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Physical Medicine Approaches To Pain Relief
Francine Manuel, RPT, Isadora Rosenbaum, MA, Ernest H. Rosenbaum, MD

Relaxation Exercises for Pain Relief

Breathing properly is a key factor in all exercise programs. By itself, breathing is a good exercise. Its benefits are twofold: therapeutic and relaxing. Breathing exercises can be used to improve the habits of those who breathe lightly, expanding only the upper chest. They are also a good way to rest between exercises. Urge your patient to let go of all the muscles in his neck and shoulders and fill his lungs all the way. This will break the cycle of shallow tension breathing.

Body relaxation techniques can be effective in pain control because they teach the patient how to reduce muscular tension. The body's natural response to pain is to contract the muscles. This contraction intensifies the pain cycles and increases lactic acid accumulation. By getting the patient to relax the muscles, he or she can experience some relief from pain.

You must start with the patient in a position that is totally relaxed. Have him lie down with his legs loosely out straight and his arms at his sides. You may want to put one pillow under his head and another under his knees.

Tighten and Release
The first exercise in the series is to tighten and release muscles in a fixed sequence. Start with the head and work down. First have the patient tighten the muscles of the forehead. When these are tightly contracted, instruct him to let them go. Move to the nose, and tell the patient to tighten the nose as if he had smelled a bad odor. Then instruct the patient to let it go. Touch each part you instruct the patient to tighten.

Move to the mouth, telling the patient to tighten the mouth muscles as if he had just bitten into something very sour. Then tell him to release the mouth. Move to the tongue, neck, shoulders,arms and on down the body in turn. Instruct the patient to hold his breath and then release it. Tell him to pull in his stomach muscles and then release them; tighten his buttock muscles, and then release them and so on. Cover each major body area-the hands, arms, shoulders, pelvis, buttocks, legs feet and toes.

This exercise lets the patient learn what each muscle group feels like, both tightened and released. Soon the patient is able to recognize when his muscles are tight.

The second exercise in the series again begins with the head. This time, have your patient visualize things that make each muscle group feel heavy. You may want to instruct your patient to imagine something that makes his nose feel heavy or his neck feel heavy and so on. After you have gone from the head to the toes, covering all the body parts in the same sequence, return to the head once again.

The third exercise follows the same progression of body parts-forehead, nose, mouth, tongue, neck, shoulders, down to the feet again. This time, instruct the patient to imagine or see images that made each part in turn feel warm.

The final exercise in the series starts with the head again. As you touch each body part, ask your patient to see images that make him feel that his forehead, nose, mouth, neck, shoulders and soon, are gently floating.

Have your patient practice these four exercises in sequence for two or three weeks, in a lying down position for 20 minutes per day. This gives the patient time to find images that please him. It is important that each patient find images that are personally pleasing. By the end of two or three weeks, your patient should know how to do the whole series without help from you.

After the patient has established comforting images and knows the exercise series well, you can move to the next stage. Have the patient practice the entire series using the same images while sitting up. Then have the patient do the series while walking around. Once learned, these body relaxation techniques can be done as often as needed.

Of Interest:
Breathing For Pain Relief
Physical Medicine Approaches To Pain Relief
Exercise For Pain Relief
