How pain affects your facial expression

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Much of our world is socially and culturally constructed, from our goals to the language we use and experiences we consider everyday life. However, a few universal experiences can be shared cross-culturally and at every age in life. One of those, unfortunately, is pain. 

We learn to express pain from a very young age. Children are reliant upon their caretakers to address and relieve sources of pain, so they cry and frown to shape the actions of the adults around them. Crying and laughing are a child’s most essential tools and stay with us as we grow into adults. This is why pain is one of the most accessible feelings to communicate without words and automatically draws the attention of those around us. 

Expressions of pain are often used in classical paintings because they draw the viewer in and are easy to read without any other understanding context of the artwork itself. The facial expressions in a state of pain are most recognizable and captivate the viewer with empathy and anguish. However, it is not just artists interested in the efficacy of facial expressions to communicate pain. Scientists of the earliest decades have been documenting and trying to understand how to quantify the individual experience of pain. 

Charles Darwin studied facial expressions of pain in humans and across species, noting that:

“…[in pain] the mouth may be closely compressed, or more commonly, the lips are retracted, with the teeth clenched or ground together…the eyes stare wildly as if in horrified astonishment.”

Later in scientific history, researchers Chapman and Jones used heat tolerance to observe common facial expressions linked to pain. They noted a specific eyelid movement that was nearly impossible to prevent: 

“[t]he pains reaction end-point was readily observed by watching for the beginning contraction of the eyelids at the outer canthus…Only a small number [of participants] could make any appreciable alteration…even when asked to keep from wincing as long as possible.”

Therefore, it is the eyes in which we most commonly see the pain in others and express it ourselves. However, there are many other ways to communicate pain without using words, some voluntary and some involuntary.

Other common expressions of pain include: 

  • Burrowing of brow 
  • Eyes squeezing 
  • Nose wrinkling and nostrils flaring
  • Lips either become tight or mouth opens
  • Cheeks raising
  • Chin quivering

We recognize these expressions in others, but quantifying them is a different story. The closest physicians have been able to come to clinical practice is the pain chart, which uses visual representations and a numeric rating system to categorize pain. However, this is still largely subjective and can only qualify pain based on self-reporting coupled with symptoms. 

Your doctor uses these expressions and your self-reported symptoms to understand your pain. The more information you can give them, which is why we encourage you to learn how to communicate your pain with a physician. 

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Best Advice for Managing Fibromyalgia Pain

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Fibromyalgia, a widespread chronic pain disease that affects 6% of the world’s population, is one of the most challenging conditions we treat at PPOA. It is tough to diagnose because of the lack of external symptoms or testing available and is even more difficult on the patients who often wait months or years to receive validation for their pain. 

90% of fibromyalgia patients are women, and these patients are often told by physicians or loved ones that they should stop being so “sensitive” instead of receiving real help. Because it shows no outward symptoms, many patients are accused of exaggerating or faking their symptoms altogether, which only adds to the pain they experience. When you’re in pain all of the time and have no one there to support you, the days can feel as if they never end. 

Below is advice from patients, physicians, and loved ones who actively fight against fibromyalgia in their daily lives: 

Take a hot bath to soothe aches and pains. 

Heat therapy is a common self-care remedy for all types of aches and pains, and it can soothe the whole-body pain experience common for fibro patients. A hot bath can not only release tension in the muscles but provides your mind with much-needed relaxation after a long day. 

Keep your body moving. 

Exercise may be the last thing you want to do when you’re exhausted and in pain, but science shows it is one of the best ways to reduce long-term pain and improve your mood. When you take daily walks or engage in a gentle yoga session, you allow your muscles to stretch rather than ache from a prolonged sedentary lifestyle. Mild exercise can also improve mental clarity and mood, which is crucial when fighting constant pain. 

Pace yourself. 

Fibro patients often feel like they have to ride the wave of their pain and push themselves on days when they’re feeling good. However, this can make flare-ups worse afterward. DOn’t feel like you have to clean the whole house in one day or walk several miles to make up for the days you skipped. Be consistent in your efforts and allow yourself to enjoy your good days rather than feeling the pressure to “make the most” of them. 

Stop comparing yourself to others. 

