VOL.3 | OCTOBER 2019
TAKING CHARGE Blue Ridge Medical Center Chronic Pain Management Program Newsletter
Action Planning At BRMC we're huge advocates of pain self-management. After all, who knows more about what your body needs than you? One of our favorite tools are action plans. Action plans are tiny, micro-goals you can accomplish in a week or less. Setting a small, achievable goal each week is an excellent way to train your brain to develop new healthy habits. An action plan can be about anything, as long as it's something that matters to YOU! Maybe you want to exercise more, to take your medication on time, or to get the pile of laundry folded. Action plans are all about taking small steps to success, and here is the best part you don’t do it every day. Those who are most successful with action plans only do them 23 times a week. We are trying to create a habit, not drive ourselves crazy!
OVERVIEW: Action Planning But I hate working Out How exercise helps ease pain
Deciding on an action plan is simple, you just need to follow a few guidelines. 1) It has to be something YOU want to do. 2) It needs to be something you can accomplish within 7 days 3) It should focus on a specific action (hence the name, action plan). Here are some questions to ask yourself as you develop your action plan:
Can Diet Heal Chronic
• What do I want to do: Be more active? • What is one thing I can do to achieve that? Walk for at least 30 minutes every week • When am I going to do that? Two days a week, Tuesday and Thursday • How long am I going to do it? I’ll walk for 15 minutes on each day • What If I can’t do it on a day I planned to? I’ll walk on a different day
Snack Time
Once you have all the details, it’s time to pull together your plan! My Action Plan: This week I will walk for at least 30 minutes. I will walk for at least 15 minutes two days a week on Tuesday and Thursday. If it rains or something else comes up, I’ll walk on another day. Now, the very last step is to do the gut test. Did you pick something you will actually do? If your gut says, “No, I don’t want to do that” then start over, this time pick something you REALLY want to do. By setting small goals each week you can trick your brain into developing healthy habits. Try it, it works. I promise!
Pain? Keep it Moving Preventing Pain Workshop
434-263-4000 www.BRMedical.org
C H R O N I C
P A I N
M A N A G E M E N T
P R O G R A M
Preventing Pain Saturday, October 19th 9:00 am - 10:00 am
with Dr. Wayne Fusco Discuss new ways to manage and prevent chronic pain with Dr. Wayne Fusco of Cox Chiropractic Center in Charlottesville.
Learn how to: Use posture to decrease pain Lift without injury Stop your chair from hurting you Improve flexibility Cost: Free. Open to the public. Class size is limited. To register please contact: Stephanie Martin 434.263.4000 ext 1526
But I HATE working out! By Stephanie Martin, Program Director
I was chatting with a friend the other day when she said how upset she was about the impacts of age on her body, "I'm so tired of being tired! I used to work all day and still have energy to go out in the evening. Now my body just wants me to sit down." When I asked her to join me at the gym she laughed. “I don’t do that! I’m not like you. I don’t like working out.” Her response shocked me. How could this woman be one of my best friends and not know how I feel about exercise? “You think I like to work out? I hate it. I hate every minute of it. Every week I force myself to go!” "Then why do you go? Why do you pay for a trainer, if you hate it?” Good Question. For the past year I’ve been working out with a personal trainer. My trainer, Susie, is wonderful. She works with me to make sure I’m not injuring myself and she understands my limitations. As much as I like Susie, I HATE working out. I literally force myself to go for the same reason I set alarms to remind me take my medication, it helps me to control my pain. I used to think going to the gym was stupid. My "gym” was my back yard. I told myself I was getting a better workout by cutting branches and digging out weeds than those idiots paying to walk on a treadmill. But, the next day I would be in extreme pain. My body would shut down. It would take days (if not weeks) to recover. I’d increase my medications, pay to see my doctor or chiropractor, and I’d hate my body for failing me. Eventually, I realized my “workouts” were Program doing more harm than good. I don’t like working out, but I By Stephanie Martin, Director DO like having control over my body. I enjoy bending without shooting pains. I enjoy having a decent night’s sleep. I enjoy having a strong body. I've learned that my body can do so much more than I thought it could. Fear of experiencing pain no longer dictates what I do which is why I force myself to go. Just last week I felt sick and wanted to skip the gym. I even called my trainer at the last second and said I wasn’t coming, but then I still went. Working out is my pain management. I can’t stop going because I have a runny nose. One of the things I do enjoy is having a friend go with me. It’s my reward to see people on a weekly basis that I may not see otherwise, so I often try to talk people into going with me. If you’re like me and hate exercise, all I can say is that’s not a good enough reason to not exercise. Moving your body regularly is essential not only to reducing your pain, but for improving mental health as well. Exercise impacts ALL the functions of your body. I’m not suggesting you run a marathon or become a body builder, but I urge you to think of one small way you can get your body active. Small changes lead to big results!
