Relaxation

When humans face a threat, our bodies respond through the fight or flight response.

• The body gets ready for action – literally, either ready to fight or ready to run to safety – by bringing extra blood flow to the muscles, raising heart rate and blood pressure, and increasing muscle tension for speed and strength.
• Like the body’s response to pain, the fight or flight response was intended for rare moments of extreme need to help you survive danger.
• The body was not meant to be this way all the time.
• Most importantly, while these changes are helpful for our survival from a life-or-death threat, they have consequences to our physical and emotional well-being if they persist for a long period of time.
• This includes making our pain, fatigue, and stress worse.

One of the most effective tools for managing pain, fatigue, and other symptoms is to learn how to stop or calm the fight or flight response.

• Ongoing symptoms of pain conditions do not need to be met by this alarm-type response.
• If we can calm ourselves, we can also calm our nervous system, reduce our stress, and give ourselves a chance to find other ways to cope with our pain, fatigue, and other symptoms.

We calm our system through relaxation strategies.

• A state of relaxation is the opposite of the “fight or flight response” and changes how you deal with stress- emotionally and physically.
• Relaxation is a very effective tool for managing pain and other symptoms that are experienced by people with chronic pain.
  • These include fatigue, problems with sleep, stress, and depressed mood.

Relaxation is helpful for pain because:

• Tense muscles make pain worse.
• Your body naturally protects itself by tensing muscles around an area that hurts or that it needs to protect.
• When your muscles are tense for too long, your pain may increase.
• Relaxation helps decrease this muscle tension that occurs when feeling pain.
• Relaxation is also a way to counter the well-known negative effects that stress has on pain and other physical problems (counteracts the “fight-or-flight” response).
• Relaxation also has a beneficial effect on the areas of the brain that are involved in sensing and reducing pain.

Relaxation can also be helpful for other symptoms because:

• It is common to feel tense when you feel depressed or anxious.
• Relaxation helps decrease physical and mental tension that can make depression and anxiety worse.
• Relaxation can help you sleep better.
• Relaxation is a good way to take a break or “time-out” from stressful situations or emotions.
• It is a helpful activity you can do to take care of yourself.
• People are usually better at planning and problem solving when they feel relaxed compared to when they feel stressed.

Autogenic (10 minutes)

• Focuses on lowering physical arousal.
• Trains the body to relax.
• Trains the body to feel calm.

Deep Breathing Exercise (4-5 minutes):

• Also sometimes called belly breathing.
• Focuses on your breathing to help you relax.
• One of the easiest and most effective relaxation skills.
• Allows us to breath more deeply.

• Uses mental imagery of calm and relaxing places.
  • Leads to relaxation.
• Uses all your senses to produce vivid mental images.
  • Creates distraction from stress.
  • Can lead to profound relaxation.

Body Scans (5-7 minutes)

• Mentally scanning each part of your body, searching for stress/tension and letting it go.
• At the end of the scan, the body has been freed of tension.

Mindfulness meditation (2 minutes)

• Focusing your attention on the here and now.
• Allowing negative thoughts to flow through and out of your mind without causing stress.

Mini progressive muscle relaxation (4 minutes)

• Rapid techniques for achieving the relaxation response.
• Often used after mastering other longer techniques.
• Can be more easily applied in real-world settings outside the home.

With regular practice, relaxation skills may help you:

• Lessen your symptoms, such as pain or stress.
• Raise your energy level.
• Sleep better.
• Ease your stress.
• Manage your emotional responses, such as anger or anxiety.

Importance of Practice

There are benefits to practicing relaxation regularly.

• You may benefit from doing it regularly, even if you are feeling well.
• Relaxation can:
  • Reduce the number and severity of painful episodes.
  • Help build energy.
• The more you use relaxation, the better you will feel.

This skill, like all the skills described in PainGuide, is most helpful when regularly practiced.

• It is best to practice relaxation exercises often.
• We recommend that you practice relaxation exercises once a day for 10-30 minutes.
• Even practicing for a couple of minutes a day helps you learn this skill.
• Using it becomes more and more automatic.