Fibromyalgia is an invisible disease, making it more challenging to communicate your experience. You may feel as if you have to keep up with the workload of your coworkers or “put on a happy face” when spending time with friends or family, but this only puts you at a more significant disadvantage. Your fibromyalgia is natural, and it does not need to be justified to anyone else. This goes for other people in your life, and other patients you see who you believe are coping better. 

Prioritize self-care. 

Tending to your body’s needs is the best thing you can do to reduce fibromyalgia pain. THings like overworking yourself, eating a sugary diet or skipping meals, and letting your sleep cycle get out of rhythm can all contribute to more pain the next day. Remember to make these things your top priority when planning each day: 

  • Diet
  • Exercise
  • Sleep
  • Stress management
  • Relaxation

While these self-care remedies can help lessen fibromyalgia pain, they can only do so much. If you’re ready to talk to a doctor about medical options for fibro pain, contact your local PPOA office today. 

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Five Common Pain Myths you Shouldn’t Believe

Pain is one of the few universal experiences among human beings. No two people lead the same life, but we all experience pain in one form or another. And unfortunately, we often believe the same myths about the pain that hinder our growth and healing. 

These common myths about pain often slow our patients from seeking treatment or expressing their struggles. Feel free to discard these limiting beliefs about chronic pain and replace them with beliefs that can help serve you to find a solution: 

Poor posture is the cause of your back pain

When someone experiences back pain, they often assume it is because they slouch at their desk or have developed “tech neck” from looking at their phone too often. While posture can play a part in back pain, especially job-related, it is not the only answer to why you’re constantly aching. There are a variety of medical conditions that can cause pain throughout the back, with poor posture and muscle fatigue being just one of them. If you are experiencing back pain, talk to a doctor to diagnose before assuming the cause. 

Rest is the best cure for my pain

Many patients with arthritis, back pain, or other chronic issues believe that the pain will subside if they rest long enough. They may take a day or two off (or several weeks if the pain is severe enough) and believe that their pain will be gone when they get back to work. Then, they’re surprised and disheartened when the first activity they do after bed rest results in more pain. 

While rest is critical after surgery or an injury, it won’t make chronic pain disappear. Exercise and stretching are often recommended remedies for chronic conditions, mainly when used with other treatments. Ask your doctor what’s suitable for your body, and don’t assume that bed rest will be your cure-all. 

Medication/surgery/physical therapy is my only option

Those suffering from chronic conditions often read online that surgery or heavy medication use is their only option to make the pain go away. This is not only untrue but limits people’s search when looking for a specialist to treat their pain. At PPOA, we take a holistic approach, incorporating medications, surgeries, physical therapy, medical interventions, and self-care routines when needed. We also go over our treatment options to give you as much control as possible over your pain management. 

The same chronic condition causes the same type of pain for everyone 

Many chronic pain sufferers feel guilty because they don’t “handle” their pain like other patients. They see someone going in for a similar procedure and feel guilty for not being as stoic or as cheerful as they are. But, the truth is that everyone’s pain tolerance and experience are entirely different. Some people experience pain differently or more sensitively or have been suffering from the same condition for much longer. You should never feel the need to compare yourself to others with the same situation or people without chronic pain because no one is going through the same thing as you are. 

Pain is unavoidable as you age

Indeed, we will all experience pain throughout life, both physical and emotional. However, this doesn’t mean that you have to accept your chronic pain condition and not seek treatment. Chronic pain from work or activity-related stress can be treated, even if it has been going on for a long time. And, just because you’re reaching retirement age doesn’t mean you have to slow down your lifestyle. 

At PPOA, we treat everyone’s pain individually to give them the best care and most effective treatments for their unique experience. Contact your local clinic today if you want to learn more about chronic pain or are ready to seek answers. 

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How to know when whiplash becomes chronic pain

Whiplash is one of the most common injuries following a car accident. For most, it causes short-term neck discomfort that goes away after rest. However, for an unlucky few, this injury will stay with them for weeks or months, developing into a chronic pain condition. 

Whiplash is caused when the soft tissue in the neck is strained from a quick back and forth movement of the head. It is commonly experienced in rear-end collisions and other car accidents. Still, it can happen when being struck or when falling, such as in a contact sports injury, a horseback riding fall, or in cases of physical abuse. 

