are good that you can learn something new from the techniques in this book.