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 Page A

is a complex task. Like mastering all new tasks, it requires knowledge, practice, and patience. Sometimes you can’t manage pain directly unless you use medications or other treatments your doctor might recommend. (These topics are discussed in detail in Chapters 16 .) But often, without medication or medical intervention, you can self-manage other symptoms that are related to chronic pain, such as stress, poor sleep, and depression. If you can address even a couple of these symptoms, you will feel more in control of your pain. The rest of this chapter and Chapter 5 are about how to self-manage common symptoms.
    In addition to managing common symptoms, you can make important lifestyle choices that will positively influence your pain, your health, and your life. These include making physical activity and exercise a regular part of your week, eating healthy, managing your stress, improving your family and partner relationships, workingwith your health care providers, and planning to use to manage chronic pain. Just as you can-for the future. That’s what the rest of this book is not build a house with one tool, you often need about. Taken together, these are all tools for you many tools to manage chronic pain.

Ineffective Breathing
    Shallow or labored breathing prevents your body from getting the oxygen it needs. Like other symptoms, it can have several causes.
Causes of Breathing Problems
    Pain from weak, tense muscles can lead to ineffective breathing. When an area of the body hurts, the natural response is to tense the muscles in that area. This is so automatic you are often unaware of how much tension you are carrying. Muscle tension can change how you move. You may move more slowly, or your posture may change so that your chest is not as open, leaving less room for your lungs to expand effectively.
    Shallow breathing may ultimately result in muscles becoming weak and deconditioned. And this doesn’t only affect your breathing muscles; the core muscles of your abdomen and the small muscles of your back can also be affected. When muscles become deconditioned, they are less efficient at doing what they are supposed to do. They require more energy (and oxygen) to perform activities.
    Excess weight can also cause shortness of breath. Additional weight increases the amount of energy you use and therefore the amount of oxygen you need. Weight also increases the workload for the heart. If excess weight is coupled with restricted movement and poor posture, your body struggles to get the oxygen it needs.
    Certain chronic pain conditions can directly impact posture and thereby reduce lung capacity. The list includes scoliosis, osteoporosis, and some severe forms of arthritis that attack the bones in the neck and back. Other causes of breathing problems include chronic lung diseases such as emphysema, chronic bronchitis, and asthma. These conditions usually require special medications and sometimes supplemental oxygen in addition to self-management techniques.
    Shortness of breath can be frightening, and this fear can cause two additional problems. First, when you are afraid, you release hormones such as epinephrine. This causes more muscle tension and more shortness of breath. Second, you may stop activity altogether for fear it will hurt you. If this happens, you cannot build up the endurance necessary to help manage your chronic pain and breathing issues.
Breathing Self-Management Tools
    Just as there are many causes of ineffective breathing, there are many things you can do to manage this problem. When you feel short of breath, don’t stop what you are doing or hurry to finish up. Instead, slow down. If shortness of breath continues, stop for a few minutes. If yourdoctor has prescribed medication for this problem, then take it.
    The basic rule is to take things slowly and gradually. Increase your activity, by not more than 25 percent each week. For example, if you are currently able to garden comfortably for 20 minutes, next