How To Know If You’ve Experienced Whiplash

Whiplash often does not express side effects until several minutes or hours after the injury. Once the adrenaline in your system dies down, you may experience the following symptoms: 

  • Neck pain and stiffness
  • Headache
  • Problems with vision or hearing
  • Pain in the upper arms or shoulders
  • Dizziness
  • Concussions
  • Fatigue or sleep problems
  • Loss of memory or ability to concentrate
  • Mood changes including irritability or depression

If you have recently fallen, were hit, or were involved in a car accident and noticed these symptoms, you may have suffered from whiplash. While these symptoms may go away on their own, it’s essential to schedule a consultation with your doctor. These symptoms could be a sign of a more severe injury or may develop into chronic pain in the neck that can limit you from living a normal lifestyle. 

When Whiplash Becomes Chronic Pain

Studies show that whiplash often results in long-term problems for the sufferer. Estimates suggest that 50-60% of those who experienced whiplash after an accident develop long-term symptoms including pain, muscle spasms, or limited range of muscle in the upper trapezius muscle (the one that contracts to stabilize the head during the trauma). Other common chronic symptoms of whiplash include: 

  • Prolonged pain or stiffness in the neck and shoulders
  • Vertigo
  • Chronic headaches or migraines
  • Degenerative disc disease and other cervical spine problems
  • Problems with mobility
  • Memory and mood disorders

Because doctors are still learning about whiplash and its effects, treatments are limited and become less effective the longer you wait to seek help. At PPOA, we take whiplash and other spinal injuries very seriously and urge you to seek help as soon as you start experiencing symptoms. The sooner you seek treatment, the more options you have and the less likely your whiplash symptoms are to become chronic. 

To learn more about whiplash treatment, diagnosis, and options in your area, contact your local PPOA clinic today. 

 

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Here’s how to describe your pain to your doctor

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Pain is the most common experience we face as humans, yet it’s the most difficult to describe. We all know what it feels like to be in pain. But, everyone’s pain tolerance, the language used to describe pain, and their reactions to it differ as much as our personalities. This makes chronic pain diagnosis difficult, especially if there are no definitive test results. 

If you are frustrated in depicting your pain to a doctor accurately or a loved one, you’re not alone. This is a common struggle with our patients, so we’ve created this guide to help you better describe your pain and have us understand precisely what you’re going through:

Frequency

Chronic pain is not the same as pain immediately after an injury. It is not always constant and often follows certain events or times of the day. This information can help your doctor tremendously in accurately diagnosing and treating your pain. Keep a pain journal with the following news to bring to your next appointment: 

  • The time of day
  • How often the pain occurs throughout the day
  • How long the pain lasts (is it constant or intermittent?)
  • If the pain lasts overnight and for how long

Triggers

Specific events can trigger chronic pain. Bending over, going outside in the cold, and disruptions in your sleep schedule can all worsen the pain. If you notice any specific triggers, let your doctor know. Some of the most common ones include: 

  • After a specific physical activity is performed
  • When outside temperatures drop
  • When certain foods are eaten
  • When stress levels are higher

Limitations

The pain itself isn’t the only important thing to communicate. How the pain changes or limits your life is essential for your doctor to understand, so they know the severity of the situation. Let your doctor know if you can’t perform simple activities or avoid specific problems due to pain. 

Sensations

The physical sensations experienced during a chronic pain episode can be difficult to describe. To the best of your ability, focus on the trends and use as many words as possible to communicate the type of pain. Some common descriptors  include: 

  • Burning
  • Aching
  • Sore
  • Cramping
  • Sharp
  • Stabbing
  • Tender
  • Throbbing
  • Pounding
  • Twinging
  • Tingling
  • Stiff
  • Dull

Failed Remedies

Tell your doctor every remedy you’ve tried, from medications to physical therapy to topical treatments and everything in between. They need to know what’s not working so they can find a cure that will. 

How To Use The Pain Scale

Like the language used to describe pain, the pain scale can seem very subjective. However, your doctor needs to know how intense the experience is for you so they can better understand your situation as a whole. When asked to rate your pain on a scale from 1-10, this is typically what we as physicians mean:

1 to 3: Mild pain that is noticeable and possibly distracting, but does not generally hinder everyday life 

4 to 6: Moderate pain that disrupts physical or mental activity and is distracting

7 to 10: Debilitating intense pain and preventing most or all types of regular activity.

