Advice from a Certified Hand Therapist: Relaxation Strategies for Chronic Pain Management

What Is Chronic Pain?

Chronic pain is typically defined as pain that lasts longer than three to six months or beyond the “normal” healing period of the original hand or upper extremity injury. It is a complex experience involving the entire nervous system. Nerves continue to send pain signals even after the original injury has healed. Many surgical and pharmacological treatments are ineffective because they address the original injury. Whereas the issue lies in the heightened response of the nervous system.

Chronic pain is often a debilitating condition that can affect all areas of one’s daily life, including work, hobbies, relationships, and one’s ability to sleep and complete simple everyday tasks.

What Are Relaxation Strategies and How Can They Help?

Understandably, people living with chronic pain just want the pain to go away. Unfortunately, the more one focuses on the pain (often called perseveration), the more one strengthens pain pathways in the nervous system that ultimately heighten the pain experience.

Relaxation strategies are self-regulatory techniques used to calm an overactive nervous system and reduce one's response to chronic pain. Common relaxation strategies include diaphragmatic breathing and imagery. Studies have shown these techniques can lessen the pain intensity, as well as provide many other health factors such as decreased stress, lowered blood pressure, and improved sleep.

What Is the Diaphragmatic Breathing Strategy?

Diaphragmatic breathing, also called belly breathing, can be a reset for your nervous system. To begin, sit or lie down. Place one hand on your abdomen and, if possible, one hand on your shoulder. The goal is to breathe in deeply and expand your abdomen as much as possible. You should feel your hand push out from the belly. As you exhale, you should feel your hand move back in as your abdomen flattens. The shoulders and chest should remain as still as possible. Some studies note increased benefit with breathing out through pursed lips (like blowing out a candle).

It is common for this process to be difficult in the beginning, as many of us tend to breathe shallowly and elevate our chest and shoulders. It may be helpful to sit in front of a mirror to practice your form. Ideally, start with five minutes of practice three times a day. The more consistently you practice, the more effective of a tool it will become.

What Is the Imagery Strategy?

Imagery is a visualization technique that can help interrupt the brain’s overactive delivery of pain signals. Begin by closing your eyes. Imagine the pain leaving your body as you find yourself in a relaxing place. Are you sitting on a calm beach with a warm breeze? In the mountains surrounded by bright wildflowers? Or maybe you are with your family and friends laughing at a barbeque? Think about the sights, smells, tastes, sounds, and sensations as you immerse yourself fully into the experience. The more you dive into the five senses, the more you activate healthy pathways in your nervous system.

Some people prefer to download mobile apps on their phone or use CDs for guided practice. Imagery can range from a few minutes to an hour or more. It might be helpful to start with a few minutes and increase your duration as you become more comfortable in your practice. Again, consistency is key. Daily practice achieves the best results.

Additional Resources

Chronic pain is a very complex issue, and this blog serves as only a quick overview. There are many relaxation and pain-management strategies, as well as systems and schedules to track what works best for you. You may also benefit from working with a certified hand therapist and/or other trained medical professionals for education and assistance in implementing a program that is right for you.

Please know that many who suffer from chronic pain develop strategies in order to live full, productive, and enjoyable lives.