“Strange times we’re living in!”
If you are like me you have probably uttered this sentence or heard someone else say something along these lines at some point in the past month. 2020 will long be remembered as one of the most unique and trying times in world history. The outbreak of COVID-19 has forced or encouraged many Americans to stay in their homes due to concerns over their own health, the health of their neighbors and community, or because their place of employment has closed.
Physical therapists across the nation remain in place as an essential health service, not in the management of patients dealing with this novel coronavirus, but to help those individuals recovering from challenging surgical operations, those dealing with long term disabilities, and people who are in debilitating pain. The needs of those recovering for surgery or long term disability are too varied and specific to address in a single blog post but for those experiencing some form of daily pain, there are several things you can do from within the confines of your own home.
It is estimated that around 20% of Americans experience some form of daily pain, most commonly in the lower back or neck. As physical therapists, we are uniquely suited to evaluate causes of pain related to movement dysfunction, posture, muscle imbalances, and other sources. While we remain open to serve those individuals who are able or feel comfortable coming into our health facility, we understand that there are many out there who are required or prefer to stay home until the spread of the virus has stabilized.
Here are 9 ways you can attempt to manage your pain at home independently until you feel comfortable to make an appointment at one of our clinics where your needs can be more completely evaluated.
One of the hardest things to convince yourself to do while you are experiencing pain is to try to exercise. Depending on the amount of pain you are experiencing and the location, physical activity can be anything from taking a lap around your dining room table to going for a jog outside to performing a recorded or live fitness routine from one of several online sources currently available (the Performance Health and Fitness YouTube page has several excellent resources available for free). A general rule of thumb with physical activity and pain is that if what you are doing is making you feel worse or increases your pain after you’ve completed the activity you should probably seek advice from a professional on whether or not that activity is safe for you to continue to perform. Physical activity doesn’t have to be fitness or cardiovascular based exercise either. Just simple movement of a limb while sitting or lying down can be very helpful in alleviating joint pain. The term “motion is lotion” is very applicable to the management of most pain at home. It’s easy to stay on the couch, in bed, or at that home office chair for hours on end but finding those little opportunities throughout the day to move can be vital to managing your pain at home.
Admittedly this is not an area that I have a lot of personal experience, but I have had many patients over the years experience dramatic changes after starting daily meditation to help with the management of particularly chronic pain. There are also many emerging studies that explore the use of guided meditation through apps or personalized sessions that have shown positive improvements in patients dealing with pain. If you don’t have a meditation app, we recommend giving one of these a try: Headspace | Calm | Stop, Breathe & Think
There are countless studies that have shown the benefits of stretching and/or yoga in the management of both acute and chronic pain. Much like the challenges in prescribing physical activity in a generalized blog post, it would be difficult and irresponsible to claim that everyone should start a structured yoga or stretching program without an understanding of their individual limitations and pain origin. However, there are many resources available online sources like YouTube and through mobile apps with stretches and yoga programs directed to address pain in different regions of the body. Our Performance Health & Fitness YouTube page has multiple recorded yoga classes you can try at home.
One of the easiest yet at the same time most difficult things to control when you are at home is your eating habits. Numerous studies have been done on the impact your diet has on inflammation levels in the body and pain in general. Performance Therapies physical therapist Molly Camacho has a terrific brochure available on inflammation that includes information on the impact diet has on pain. Making good choices on food intake is a challenge for most of us, regardless if we are in pain or not, but when you are isolated at home with less access to groceries it can be more difficult. Making good choices on a properly balanced diet including lots of different fruits and vegetables and avoiding processed and packaged foods are just a few of the suggestions supported by research. Your best resource for advice and guidance on nutrition would be from a registered dietitian. Our in-house registered dietitian, Ashley Pearson, would be an excellent resource to consult with if you have specific questions or dietary concerns
Another aspect of general health and well-being, but something that also specifically relates to the management of pain independently is the importance of good hydration. Working from home or practicing social distancing can take many of us out of our normal routines. Passing by the drinking fountain or water cooler at work is oftentimes an easy reminder to stop and fill your water bottle or at least take a few sips of water. Without some of those normal cues at home, it can be easy to forget to keep proper hydration throughout the day at home. Numerous studies have shown direct links between both chronic and acute dehydration and perception of pain. Research has shown adequate fluid intake for men to be approximately 15.5 cups per day and 11.5 cups per day for women. This includes fluids consumed through both foods and drinks. Other common guidelines are to aim to drink 8 glasses of water a day or to consume half of your body weight in ounces. Each person’s hydration demands will be different, but for optimal health, you should not wait until you feel thirsty to drink fluids and you can monitor the color of your urine to help guide your personal fluid intake. Keep in mind that consumption of caffeinated or alcoholic beverages, while contributing to fluid intake, are also diuretics that can lead to additional fluid loss from the body following consumption. Avoiding alcoholic beverages may help from a mental health perspective during isolation as well.
