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GET YOUR BODY RIGHT - PASSIVE
Passive Therapies
While everyone likes a hot pack and a massage, you are generally not going to hot pack yourself back into good health. Passive therapies include heat/cold, massage, e-stim, spinal manipulation, etc. These peripheral treatments may be worth a try, but if they are going to work you will know after a short course. It is not likely that your 87th massage will result in a sudden breakthrough of meaningful and lasting relief. These treatments tend to work best for focal acute pain flare ups, but there are inconsistent results with people that have chronic nociplastic pain. Considering adding passive therapies to your Rescue Plan as a distraction when the volume is turned up.(19)
Medications
Expectations are essential. There are no medications that will consistently take your chronic pain from an 8 down to a 0. With nociplastic pain the volume is turned up on the entire nervous system. Medications are generally selected to calm down the nervous system. Unfortunately, any medications designed to calm down the nervous system will often have sedating and other side effects. Sometimes you can use these medication side effects to help with other issues, like improving sleep or mood.
Regarding dosing, there is a balance between symptom relief and side effects. Often the side effects may subside after a few days. It is best to start with a lower dose and taper up slowly. If you do not experience any relief or side-effects, then you may be at too low of a dose and you should consider slowly tapering up. Communication with your healthcare providers is important to optimizing medication dosing.(19)
Procedures & Surgery
Again, expectations are essential. Peripherally based injections and surgery tend to work well for acute peripheral pain generators. Chronic pain (longer than 3 months) tends to have an inconsistent response to these procedures.(17) If you have failed to respond to focal peripheral procedures in the past, then it is more likely that you have nociplastic pain amplification. "Back in Control" has some nice guidance if you are considering procedures for a chronic pain condition.
It is best to put your efforts towards the two things you can actively control
Work on your Body & Work on your Mind
If you are still unsure if you have nociplastic pain,
consider going through the Learning Module again.
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