How Exercise Helps Ease Pain By Sanaz Amirpour for Chronicality
Pain is an interesting phenomenon. Normally, when you hurt yourself, your body automatically responds by stimulating receptors that release chemicals. Let's say you jam your finger in the car door, for example. These chemicals carry messages directly to the spinal cord, which then relay those pain messages to the brain. This all happens so quickly that you feel the pain pretty much immediately after jamming your finger. But for those who experience chronic pain that just won’t go away, the same pain process as acute pain from injury doesn’t apply. Instead, chronic pain seems to affect the central nervous system, which can become overly sensitive to pain, says Abaci. Research shows that those who experience chronic pain may have impaired neuroplasticity, which is a term that describes the brain’s ability to change with experience and use. It allows the body to adapt to injury and disease. Without neuroplasticity, the nerve cells become so sensitive that By Stephanie Martin, Program Director the brain may perceive even a gentle touch as painful. This pain perception leaves an imprint on the brain, which means that over time, the brain feels chronic and persistent pain more intensely. Fortunately, increasing neuroplasticity may help with chronic pain treatment, according to a recent study in the Journal of Pain. And research suggests that exercise can help by improving blood flow and oxygen to the brain, which are crucial for improving neuroplasticity. “Even though exercise is not going to act like a Tylenol and immediately make the pain better, over time it will address the neuroplastic changes that cause pain and work to help people feel better,” says Abaci.
Can diet heal chronic Pain? The foods you eat (and don't) can determine how well your body fights painful inflammation Harvard Men's Health Watch, published July 2018
It's been said that you are what you eat, and that's definitely true when it comes to chronic pain. "A lot of chronic pain is the result of chronic inflammation, and the evidence is quite strong that your diet can contribute to increased systemic inflammation," says Dr. Fred Tabung, a visiting researcher with the Department of Nutrition at Harvard's T.H. Chan School of Public Health. "But your diet is also one of the best ways to reduce it." Inflammation has a good-guy/bad-guy role in your health. When you are injured or get infected, your body signals the immune system to send white blood cells to the affected areas to repair the injury or fight the infection. When the injury heals or the infection goes away, inflammation normally goes away too. However, sometimes your immune system gets turned on and stays on after the "crisis" has passed. Over time, this can damage healthy cells and organs and cause constant pain in muscles, tissues, and joints. Chronic inflammation also can raise your risk for heart disease, diabetes, certain cancers, and even Alzheimer's disease. How does your diet fit into all this? It's much like a domino effect that works two ways, according to Dr. Tabung. "Your diet can help support your immune system by having it turn on and turn off at the appropriate times," he says. "Yet a poor diet can alter your immune system, so it acts abnormally, and can contribute to persistent low-grade inflammation." In fact, some studies have found that the immune system reacts to an unhealthy diet in much the same way it would respond to a bacterial infection. How a healthy diet directly helps the immune system is not quite understood, says Dr. Tabung. However, some evidence suggests that deficiencies in various micronutrients — like zinc, selenium, iron, folic acid, and vitamins A, B6, C, and E — may alter immune system function. The strongest scientific evidence suggests foods rich in a group of antioxidants known as polyphenols can have an anti-inflammatory effect that helps soothe and prevent painful flare-ups.
