In a study in Denmark, researchers investigated the minds\u2019 impact on the experience of post-operative pain. Patients were guided to visualize a place where they felt safe, such as the beach. Pain and anxiety levels were recorded in intervals between the visualization group and a control group. The study found that patients in the visualization group reported less pain and requested fewer painkillers.[footnote]N\u00f8rgaard, M. W. (2018). Visualization, a strategy for patients to manage pain. Aalborg Universitetsforlag. Aalborg Universitet. Det Sundhedsvidenskabelige Fakultet. Ph.D.-Serien. Retrieved from: https:\/\/vbn.aau.dk\/ws\/files\/283436746\/PHD_Marianne_Wetendorff_Noergaard_E_pdf.pdf[\/footnote] In addition, a literature review reveals numerous research studies specific to nurses helping their patients use guided imagery as an effective pain management tool.[footnote]Quinn, C. (2019). Guided imagery: An effective pain management tool for total joint replacement?. Nursing: 49 (10) 57-59.[\/footnote] [footnote]Nursing 2023. (2003). Putting imagery to work for your patient. 33 (6), 73.[\/footnote] [footnote]Cole, L. (2013). Using guided imagery to reduce pain and anxiety. Journal of Nursing Care, 2 (3).[\/footnote]<\/div>\r\n \r\n\r\nGuided imagery can be practiced on one's own, using just your imagination or an audio recording, or facilitated by a practitioner. It involves finding a quiet, comfortable place, closing your eyes, relaxing and imagining a scene that makes you feel peaceful or happy, such as on a beach, walking in the forest, sitting on a mountain, or just doing something that you love to do. \u00a0Visualize and feel yourself within that scene - utilizing all your senses - hearing, smelling and tasting everything in that scene around you. The purpose is to imagine yourself doing those things without any pain. This process increases relaxation, reduces stress, and decreases pain perception.\r\n\r\n
Graded motor imagery<\/strong> is a visualization technique that involves imagining doing painful movements pain-free, helping to break the association the brain has made between movement and pain.[footnote]Walz, A. D., Usichenko, T., Moseley, G. L., & Lotze, M. (2013). Graded motor imagery and the impact on pain processing in a case of CRPS. The Clinical journal of pain, 29(3), 276\u2013279. Retrieved from: https:\/\/pubmed.ncbi.nlm.nih.gov\/22914244\/[\/footnote]. It has shown effectiveness in decreasing pain and disability in musculoskeletal pain.[footnote]Louw, A., Schmidt, S. G., Louw, C., & Puentedura, E. J. (2015). Moving without moving: immediate management following lumbar spine surgery using a graded motor imagery approach: a case report. Physiotherapy theory and practice, 31(7), 509\u2013517. Retrieved from: https:\/\/pubmed.ncbi.nlm.nih.gov\/26395828\/[\/footnote] There are 3 stages of graded motor imagery. The first step<\/span> involves left-right discrimination practice of painful body parts. Persons with chronic pain tend to be slower to identify the painful side of their body,[footnote]Seniors Flourish. (2018). Left\/Right Discrimination Treatment for Chronic Pain\/Motor Control (Step 1 of Graded Motor Imagery Training). Retrieved from: https:\/\/seniorsflourish.com\/left-right-discrimination\/[\/footnote] so using flash cards to identify the side of the body pictured can help increase the speed of identification. The second step<\/span> is explicit motor imagery. Did you know that 25% of the neurons in the brain are called \u2018mirror neurons\u2019, which means that they start sending signals out even when we start thinking about moving or when we see another person move?<\/span>[footnote]Kilner, J. M., & Lemon, R. N. (2013). What we know currently about mirror neurons. Current biology : CB, 23(23), R1057\u2013R1062. Retrieved from: https:\/\/www.ncbi.nlm.nih.gov\/pmc\/articles\/PMC3898692\/[\/footnote] Therefore, if we can imagine making certain movements that usually causes pain without actually doing the movement,[footnote]Mulder T. (2007). Motor imagery and action observation: cognitive tools for rehabilitation. Journal of neural transmission (Vienna, Austria : 1996), 114(10), 1265\u20131278. Retrieved from: https:\/\/www.ncbi.nlm.nih.gov\/pmc\/articles\/PMC2797860\/[\/footnote] this will help the brain to learn that this action shouldn\u2019t be associated with pain. The\u00a0final step<\/span>\u00a0is mirror therapy. Mirror therapy is a technique used to trick our brain into reducing pain sensitivity. For example, if you have left-hand pain, you can put your left hand behind a mirror and right hand in front, thus to your brain, you are exercising your left hand when you start to move your right hand.[footnote]Graded Motor Imagery Website. (2023). Retrieved from: http:\/\/www.gradedmotorimagery.com\/[\/footnote] The mirror therapy technique is also commonly used to help with the phantom pain that amputees experience.[footnote]Amputee Coalition (2023). Mirror Therapy. Retrieved from: https:\/\/www.amputee-coalition.org\/resources\/mirror-therapy\/[\/footnote]\r\n\r\nThere are also numerous other visualization methods utilized in pain management. The Canadian Cancer Society speaks to the Simonton method<\/strong>,[footnote]Canadian Cancer Society. (2022). Guided Imagery. Retrieved from: https:\/\/cancer.ca\/en\/treatments\/complementary-therapies\/guided-imagery[\/footnote] which has people with cancer imagining their bodies fighting the cancer cells or breathing in a cloud of soft healing energy. The website also refers to the palming method<\/strong>,[footnote]Canadian Cancer Society. (2022). Guided Imagery. Retrieved from: https:\/\/cancer.ca\/en\/treatments\/complementary-therapies\/guided-imagery y[\/footnote] which involves imagining different colours surrounding your body that represents a positive connotation for you. For example, if you picture an area of your body with pain as being a searing red colour, you would visualize replacing that colour with a calming and cooling blue. Other pain controlling images might be imagining a pain switch that you turn off, or transforming the image of the pain (a burning hot knife) into something [pb_glossary id=\"380\"]benign[\/pb_glossary] (a vibrant flower). Another visualization is to gather all of your pain into a red ball. Start to make it smaller and move it slowly further and further away from your body each time you exhale. You can think of different methods to get rid of it \u2013 you can explode it, you can crush it or do whatever comes to mind to obliterate it away.