Session 1: Acute VS. Chronic Pain
I.  Review of Homework – Making Changes
II. Understanding the Differences Between Acute and Chronic Pain
III. Treatment
IV. Summary of Differences
V.  Study of Healthy College Students
VI.  Homework – Practicing Relaxation Techniques
VII. Relaxation Technique - Progressive Muscle Relaxation
Session 1: Acute VS. Chronic Pain
I.   Review of Homework – Making Changes
II. Definitions of Acute Verses Chronic Pain
Acute Pain – Pain of short duration that is the result of tissue or nerve injury (visible damage). This type of pain generally comes on suddenly, for example, after trauma or surgery and usually disappears when the injury heals. Pain may be accompanied by anxiety or emotional distress. The cause of acute pain can usually be diagnosed and treated.

Symptoms: Inflammation of tissue, warm and/or red appearance, cut or broken bones

Chronic Pain – Pain that is most commonly defined as persisting past healing and for 6 months or longer. Specific damage cannot be identified and there may not be specific localized pain. Can be severe.

Symptoms: Pain without a clear fixable cause.
III. Treatment:
Acute Pain – Medications, Passive Therapy, Whirlpool, Use of Hot and Cold, Immobilization (Cast), Repositioning, and Rest As well as, Massage (Pressure and Vibration), Relaxation Techniques, Exercise, and Distraction

Chronic Pain - Massage (Pressure and Vibration), Relaxation Techniques, Spinal Cord Stimulators, Exercise, Distraction, and avoidance of opioid meds. The treatment of chronic pain with medications is often poor and ineffective.
IV. Summary of Differences:
Acute Pain
Chronic Pain
New Damage or Injury
Improves with Rest and Time Gets Worse with Rest and Fluctuates Over Time

Activity Interferes with Recovery              Activity is Necessary with Recovery

Narcotics are Needed 
Control of Medication is Important

Short-term Distress             
Long-term Stress and Depression

Doctor “Cures”             
Patient and Doctor Work Together

Jamison, R. N. (1996). Learning to Master Your Chronic Pain. Sarasota, FL:
Professional Resource Press.

V. Study of Healthy College Students
VI. Homework – Practicing Relaxation Techniques
VII. Relaxation Technique – Progressive Muscle Relaxation
Get into a comfortable position you can either lie down on the floor or sit up straight in a chair. Make sure not to cross your arms or legs. You may want to loosen your clothes and remove your shoes. Begin to relax as you take a few slow deep breaths. Pause. Now let the rest of your body relax.

Notice the tension in your fists and forearms. Clench your fists and bend them back at the wrist…tighter and tighter…feel the tension in your fist and forearms…NOW RELAX…Feel the looseness in your hands and forearms…Notice the contrast with the tension. Notice the tension in your elbows and biceps. Now bend your elbows and tense your biceps… Tense them as hard as you can and observe the feeling of tautness…Let your hands drop down and relax…Feel that difference…

Notice the tension in your head and face. Wrinkle your forehead as tight as you can…Feel the tension in your forehead and scalp…now relax and smooth it out. Imagine your entire forehead and scalp becoming smooth and at rest. Now frown and notice the strain spreading throughout your forehead…Pause…Let go. Allow your brow to become smooth again. Squeeze your eyes closed…tighter…Relax your eyes. Let them remain closed gently and comfortably. Now open your mouth wide and feel the tension in your jaw…Pause…Relax your jaw. Notice the contrast between tension and relaxation. Now press your tongue against the roof of your mouth. Experience the ache in the back of your mouth…Relax. Press your lips now, press then into an “O”…Pause…relax your lips. Feel the relaxation in your forehead, scalp, eyes, jaw, tongue, and lips.

Notice the tension in your neck. Roll your head slowly around on your neck, feeling the tension shifting as your head moves…and then slowly roll your head the other way. Relax, allowing your head to return to a comfortable position…Notice the tension in your shoulders. Now shrug your shoulders; bring your shoulders up towards your ears…hold it…Drop your shoulders back down and feel the relaxation spreading through your neck, throat, and shoulders…pure relaxation, deeper and deeper…

Notice the tension in your chest. Now breathe in and fill your lungs completely. Hold your breath. Experience the tension…Now exhale and let your chest become loose…Continue relaxing letting your breathe come freely and gently…Notice the tension draining out of your muscles with each exhalation…Next tighten your stomach and hold. Feel the tension …Relax…Now place your hand on your stomach. Breath deeply into your stomach, pushing your hand up. Hold…and relax. Feel the contrast of relaxation as the air rushes out… Notice the tension in your back. Now arch your back, without straining. Keep the rest of your body as relaxed as possible. Focus on the tension in your lower back…Now relax…Let the tension dissolve away.

Notice the tension in your buttocks and thighs. Tighten your buttocks and thighs…Pause…Relax and feel the difference…Notice the tension in your legs. Now straighten and tense your legs and curl your toes downward. Experience the tension…Relax…Straighten and tense your legs and bend your toes toward your face…Pause…Relax

Feel the comfortable warmth and heaviness of deep relaxation throughout your entire body as you continue to breathe slowly and deeply…You can relax even more as you move up through your body, letting go of the last little bit of tension in your body. Relax your feet…Pause…relax your ankles…Pause…relax your calves…Pause…relax your shins…Pause…relax your knees…Pause…relax your thighs…Pause…relax your buttocks…Let the relaxation spread to your stomach…Pause…to your lower back…to your chest…Let go more and more. Feel the relaxation deepening in your shoulders…Pause…in your arms…Pause…and in your hands…Deeper and deeper. Notice the feeling of looseness and relaxation in your neck…Pause…your jaw…Pause…your face…Pause…and your scalp…Continue to breathe slowly and deeply. Your body is comfortably loose and relaxed, calm and rested.

Davis, M., Robbins Eshelman, E., & McKay, M. (2000). The Relaxation and Stress Reduction Workbook 5th Edition. Oakland, CA: New Harbinger Publications, Inc.
Death of a Painkiller?
2009-12-22 15:37:24

When an advisory panel to the Food and Drug Administration (FDA) recommended a ban on acetaminophen-containing pain relievers in June 2009, the response was quick and angry. We were deluged with consumer calls, says FDA spokeswoman Karen Riley. Why the outcry? The panel had suggested that the FDA remove acetaminophen from all prescription drugs, including Percocet and Vicodin, two of the most popular painkillers in the world. The panel also advised lowering the amount of acetaminophen in over-the-counter medications like Tylenol from 500 milligrams to 325, which would cap the maximum daily dose at 2,600 milligrams. The reason: Every year, about 400 Americans die and 42,000 more visit the ER because of acetaminophen overdoses, which can lead to liver damage.

The Sound of Music Eases Pain
2009-12-22 14:55:35
Researchers at Glasgow Caledonian University in Scotland found that people who were listening to their favorite music felt less pain and could stand pain for a longer period.
Running Barefoot Eases Pain
2009-12-22 14:54:49
Scientists have found that those who run barefoot, or in minimal footwear, have a very different stride from their shoe-wearing peers. The sneaker-less tend to avoid "heel-striking," and instead land on the ball of the foot or the middle of the foot. By landing on the middle or front of the foot, barefoot runners have almost no impact collision, much less than most shod runners generate when they heel-strike.