These tools can help you better communicate with your physician so you can find a cure for your chronic pain. Don’t be afraid to talk about every symptom, as they can all be clues in helping us find a diagnosis and long-lasting cure. 

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How does meditation work for pain management?

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Chronic pain patients are often tired of hearing advice about managing their pain. Well-meaning friends and even some physicians may tell you things like yoga or a more positive attitude will make your physical pain go away. While the thoughts are hopeful, they often belittle the genuine pain that a chronic pain patient is in all the time. 

These platitudes often leave you feeling misunderstood, maybe even patronized. “How can they tell me to think more positively, as if that will suddenly make my pain go away?” 

In many cases, chronic pain is much more than psychological and needs actual medical intervention to be solved. However, there is something to the idea that you can control your pain with your thoughts or control how much that pain limits your life. 

The Science Behind Mindfulness Meditation

Mindfulness Meditation is gaining increasing attention in the American medical community, and there’s no surprise as to why. Though its effects have remained a mystery helped by Eastern alternative medicine for centuries, we are finally catching on to the actual medical benefits of mindfulness as a pain and stress management technique. 

A 2017 review of medical research on mindfulness meditation found that “Mindfulness meditation has a most prominent effect on psychological aspects on living with chronic pain, improving associated depression and quality of life.”

Similarly, a 2020 study of 28 chronic pain sufferers who took a Mindfulness-Based Stress Reduction (MBSR) course found that “MBSR classes were found to benefit participants with chronic pain and depression in this setting, fostering significant improvement in participant perceptions of pain, mood, and functional capacity.”

While mindfulness will not make your pain go away, it can help you overcome its debilitating effect on your daily life.

An Easy Way To Start Meditating

Meditation doesn’t have to take up a significant portion of your day, and you don’t need any equipment to do it. If you’re starting, this is an excellent method for meditation that will quickly become a part of your routine if you stick to it. 

  • Choose a simple activity that lasts 10 minutes or less. Meditate while drinking your morning cup of coffee, while walking the dog, or make 10 minutes before bedtime to sit and relax with your thoughts. 
  • Choose a time and place. To make meditation an effective routine, try to do it simultaneously and at home every day. 
  • During your activity, focus on your physical sensations. What does it feel like to put the coffee cup to your lips? What does it taste like? How does it feel to breathe in and out? These physical sensations are often overlooked, but you gain new awareness of your body and mind by taking them in. 
  • Let your thoughts come and go. Many of us struggle to tune out our inner monologues, especially those filled with negative thoughts or feelings about pain. As you’re meditating, close your eyes and listen to these thoughts. Let them come and go, and think about them as separate from you. Just because you have an idea doesn’t mean you have to claim it or identify with it if the thought no longer suits you.
  • Take deep breaths. Breathing more profoundly not only improves your feelings physically but can help you focus on your body rather than your mind. This simple, soothing action will help you center yourself and control your mind. 

Meditation can help manage flare-ups, control your pain levels, and help you get through the day even when dealing with aches and soreness. However, meditation is often not enough to make chronic pain bearable long-term. If you are interested in comprehensive pain treatment, talk to your local PPOA clinic to schedule a consult. 

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How To Use Aromatherapy for Pain Management

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Aromatherapy is a popular method for relaxation and self-care. Diffusers, lotions, body sprays, and homemade salves are standard integrations of essential oils in daily life. However, few people utilize the full effects of these oils, especially when it comes to pain management. 

Essential oils can help relax the muscles and mind, which allow the body to rest and recover. While it may not be as immediately noticeable as a painkiller, research shows that aromatherapy can help manage pain when coupled with other treatments. 

The NIH published a 2016 analysis comprising 12 studies on the effectiveness of aromatherapy for pain management. The results were as follows: 

“There is a significant positive effect of aromatherapy (compared to placebo or treatments as usual controls) in reducing pain reported on a visual analog scale. Secondary analyses found that aromatherapy is more consistent for treating nociceptive and acute pain than inflammatory and chronic pain, respectively. 

Based on the available research, aromatherapy is most effective in treating postoperative pain and obstetrical and gynecological pain…. The findings of this study indicate that aromatherapy can successfully treat pain when combined with conventional treatments.”

The next time you see aromatherapy products in the store, you may want to think twice before brushing them off. Even the relaxation benefits of aromatherapy can help you recover after an injury or operation and care for your body more holistically. 

