Free Living a Healthy Life with Chronic Pain by Sandra M. LeFort, Lisa Webster, Kate Lorig, Halsted Holman, David Sobel, Diana Laurent, Virginia González, Marian Minor

you did, if anything, to alleviate the discomfort (quit cleaning, took medication, massaged the area, did a relaxation exercise, took a walk, and so on) and its effect.
    Look for patterns in your entries. For example, is your pain worse after sitting for a long time? Is it less when you are engaged in a favorite hobby? Such factors as your mood, fatigue, and muscle tension may affect how much you notice pain.
    It’s important to distinguish between physical pain sensations (physical stabbing, burning, and aching sensations) and emotional pain distress (the accompanying anger, anxiety, frustration, or sadness). This is useful because even if your pain sensations cannot be changed, you can work on changing how you feel about the pain. By doing so, you can experience less distress, anxiety, helplessness, and despair and live a healthier, happier life.
    Apply heat with a heating pad or a warm bath or shower (with the water flow directed at the painful area). You can improvise a heating pad by placing uncooked rice or dry beans in a sock, knotting the top of the sock, and heating it in a microwave oven for three to four minutes. Before use, be sure to test the heat so you don’t burn yourself. Do not use popcorn!
    Some people prefer cold for soothing pain, especially if the pain is accompanied by inflammation. A bag of frozen peas or corn makes an inexpensive, reusable cold pack. Whether using heat or cold, place a towel between the source and your skin. Also, limit the application to 15 or 20 minutes at a time (longer can burn or freeze the skin).
    Massage is one of the oldest forms of pain management. Hippocrates (c. 460–380 b.c.e.) said, “Physicians must be experienced in many things, but assuredly also in the rubbing that can bind a joint that is loose and loosen a joint that is too hard.” Self-massage is a simple procedurethat you can perform with little practice or preparation. Simply rubbing or stretching the painful area with a little applied pressure stimulates the skin, underlying tissues, and muscles. Always use a nonirritating skin cream or oil to provide lubrication. If you prefer a cooling effect, use a mentholated cream.
    There are three basic approaches to self-massage:
Stroking. Place your hand on the muscle you want to massage. When you slightly cup the hand, the palm and fingers will glide over the muscle as you massage. A slow, rhythmic movement repeated over the tense or sore area works best. Experiment with different pressures. If you have an affliction such as complex regional pain syndrome, try putting your hand in a bath of warm water and then firmly stroking the painful area with your warmed hand.
Kneading. If you ever reached up and squeezed your tense neck or shoulder muscles, you were kneading. Grasp the muscle between the palm and fingers or between the thumb and fingers as if you were kneading dough. Then slightly lift and squeeze it. Don’t pinch the skin; work more deeply into the muscle. A slow, rhythmic squeeze and release works best. Don’t knead one spot for more than 15 or 20 seconds.
Deep circular movement. To create soothing heat (friction) that penetrates into muscle, make small circular movements with the tips of the fingers, the thumb, or the heel of the hand, depending on how large an area you are massaging. Keeping the fingers, thumb, or palm in one place, begin lightly making small circles and slowly increase the pressure. Don’t overdo it. After 10 seconds, move to another spot and repeat.
    Massage is not appropriate for all cases of pain. Do not use self-massage for a “hot” joint (one that is red, swollen, and hot to the touch) or an infected area. Avoid massage if you are suffering from phlebitis (inflammation of a vein), thrombophlebitis (a blood clot in a vein), or any kind of skin bite or eruption.
    Medications and other treatments can also be useful to manage localized pain. These are discussed in Chapters 16 .
Tools for Managing Chronic Pain
    Managing chronic pain