\r\n\r\nGuided Meditations for Pain<\/strong>\r\n\r\nHere are a few free guided imageries for pain relief resources. There are tons available for you to choose from on platforms such as YouTube.\r\n\r\nBody Scan Meditation for Chronic Pain<\/a> 12 minutes\r\n\r\nMindfulness Meditation for Pain Relief by Jon Kabat-Zinn<\/a> 10 minutes\r\n\r\nGuided Mindfulness Meditation on Coping with Pain<\/a> 20 minutes\r\n\r\nPain Relief & Healing guided meditation \"The Cleansing Pool\"<\/a> 20 minutes\r\n\r\nThere's an App for That<\/strong>\r\n\r\nIn 2019, scientists in New Zealand performed a systematic review of 939 smart phone apps promoting self-management in people with chronic pain.[footnote]Devan, H., Farmery, D., Peebles, L., Grainger, R. (2019). Evaluation of Self-Management Support Functions in Apps for People With Persistent Pain: Systematic Review. JMIR Mhealth Uhealth.7(2):e13080. Retrieved from: https:\/\/mhealth.jmir.org\/2019\/2\/e13080[\/footnote] Of the 14 item measures the authors set, only 19 apps met the criteria. 3 apps met 8 out of 14 items that help to foster self-management of pain. Those apps were Curable, PainScale, and SuperBetter.\r\n\r\nLet\u2019s overview each of these.\r\n\r\nCurable<\/a> is a popular subscription app that uses a biopsychosocial approach to pain management by helping address pain from multiple angles: physical, emotional, and psychological. Curable utilizes clinical science with input from doctors, pain psychologists, physical therapists and neuroscientists. The website states \u201cThe Curable program guides users through engaging audio lessons about modern pain science and teaches them how to apply a wide range of science-backed techniques to reduce their symptoms, including: somatic tracking, graded motor imagery, cognitive behavioral therapy techniques, guided meditations, pain reduction visualizations, expressive writing techniques, and more.\u201d[footnote]Curable Health. (2023). What is Curable. Retrieved from: https:\/\/www.curablehealth.com\/help#help-top-faq\/general\/what-is-curable[\/footnote]\r\n\r\nPainScale<\/a> was listed as one of the best fibromyalgia apps of 2019. It is free to use, and offers education from clinically reviewed information. It also provides condition tracking for things such as pain, sleep, activity and mood, as well as personalized reports to help individuals and their doctors spot trends and patterns.\r\n\r\nSuperBetter<\/a> is super different in that it utilizes a gameplay framework to build resilience and promoting success in real life, not only for chronic pain, but other challenges like anxiety and depression. The website states the free app is \u201cbacked by randomized controlled clinical trials to build resilience and improve mental health\u201d,[footnote]SuperBetter. (2023). Science. Retrieved from: https:\/\/www.superbetter.com\/science[\/footnote] and that using a gameplay method promotes personal growth as a result of stress and change. The game involves challenges, battles and quests, building resilience by encouraging motivation and optimism even in the face of a tough challenge.[footnote]SuperBetter. (2023). Retrieved from: https:\/\/www.superbetter.com\/[\/footnote]\r\n\r\nClearly with the dramatic scope and individualized experience of chronic pain, there will never be one-size-fits-all cure. But knowledge brings power and understanding that chronic pain does not have to be a life sentence can start a person on the journey to self healing.\r\n\r\nLearning to accept your pain leads to understanding your pain:\r\n\r\nWhat is the pain\u2019s purpose? Is it to warn you, punish you, protect you? Is it time to heal unresolved emotional trauma that is causing you to hold onto your pain?<\/em>\r\n\r\nWe know that the concept of pain has gone from being thought of as purely physical to the knowledge that it is made up of psychological and neurological factors as well. A high percentage of chronic pain is emotion. Managing negative feelings such as fear, anger and guilt by expressing the feelings and letting them go versus holding them in can decrease the overall stress response, leading to a stronger sense of control over your pain. You don\u2019t have to suffer; learning how to engage the power of your mind to manage chronic pain is a real strategy that can help. The bottom line is to develop self-compassion<\/em><\/strong> \u2013 stop judging yourself and start loving yourself! Accept your limitations, living life at your pace. Unlearning painful patterns takes time; keep hope and trust that your subconscious will respond to your efforts in its own time.","rendered":"Recognizing the unique challenges that persons with chronic pain face, Health Canada established the Canadian Pain Task Force in 2019. Over three years from 2019 to 2021, the Task Force delivered 3 reports to Health Canada, outlining their findings for three mandates. The first report assessed how chronic pain is currently addressed in Canada; the second report had experts review the findings to identify best practices and areas for improvement; and the third and final report provided recommendations on priority actions to ensure people with pain are supported and treated effectively across Canada.