Evolution of the Emergency Room – Breathing Techniques for Pain Management

This past weekend I had to visit the emergency room at our local hospital. (Thank goodness, we’re all okay.) Upon leaving, I was given a 7-page printout of Discharge Instructions.  In addition to a summary of the prescriptions and their usage, the packet included a lengthy Pain Management section which included the breathing and visualization techniques below. Of course, we’re all familiar with the Lamaze techniques taught to pregnant women for pain management, but as a yogi, I was excited to find that pranayama along with other alternative exercises are now being taught in a more main stream environment — the ER.

Alternative Techniques for Pain Management

1) Breathing exercises

Deep breathe/tense, exhale/relax, yawn for quick relaxation:

1. Clench your firsts; breathe in deeply and hold it for a moment.
2. Breathe out slowly and feel yourself becoming limp.

Slow rhythmic breathing for relaxation:

1. Breathe in slowly and deeply.
2. As you breathe out slowly, feel yourself begin to relax; feel the tension leaving your body.
3. Now breathe in and out slowly and regularly, at whatever rate is comfortable for you.
4. To help you focus on breathing slowly and rhythmically:
   • breathe in as you say silently to yourself, “in, two, three”
   • breathe out as you say silently to yourself, “out, two, three”
5. End with a slow deep breath. As you breathe out say to yourself, “I feel alert and relaxed.”

2) Imagery

There are a number of ways to help your body relax when you are having pain. Remembering a relaxing experience that happened to you in the past can make you relax again. Close your eyes and take yourself away from the present as you think of the answers to the following questions.

• Can you remember a time when you felt calm, peaceful, secure, hopeful or comfortable?
• Have you ever daydreamed about something peaceful? What were you thinking of?
• Do you get a calm feeling when you listen to music? What special music helps you relax?
• Do you have any favorite poetry that you find uplifting or reassuring?
• What favorite readings, hymns, or prayers do you find calming?

3) Music

1. Get a CD player or cassette player [ipod] and play the type of music you enjoy and find relaxing. Some people find fast, lively music can help distract them.
2. Get earphones or headset. Reduce the other noise in your immediate area, if possible.
3. Mark the time to the music by tapping out the rhythm with your finger or nod your head. This will help you concentrate on the music rather than on the pain.
4. If the music alone is not enough, try adding one or more of the following:

• massage your body in rhythm to the music
• add other music
• mark the time to the music

4) Simple touch, massage or warmth

• Try holding onto someone’s hand.
• Try briefly touching or gently rubbing the painful area.
• Try a warm foot soak in a basin of warm water, or wrap your feet in a warm, wet towel.
• Try taking a warm bath.
• Get a massage (from a whole body massage or a specific area of the back, hands or feet). Use a warm lubricant (small bowl of hand lotion warmed by putting it in warm water for 10 minutes).
• The person massaging the area for you should use smooth, long, slow strokes. Gently putting some pressure on your body may feel comfortable.
• A back rub will produce relaxation in just 3 minutes with continuous hand pressure.
• Setting aside a regular time for a massage will give you something to look forward to and be a very important strategy to control pain.

The Future is Integrative Medicine

Integrative medicine (which is the exploration of new ways to treat the mind, body, and spirit — all at the same time) is an exciting evolution of our health care system. Duke Integrative Medicine, one of the leading institutes in this area, offers a program called Mindfulness Based Stress Reduction (MBSR), which uses meditation and yoga to cultivate awareness, reduce stress and promote healing. The Duke model emphasizes preventive care and patient responsibility alongside conventional, Western approaches to health care.

Take a close look at the Duke circle diagram here. The patient (YOU) is at the center of the diagram meaning that personal responsibility and mindfulness are at the core of the Wheel of Health. Continuing outward, falling under the green “Self-Care” area shows each patient is responsible for their own:

• Nutrition
• Mind-Body Connection
• Movement, Exercise and Rest
• Personal and Professional Development
• Spirituality
• Relationships and Communication
• Physical Environment

Connected to the Self-Care area are the Professional Care areas of:

• Prevention and Intervention (I would add “Patient Education”)
• Conventional and Complementary Approaches

The genius of the diagram is that it is a circle — all areas are interconnected.

The whole is greater than the sum of its parts

I am excited about the potential for healing and growth as more and more experts treat the whole person and as more patients educate themselves and become their own health care advocate.  Aristotle wrote over 2200 years ago in his Metaphysica, “The whole is greater than the sum of its parts” (paraphrased) and the same could be said about the application of integrative medicine.

Alternative techniques above provided by Little Company of Mary Medical Center

Tagged as: integrative medicine, pranayama for pain, yoga for pain, yoga health benefits