Tips To Use Aromatherapy for Pain Management

Essential oils can be applied as a topical treatment or diffused into the air. When used as a topical treatment, it is recommended to mix the essential oils into another oil, such as sweet almond oil, to create a more smooth and even application. When diluted with water, oils can also be used with a diffuser or in a spray bottle to provide similar effects. Common essential oils used for pain management include:

  • Lavender 
  • Peppermint 
  • Ginger 
  • Marjoram
  • Geranium
  • Clary Sage 
  • Black Pepper
  • Lemongrass 
  • Roman Chamomile 

Ask your local apothecary about different uses of essential oils, as well as your doctor, for safe topical application. 

While aromatherapy is not the most effective form of pain management for chronic pain, at PPOA, we like to explore all of our patient’s options. If you are interested in long-term treatment for a chronic pain condition, talk to our physicians today about medication-free possibilities and how to recover from injuries resulting in chronic pain. 

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How to Manage Chronic Pain Flare-ups

Flare-ups are one of the worst symptoms of chronic pain. It’s troubling enough to have to handle a constant ache in your bones or muscles, but to have that pain increase quickly and without warning is truly taxing on one’s mental fortitude. Flare-ups can drain you not only of your energy and pain tolerance but can make you believe that the struggle will never end. 

PPOA fights chronic pain burnout as much as we fight the illnesses themselves. That is why we take a close look at flare-ups and why they happen, to ensure our patients experience them less frequently and manage them when they do. If you are experiencing a chronic pain flare-up, these five practices can help you manage the symptoms: 

Distraction techniques

Distractions are one of the most common tools to help manage flare-ups at home. While it may seem counterintuitive to engage in something active when your pain worsens, it can lessen the intensity solely by putting your energy in a different direction. When our minds are engaged, our pain subsides so that we can concentrate. Some standard distraction techniques include: 

  • Engaging in a fun hobby or activity such as fishing, painting, or dancing to your favorite music
  • Stimulating activities such as going on a date with a partner or having lunch with a friend (this can be done at home if the pain is too intense).
  • Practical activities such as grocery shopping or tidying the house 
  • Daydreaming and fantasy creatures to take your mind off the pain (watching TV and movies can also be beneficial if you engage strongly with the narrative)

Monitor your health

Did you notice any changes in your routine right before the flare-up started? Maybe you were feeling fatigued, or your eating patterns changed recently. Often lifestyle changes can cause explosions or make them worse s be sure to manage your eating, sleeping, stress, and exercise to give your body all the strength it needs to fight chronic pain. 

Mindfulness meditation

Meditation for pain relief is becoming increasingly common for chronic pain patients. This practice helps you focus your thoughts and control your reactions to pain. When trying to get through a necessary activity such as going to the doctor or taking care of the kids, mindfulness techniques can help you manage your flare-up no matter the situation.  

Use heat

Heat is a great way to relax muscles and manage the pain of arthritis and other joint conditions. A hot bath, shower, or heat compress can relieve pain quickly and last for several hours. While this s not a permanent solution, it can reduce inflammation and help you recover after a long day. 

Plan your days

Flare-ups can zap your energy and make it very difficult to get through your daily routine without extreme fatigue. Therefore, it’s essential to manage your day properly, so you don’t overexert yourself or crash in the middle of something important. Some of the ways you can plan your day around flare-up management include: 

  • Limit physical activity that is not on your terms (such as working, playing with the kids, or going out to visit friends). While physical activities such as walking and swimming can be beneficial, you need to stop whenever your body tells you to. 
  • If your flare-ups result from cold weather, plan errand and social outings to days where temperatures are warmer. 
  • Plan several hours throughout the day for rest. Start your day late and head home early, so you have plenty of time for a hot bath and a mindfulness meditation when you get home. 

PPOA works with patients to manage flare-ups and prevent them entirely with comprehensive pain treatment. If you are tired of the constant threat of an explosion, contact your local PPOA office today to schedule a visit with our doctors. 

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What is Carpal Tunnel Syndrome? 

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Carpal tunnel is one of the most common causes of chronic pain in the U.S. Caused by inflammation and pressure on the median nerve in the wrist, it can cause pain and numbness which can be debilitating in the hand. With so few treatments available, many patients believe that they must have surgery to relieve the pain. However, PPOA can often help patients find relief through other treatments before surgery becomes the only option. 