It’s also best, when you’re learning a new skill, to practice it when your symptoms are not at their worst.

• Try to find a quiet place to relax.
• Being in a calm and quiet place makes it easier to relax.
• You can practice relaxation with or without the assistance of guided recordings.

The more you practice, the more it will benefit you.

• It will help you when your symptoms are bothersome.

Use the self-management log to track the time you spend practicing.

• You may also rate your stress level before and after practicing, using a 0-10 rating (0 = not at all stressed to 10 = worst stress/discomfort imaginable).

Overcoming Barriers to Practice

Taking time to relax and to practice relaxation when life is so busy may not make sense to you. There are benefits.

• It’s an important way for you to help manage your pain and stress.
• Below are some common barriers and challenges people face when learning to control their body’s relaxation response.

I don’t have time to practice

Your ability to relax can improve with regular practice.

• To start, try doing it just a few days or nights for a few minutes each week.
• With time, and as you learn how to do it, it may become easier for you to relax.
• You may start looking forward to your “relaxation time.”

I want to relax, but other people need me

Sometimes, other people need you, leaving you little or no time for yourself.

• Explain to them that having time for yourself to relax may help reduce your pain, raise your energy level, and ease your stress.
• To protect this time, you may want to talk with them about how much they can ask of you and when.
• Making time for yourself may feel selfish at first, but it is important that you make time to take care of you.
• The PainGuide Communication module can help you find ways to talk to others about this concern.

I’m not sure I’m relaxing the right way

If the approaches discussed here aren’t working for you, there are other books, podcasts, YouTube videos, and classes that can help you learn more ways to relax.

• One way to know if you are doing it correctly is to practice most days.
• A good way to tell if you are being effective is to write down what you are doing. (See the PainGuide Worksheet for Relaxation).

I don’t feel comfortable when I relax

Some people feel anxious or notice bodily discomfort when they first try relaxation. This is more common for people who are not used to sitting quietly with themselves. This new awareness of your body is normal, especially if you’re used to feeling tense.

• A small number of people may get very emotional and upset when they try certain relaxation techniques.
• If this happens to you, feel free to stop the relaxation technique.
• Talk with your healthcare provider about what you are feeling.

For some people, it is hard to sit or lie still when they are first practicing relaxation.

• If this is true for you, you might try doing a moving relaxation exercise.
• This might include doing some gentle stretches and focusing on your breathing or doing deep breathing practice while taking a slow and relaxing walk.
• As you get more and more comfortable with your relaxation practice, you can incorporate new things, such as being still.

It’s hard making relaxation a priority

For relaxation to work, regular practice is needed.

• If you are having problems practicing, think about the benefits of relaxation for you.
• Go easy on yourself.
• It may take practice to make relaxation a regular part of your life.

How you can help:

When the people we care about are struggling with their symptoms, it’s normal to want to help them.

• Helping someone with pain to relax or practice a relaxation technique, even for just a few minutes, may have important health benefits.
• You may find these techniques helpful for you too!
• You can support the person with pain by:
  • Helping with daily chores and tasks so he or she has more time to take care of herself or himself.
  • Doing a relaxation exercise together:
    • Deep breathing.
    • Stretching.
    • Muscle relaxation.
    • Meditation.
• Encourage the person you care about to take time to enjoy other calming activities such as:
• Going for a walk.
• Watching a movie.
• Playing with a pet.
• Calling a friend or family member.
• Listening to music or an audio story.
• Talk with the person with pain to see if it makes sense to schedule relaxation time on the calendar so that they remember to do it.

Other Resources

Other relaxation resources:

• There are many additional resources available to help you find a relaxation practice that works for you.
  • Meditation and relaxation apps are available for free or for purchase. to download to your smartphone or other device.
  • Check your local library for materials:
    • Your library may have relaxation CDs or DVDs in addition to books about relaxation or meditation.
  • Consider installing a reminder “pop up” on your computer to take a deep breathing break a few times a day.
  • Set your alarm on your phone to practice breathing.
  • Community classes, like beginner yoga classes, can help your skill of relaxation practice.
  • Try adding movements and stretches if you are mostly doing your relaxation while sitting or lying down.