Evaluating Your Home Office/Work Space
One of the most common reasons we see patients for pain, especially in the upper back and neck, is from sitting behind an office desk for long periods of time at work. If you are one of the many individuals finding yourself working from home right now the problems can become much worse. Commonly your desk setup at work will be made up of office furniture specifically designed with ergonomics and prior testing in place. It may not fit your specific needs exactly which is why on-site ergonomic assessments are necessary at times to make subtle changes. When working from home, however, we often find ourselves working from our laptops at the dining room table, kitchen counter, family room recliners, or patio furniture. Humans are adaptable and can operate in less than ideal conditions quite well for at least a short period of time. However, after days or weeks of working from these compromised positions, our bodies can start letting us know that they aren’t happy with the new office. There are numerous online resources available, including our article on proper sitting posture while working from home, with recommendations about desktop and laptop computer setups for home or the office. One of our physical therapists would be happy to give advice on your home office set up as well. Many times this can be done via email or possibly through photos or video. Contact us if you would like to learn more or speak to someone at Performance about your home office setup and proper ergonomics.
At its root, pain is a perception in our brain. This does not mean that pain is imaginary or “all in your head,” but there are no physical tests to assess or quantify pain. Each of us experience pain differently. It is believed that our perceptions of pain can be shaped by our historical experience of pain, the social guidance of culture or one’s individual upbringing, or other emotional factors going on concurrently with the pain. When we are experiencing pain, especially severe pain, it can be very difficult to focus on anything else going on in life outside of that feeling. Distraction can be a powerful tool for managing pain much in the same way as meditation mentioned earlier. Distraction, in this example, is not as much about finding a higher or more distant mental state but is finding other more enjoyable things to focus your attention on rather than fixating on pain. I talk to my patients frequently about finding a favorite movie or television show to watch that will keep the mind fixed on positive emotions. Comedies or action films can work very well for this as the laughter and excitement tend to hold our focus easily, but anything that makes you feel good can work. As a physical therapist who often talks to young people about the risks and downside of extensive gaming the next example of distraction is difficult for me to write about, but the World Health Organization (WHO) recently came out with a statement in favor of gaming during the COVID-19 pandemic. If you enjoy gaming and have access to console, online, or mobile games this may be a good way to keep your mind focused on something other than pain. This is a great time to increase indoor family-friendly activities like putting together a jigsaw puzzle or breaking out some of those old board games from the closet as well.
One of the most significant changes in the past decade has been the meteoric rise of social media. While a quick online search can point out the many downsides of social media from a mental health standpoint, technology can give us a very important outlet for social contact during a time where we are being asked to stay indoors and away from other people. Pain and a depressed mental state have been linked together for a very long time much the same as depressive mental states and social isolation are often linked. The mental health benefits of virtual socialization are outside my scope of practice and the intent of this article but there are significant benefits of social interaction to help with better management of pain. Picking up the phone and calling someone is helpful but there are so many different video chatting services available that give you the opportunity to actually see that loved one or old friend. If you are in pain or know someone that may be experiencing pain now would be a great chance to reach out to them virtually.
If you are a patient who has been currently being seen in one of our clinics and just no longer feel comfortable leaving home for health concerns or have been instructed to officially quarantine due to exposure to this virus we are now able to offer telehealth services through all of our locations. Physical therapy, and especially manual therapy like we specialize in, really is best practiced in person and in a one-on-one setting like we offer at Performance Therapies. However, telehealth sessions offer another avenue for you to interact with your normal physical therapist to discuss exercise and pain management in real-time. With the use of webcams, we are sometimes able to visualize swelling or watch your movement mechanics in ways that dramatically improve our ability to assist your recovery from the comfort of your own home. As always we are here to answer your emails and phone calls, but certain things are difficult to explain with only words or print which is where telehealth has really opened up another path for us to help our patients.
In conclusion, as physical therapists, our best way to assist with your pain management is in our office and with home exercise and movement prescription. However, unusual situations like we are currently faced with require unusual solutions and some creativity. Hopefully one or more of these suggestions will help you manage or improve your current pain levels in the long term or at least until we can get you back into the office or health club and help on a more personal level.