By Nora Rosenau,​ MOT, OTR/L, CDP, LSVT‑BIG
Occupational Therapist, Northeast Illinois

Pain is something everyone experiences, whether it be at random, once a week, when it rains, or simply all the time. No matter the frequency or the cause, pain is something we don’t like to deal with, and we are often looking for ways to help us feel better. Below you’ll find a few solutions that are not meant to take away pain but instead could help reduce pain to a more tolerable & functional level. 

They can be useful for your occupational therapy patients, or even for clinicians themselves! It’s always best to ensure these recommendations are appropriate for your patients and have been successfully trained for them prior to having them perform alone.

1. Body Warm Ups

Body warm-ups can often help reduce knee pain, shoulder pain, and neck pain by warming up our muscles and joints prior to completing activities. Try these when you wake up, have been sitting for a prolonged period, or are just feeling tight and slow moving. 

When laying down: Move your head, arms, and legs side to side as well as up and down before you start to transition to sitting up.

When sitting on the edge of bed or in a chair: Open and close your hands, raise and lower your arms, roll your shoulders forward or backward, march in sitting, individually kick your legs out, make circles with your ankle, move your feet from heels to toes like you are stepping on a gas pedal.

When standing up and stable: Lift your arms up and down one at a time, march in place, and step forward and back one leg at a time. Don’t be afraid to hold onto a sturdy surface, grab bar, or walker while doing these.

I recommend doing each of these movements at least 10x, nice and slowly, and listening to your body. If a movement doesn’t feel right, stop.

2. Deep Breathing

Pain often increases because we are not relaxed, causing our muscles to tighten up — especially around areas where we are already having discomfort. Often, we don’t realize it, but when we are doing tough things, we tend to compensate by holding our breath, which can cause muscle and blood vessel constriction. A good way to relax our muscles is through deep breathing. Deep breathing allows for blood flow and oxygen to get to our muscles, relax them, and give them the full benefit from your exercises and daily activities.

The phrase I always use is “Smell the roses and blow out the candles”. This means to take a deep breath in through your nose and then blow that breath out through your mouth.  Make sure you try to inhale through your nose for at least 3 seconds and out your mouth for the same. You can do this breathing anywhere from 1 minute to 5 minutes and if you would like to increase relaxation, you can turn on some calming music or close your eyes while completing the deep breathing.

If you notice you are having pain during a specific activity, try coordinating your deep breathing with that activity. For example, if you’re experiencing shoulder pain when you reach into the fridge. Here I would “smell the roses” as I reach into the fridge to grab the item and then as I hold the item and pull it out of the fridge, I would “blow out the candles.”

Another tip to ensure you are breathing deeply is to try talking, counting out loud, or even singing while you do an activity. I always say “If you’re talking, you’re breathing.” It may seem funny to count or sing out loud, but doing so can be a fun solution to making sure you are breathing and actually put you better in control of your pain.

3. Repositioning

Pain can sometimes evolve from being in an uncomfortable position for a prolonged period of time. This pain we are having, may not be from the activity we are doing itself, but instead may be from how we are doing that activity.

Here are some ways to manage this type of pain. 

Elevation

Lower leg pain can oftentimes be reduced by elevating our feet up on a couch, ottoman, or pillow in bed. If you notice swelling, redness, isolated areas of pain, unilateral warmth, or overall unusual discomfort in your lower legs, please contact your doctor as soon as possible as this could mean there is something more serious going on in your body that will require a formal assessment and treatment by your provider.

Sleeping Positioning

Many of my patients often report shoulder pain or hip pain only while they are sleeping. My first question is always:  “How are you sleeping?” Pain while sleeping can often stem from pressure being put on a nerve for a prolonged period of time. If you reposition pillows under the area of pain to support your shoulder, hip, leg, etc., it can often reduce compression that may be put on that area in your typical sleeping position.

Neck & Back Support

Have you ever thought about how you are sitting when you are at the table, on the computer, reading a book, or driving? Often, when we complete our task and get up, we’re left wondering why a localized part of our body is sore.

Try the 90-90-90 technique. Have your feet flat on your floor, knees bent, back flat up against a chair, and arms bent at elbows so your wrists are in a straight line with your forearm.

A similar technique can be applied to the position of your car seat. However, this is often more of a trial-and-error routine until you find that optional position. You may need to raise, lower, or move your seat forward or back to allow for the highest level of comfort in your hips and knees and therefore decrease pain. You also may need to raise or lower your steering wheel to allow for your shoulders to be relaxed and your back to be flat with back support. Don’t forget to align your mirrors with your new car seat positioning as well!

If you find yourself looking down at a computer, try placing a box or a few heavier books underneath it so your screen is at eye level. When reading a book, try placing a few pillows on your lap to rest your forearms with the book at eye level. Both of these decrease the strain we tend to put on our back or neck when looking down.

Bonus Pain Tip: Follow Your Home Exercise Program!

This is probably something you hear on repeat from your therapist (or something therapists are used to saying to their patients). A lot of times, pain can actually stem from an area of weakness that is forcing your body to compensate for another area of your body that typically would not take on that burden. This can cause pain in that compensating area of your body from overuse in addition to the already present pain in the weak area of your body. 

If you continue strengthening your weak muscles with the exercises your skilled therapist provided you,  those muscles that were compensating will no longer be overused. This will allow the daily stress you are putting on your body to be divided among the proper muscles and overall reduce the pain experienced.

I hope these at-home techniques help you manage your pain at home. Many people have pain management regimens prescribed by their doctors and these techniques are not meant to replace those, but instead enhance self-management of pain. These may not work for every person so please consult with your doctor if your pain is to an unmanageable level and impairing your ability to complete your daily routines.