These foods include many of the staples of the Mediterranean diet, such as whole fruits (especially all types of berries), dark green leafy vegetables, nuts, legumes, and whole grains. "Many of these also are rich in the micronutrients your immune system requires to function at a high level," says Dr. Tabung. Some research has suggested that omega-3 fatty acids, which are found in olive oil, flaxseed oil, and fatty fish (like salmon, sardines, and mackerel), also may help control inflammation. The best dietary approach to help your immune system, and thus help reduce chronic inflammation, is to cut out the bad inflammatory foods and adopt more of the good antiinflammatory kinds, says Dr. Tabung. Many of the bad foods are processed "junk" foods with low nutritional value, including soda and other foods that contain simple sugars like high-fructose corn syrup; processed meat; and white bread, white pasta, and other foods high in refined carbohydrates. (These are foods you want to eliminate for other health reasons, too.) When it comes to the anti-inflammatory foods, Dr. Tabung says you shouldn't load up on a few favorites, as you may miss getting some of the vital nutrients your immune system needs. Instead, aim for variety. For example, break down your regular meals like this: Half your plate should be filled with whole grains like whole-wheat bread, whole-grain pasta, and brown rice, along with healthy proteins, such as fish, poultry, beans, and nuts. The other half should be mostly vegetables along with some fruit. Always use healthy oils like olive and canola oils instead of butter or other flavorings. Keep in mind that you have to make lasting change in order for your diet to work for you. "Your diet is not a quick-fix pill," says Dr. Tabung, "but it has high potential to help manage and even prevent inflammation, which can help soothe chronic pain."
Snack Time Cauliflower Crust Pizza by LINDSAY FUNSTON, September 16, 2019 @delish.com
Cauliflower is a magic vegetable. In this easy, gluten-free pizza recipe, you're basically making cauliflower rice as the base for your crust. Test Kitchen Tip: You MUST drain the cooked cauliflower, as it keeps the crust dry and encourages crisping while it bakes. Simply transfer the drained cauliflower to a clean dish towel and squeeze or twist to drain any remaining liquid. Topping Variations: Keep things simple with fresh tomatoes and basil, or get creative. Sautéed peppers and onions, sliced olives, cooked and crumbled sausage. Ham and pineapple? Why not! And pepperoni is always a good call—and you can even buy a vegan version if someone at your table doesn’t eat meat. INGREDIENTS 1 large head cauliflower, roughly chopped 1 large egg 2 c. shredded mozzarella, divided 1/2 c. freshly grated Parmesan, divided kosher salt 1/4 c. marinara or pizza sauce 2 cloves garlic, minced 1 c. grape or cherry tomatoes, halved Torn fresh basil, for serving Balsamic glaze, for drizzling
DIRECTIONS 1.Preheat oven to 425°. In a large skillet, bring about 1/4 cup of water to a boil. Season with salt. Add cauliflower in one even layer and cook until crisp-tender, 3 to 4 minutes. Transfer to a clean dish towel (or paper towels) and squeeze to drain water 2. Add drained cauliflower to food processor and pulse until grated. Drain excess water in paper towels. 3. Transfer drained cauliflower to a large bowl and add egg, 1 cup mozzarella and 1/4 cup Parmesan, then season with salt. 4. Transfer dough to a baking sheet lined with cooking spray and pat into a crust. Bake until golden and dried out, 20 minutes. 5. Top crust with marinara, remaining mozzarella and Parmesan, garlic and tomatoes and bake until cheese is melted and crust is crisp, 10 minutes more. 6. Garnish with basil and drizzle with balsamic glaze.
Keep it moving Wall push-ups
Back Leg Raise
1. Face a wall, standing a little farther than arm’s length away, feet shoulderwidth apart.
1. Stand behind a sturdy chair, holding on for balance.
2. Lean your body forward and put your palms flat against the wall at shoulder height and shoulder-width apart. 3. Slowly breathe in as you bend your elbows and lower your upper body toward the wall in a slow, controlled motion. Keep your feet flat on the floor. 4. Hold the position for 1 second. 5. Breathe out and slowly push yourself back until your arms are straight. 6. Repeat 10-15 times. 7. Rest; then repeat 10-15 more times.
2. Slowly lift one leg straight back without bending your knee or pointing your toes. Try not to lean forward. The leg you are standing on should be slightly bent. 3. Hold the position for 1 second. 4. Repeat 10-15 times 5. Repeat 10-15 times with the other leg. Tip: As you progress you may want to add ankle weights.Â
4038 Thomas Nelson Highway Arrington, Va 22922 C H R O N I C
P A I N
M A N A G E M E N T
P R O G R A M
Preventing Pain
Saturday, October 19th 9:00 am - 10:00 am
with Dr. Wayne Fusco Discuss new ways to manage and prevent chronic pain with Dr. Wayne Fusco of Cox Chiropractic Center in Charlottesville.
Learn how to: Use posture to decrease pain Lift without injury Stop your chair from hurting you Improve flexibility Cost: Free. Open to the Public. Class size is limited. To register please contact: Stephanie Martin, 434.263.4000 ext 1526