Chronic pain is at epidemic levels and has become the highest-cost condition in health care. This course uses evidence-based science with creative and experiential learning to better understand chronic pain conditions and how they can be prevented through self-management in our cognitive, behavioral, physical, emotional, spiritual, social, and environmental realms. The goal of this course is to blend creative, experiential, and evidence-based teaching strategies to help participants understand chronic pain conditions and how a human systems approach can be applied to self-management strategies to reduce risk factors, enhance protective factors, and prevent chronic pain. There are four major objectives to the course; 1. Describe the prevalence, personal impact, and health care dilemma associated with chronic pain. 2. Recognize the clinical characteristics and underlying etiology of several common pain conditions and the peripheral, central, and genetic mechanisms of chronic pain 3. Based on the literature associated with risk and protective factors in the seven realms of our lives, learn specific strategies in each realm that can be employed daily to prevent chronic pain and enhance wellness. 4. Appreciate the value of a human systems approach to health care and how it can provide a basis for integrative, interdisciplinary, and individualized care to preventing pain and enhancing wellness. CONTINUING EDUCATION CREDIT OPTION Accreditation Statement: University of Minnesota, Interprofessional Continuing Education is accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team. American Medical Association (AMA) The University of Minnesota, Interprofessional Continuing Education designates this enduring material for a maximum of 24.0 AMA PRA Category 1 Credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity. American Nurses Credentialing Center (ANCC) This activity is awarded up to 24.0 ANCC contact hours. Other Health Care Professionals Other health care professionals who participate in this CE activity may submit this certificate statement of participation to their appropriate accrediting organizations or state boards for consideration of credit. The participant is responsible for determining whether this activity meets the requirements for acceptable continuing education. Registration and disclosure information is available here at http://z.umn.edu/chronicpain and pay the additional fee. Then, email your Coursera certificate statement of completion to cme@umn.edu.
6 Daily routines (Activity Level, Balance, Pacing, Timing, and Variation)
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來自 University of Minnesota 的課程
Preventing Chronic Pain: A Human Systems Approach
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Risk and Protective Factors in the Seven Realms (Week 8)
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Dr. James Fricton, DDS, MSProfessor and Pain Specialist
University of Minnesota, HealthPartners Institute, and Minnesota Head and Neck Pain Clinic
Hi. Welcome back to the final part of
the module on lifestyles.
And in this part we're going to discuss your daily routines, the activity level,
balance, pacing, timing, and the variation of your lifestyle.
We all have a significant amount of challenges into
having balance within our lifestyles.
There's just a ton of demands placed on us.
And we really have to address and
deal with those demands in a way that allows us to relax during the day.
So lifestyle factors and
our daily routines play a significant role in the development of chronic pain.
Whether it's poor pacing, feeling rushed,
the lack of breaks, sitting too long throughout the day.
These risk factors probably play as much of a role in chronic pain as
other factors.
For example, women on the average spend about 17 minutes of alone time per day.
Well, without time to sit and take a deep breath.
To think about your day and you're only reacting.
Plays a huge role in the development of chronic pain.
And this is what's called Acute Lifestyle Stress.
Often we try to take on too much.
We have too many irons in the fire.
We don't organize ourselves very well.
We have lots of pressure needing our attention.
And all of this creates this sense of fight or
flight a sympathetic response where we're always in a tense situation.
Always not, not really predicting what is happening next,
but just reacting to the circumstances in our life.
And with this we are over-aroused, often can become short-tempered, irritable,
anxious, and tense.
And is a significant risk factor for chronic pain.
And you can see some of the characteristics associated with that.
So how do we prevent Acute Lifestyle Stress?
Well there's a variety of things that can be done.
I mean the bottom line is that we have to balance our lifestyle between those
things that are hyper active, very busy, reactive, and
those things that are introspective, and calming and relaxing.
So with that we'll be able to prevent a lot of chronic pain and
a variety of other conditions that are listed right here.
So we have to recognize that life is really too short to be in a hurry.
We need to, as they say in the quotes, smell the roses along the way.
So, these are all things that increase stress muscle tension,
sympathetic activity.
So, ways to change that is to really set goals for a particular day.
Don't set lofty goals, set realistic goals so you have time
to take a deep breath, to do mindfulness meditation, to go for a walk, to exercise.
[COUGH] we need to prioritize and plan out our day.
Don't necessarily do everything.
Don't try to get everything done in the same day.
We need to be patient with ourselves and others.
We don't want to overdo things or, on the other hand,
we don't want to lay around all day either.
So we need to do practice re, relaxation and
breathing to reduce that tense muscles throughout the day.
[COUGH] and they, one of the quotes that I, I,
I love to say is that 20 bad postures throughout the day
is better than one good posture that you hold all throughout the day.
So the key is, is variation.