What is carpal tunnel syndrome? 

Carpal tunnel is caused when the median nerve, which runs through the carpal tunnel in your wrist, is compressed due to inflammation or pressure. Most often this causes pain, numbness, tingling, and limiting of movement in the hand and wrist. For some, the symptoms are minor can be dealt with using a wrist brace or OTC pain medications on certain days. But for others, the pain is constant and limits motor function permanently. 

Who is at risk for carpal tunnel?

Carpal tunnel is unfortunately very common and can be caused by a variety of factors. You may be more at risk if: 

  • You’ve experienced trauma to the hand or wrist such as a sprain or fracture
  • You have pituitary or thyroid gland issues
  • You’ve been diagnosed with rheumatoid arthritis. 
  • You use vibrating hand tools or do repetitive hand motions at work
  • You experienced fluid retention during pregnancy or menopause
  • You develop a cyst or tumor in the wrist or hand
  • You’ve been diagnosed with diabetes or another metabolic disorder

When is surgery the best option?

Most physicians use surgery as a last resort if other treatment options fail and the pain returns or worsens over time. Common treatments include splints, corticosteroid injections, and other pain medications to help reduce swelling and pain in the area. Surgery involves cutting the flexor retinaculum in the wrist to reduce pressure, which can relieve the pain but will permanently alter the wrist’s function.

What other options are there for treatment?

PPOA works with patients individually to find treatment options that work for them. We combine physical therapy; medications and injections; medical devices and splints, and surgical options to find the best course of action depending on the patient’s pain level and motor function. 

 

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Arthritis: Types, Sign and Symptoms, Treatments

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Arthritis is an often debilitating condition that affects people’s ability to work, engage in daily activities, and generally enjoy life pain-free. It affects nearly 1 in 5 adults in the U.S. and typically worsens as we get older. While arthritis is widespread, it does not have to limit your life. With the help of a physician, you can find lasting pain relief and enjoy your life again without aches, pains, and tenderness in your joints. 

Types of Arthritis

Arthritis is characterized by pain and swelling in the joints caused by degradation over time. This can happen due to genetic conditions, natural wear and tear in the joints, or injuries. The two most common types of arthritis in America include osteoarthritis and rheumatoid arthritis.

Rheumatoid arthritis is an autoimmune disorder that causes the immune system to attack the lining of the joints. Not only does this cause pain in the joint, but it can also put those with rheumatoid arthritis at greater risk for immune deficiency-related health problems. 

Osteoarthritis is the type of arthritis most common in people and those who have suffered from joint injuries. Cartilage begins to break down, making the joints weaker, and therefore experience pain and stiffness. 

Other types of arthritis include:

  • Gout
  • Psoriatic arthritis
  • Juvenile idiopathic arthritis
  • Septic arthritis
  • Reactive arthritis
  • Thumb arthritis

You may be at greater risk of developing arthritis due to aging, genetic conditions, previous injuries, or certain health conditions like obesity. For example, women have a higher risk of developing rheumatoid arthritis, while conditions like gout are more common in men. While some lifestyle changes and immediate care after injury may prevent arthritis, some types of arthritis can only be treated after it develops.  

Early Signs and Symptoms

Arthritis progresses over time, starting with a slight pain or stiffness in the mornings to a debilitating condition that can affect your quality of life. Below are the four most common signs of arthritis that should cue to you visit a doctor; 

  • Joint pain – Pain after an injury is normal, but if you have recurring or daily pain in a joint, it may be a sign of an underlying condition.
  • Swelling – Your joints may feel inflamed or visibly swell with no provocation.
  • Stiffness – You may feel as if your joints are sore without using them or as though they’re slower than usual.
  • Difficulty moving a joint – If you have difficulty fully flexing a joint or moving it without pain, this is a clear sign of arthritis.

When To See a Doctor

If you are experiencing any of these symptoms regularly, for more than a month after an injury or spontaneously, talk to a doctor right away. The sooner you diagnose the issue, the more your doctor can do to prevent the progression of arthritis or another joint pain condition. 

PPOA offers comprehensive joint pain solutions for all types of arthritis and related conditions. If you have questions or are looking for long-lasting relief, give us a call to learn about your options.

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