The k, the key is to have some relaxation, have some busy-ness some
deep breathes, and some very intense activity that you do.
So these are things that are part of developing that
balance within our lifestyle.
But also the opposite can be true, too.
So as this picture I kind of laugh at this, is the fact that,
you know, we have evolved over time, now to spend a lot of time on the computer.
And with that, it's sitting, it's sedentary, it's often poor posture and
a tense posture.
All of that will increase the potential for chronic pain.
So sedentary activity and
sitting, lots of studies have demonstrated relationship between the two.
They did a study of 63, 63,000 Australian men, ranging from age 45 to 65.
And those people sitting for four hours or less had significantly less cancer,
diabetes, heart disease, and high blood pressure and chronic pain.
And a study of sedentary time between pain group and
a control group showed that the total sedentary time was about the same, but
the pain group had longer periods of sitting.
So the total sedentary time was the same.
But it's the duration of the periods of
sitting that the chronic pain patients had more.
So variation again, get up, take breaks.
Walk around a little bit.
Vary your day.
So 20 bad postures during the day
is better than one good sitting posture all day long.
So a number of studies for instance found that
an active lifestyle correlates to a reduction or prevention of back pain.
And so, one study showed that when you injure your back,
those people that had a quick return to normal activity and stayed active,
they improved their pain intensity and functional status much better than those
people who stayed in bed for a few days to three to four weeks.
and, and then at 3 to 4 weeks and 12 weeks, the pain was significantly better.
So avoid bed rest after your injury, but take it easy.
I mean, don't overstrain it but don't be inactive.
Don't do sustained sitting or lying down after back pain.
So some of the take home things with regard to a healthy daily routine is you
need to develop those routines that prevent insomnia, obesity, chronic pain,
and many other illnesses.
Avoid missing eating, sleeping, fluids, and exercise.
This will disrupt the natural body clock and interferes with the body's metabolism.
It will lead to chronic pain.
So take a regular timetable for meals, going to bed and exercise.
Having this balance between work and personal life,
between very busy activities and quiet, contemplative activities.
And use daily reminders on your phone, your kitchen, on your bed.
Because it's the little things you do everyday that plays the most
significant role.
And I've said that over and over again but that's really the bottom line.
So we need to change our bad habits also.
So as Mark Twain quoted, I love this quote, habit is habit and
not to be flung out the window by any man but coaxed downstairs a step at a time.
So, to change bad habits you just can't stop it.
It's hard to do cold turkey.
On any particular habit.
Gradually decrease or improve good habits on a daily basis.
Increase the size of that salad.
Decrease the length of time that you're sitting.
Take breaks throughout the day,
those little things done every day are really the key.
So habit reversal steps are very important.
And here's six steps that you can follow.
You can read it.
The key is really identify the habits, and
then every time you notice a habit, make a change.
And then follow this everyday until the habit is changed.
So these six steps are particularly helpful.
So here's a few other suggestions that may be helpful.
The 90/10 rule is critically important throughout your daily routine.
Develop a routine that has 90% protective factors, 10% risk factors.
Maintain your weight.
Substitute, find healthy options for any food weaknesses that you might have.
Chocolate is a good one.
Find something else, coconut for instance, or something else that
you really like just as much that has more natural nutrients in.
track, track your activities, your biometrics, whether it's weight,
diet, activity level, exercise, sleep patterns.
If you write it down you're going to have a tendency to comply much better with it.
And then pace yourself.
Do not hurry through any activity.
Drive slowly out there.
There's no reason to get there one minute ahead of if you
didn't drive a little bit slower and more cautiously.
And the same thing applies to your daily routine,
don't go rush through a daily routine.
I know many of you are very busy but
at the same time doesn't really get you any further ahead necessarily.
so, and then be prepared, keep healthy snacks and water on hand at all the time.
Try to avoid other beverages throughout the day,
just drink water and have something there available for you.
And finally the last thing is have a positive attitude,
it really leads to a positive action.
Then get applications, apps through our the cellular phones that we have.
There is a lot of personal care devices and, and ways to monitor,
to improve our diet, sleep, exercise and other physiologic parameters.
For instance, the Jawbone and the Fitbit are a couple of them.
There's Sleepbot, SleepRate, Aura, Beddit are all characteristics of
apps that are particularly good in helping us monitor our daily routine.
And then a few other suggestions learned from the young and the old.
Don't move too fast through life.
It's important to take breaks.
Do some daydreaming everyday.
And really enjoy yourself throughout the day.
I mean do the things that you, you enjoy, have some fun.
And then the experiential learning is really to listen to
the relaxation recording.
So I record a few minutes of just a very brief relaxation recording.
Listen to it and learn to settle your mind.
Breathe deeply, maintain a relaxed posture and quiet your inner roar.
Because, remember, it's the little things in life again that are most important.
And you need to set up your own [SOUND] routine of little things.
[SOUND]
