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Relaxation:
Spending minutes of your day in quiet reflection can help you stick with your priorities and
reduce stress. Meditation can relax your breathing, decrease muscle tension and slow your heart rate. It may also reduce your
blood pressure.
Here's how to get started:
* Get into comfortable clothes.
* Choose a quiet space where you won't be interrupted.
* Sit comfortably. (The lotus position is not required!)
* Close your eyes, relax your muscles and breathe slowly and naturally.
* Repeat a focus phrase. It doesn't have to be "ohm." Try, "I am calm." When other thoughts intrude, bring your attention
back to your focus phrase.
* Start with 5-minute sessions, working your way up to 20-minute meditations.
* When you're finished, sit quietly for a minute or two to make the transition back to the real world.
* Use these techniques to meditate once or twice a day.
People first have to acknowledge that medications alone cannot work and that they need to modify their activities.
There are a number of non-pharmacologic approaches. One is that people first have to acknowledge that medications alone cannot
work and that they need to modify their activity. They need to learn to find how to offload inflamed joints and modify the
way they do tasks to protect those joints. A good example of that would be that if fingers are really sore, to find a way
maybe to grasp which is different than just grasping or if someone has a problem with their wrist, perhaps use a splint which
is a way of supporting that when they're doing a task that might irritate it, like vacuuming.
There are a number of other types of approaches, like using adaptive footwear, like shoe orthotics or adaptive
shoes. And of course as you know there are a number of exercise-directed therapies which can really reduce muscle tension,
improve sense of well-being and general conditioning.
The issue is learning to respect pain, and sometimes people use what's called the two-hour rule, that individuals can
do what they feel comfortable doing as long as they don't have pain that persists more than two hours after the activity and
they're not stiff and sore the next day.
Like anything, adaptation starts with doing something. And usually people get so excited about starting an exercise program
that they often will kind of wear themselves out and not persist with it.
People need to return to the games and the activities of their youth. Having some type of activity that a person enjoys
on a daily basis is a good thing, but, research would suggest that you could exercise intermittently and have a lot of benefits
from that, too. Everything should be done in moderation and what your condition will permit without excessive demands.
There are lots of different ways that people cope with pain which are kind of interesting. Some of these are sort of
short-term interventions, and some are longer-term, but certainly distraction, and changing what you're doing, and changing
your physical activity you're doing at a time is a good technique. Sometimes people will meditate or pray.
There's some pretty interesting research written about reflective writing, where people who are experiencing pain
will write essays, and this activity often brings insight into the experiences people have but also reduce pain because it
distracts the brain from really focusing on the pain itself. Essays about anything except pain
Heat and cold treatments are time-honored, which many people find provide temporary benefit, and always the question
people have is, "Which should I use, hot or cold?" The most important thing is you do what feels comfortable. Some people,
in fact, alternate between the two.
Then the whole other question is how do I safely apply heat and cold? And
there are many ways. You could use radiant heat from a heat lamp. You could use a moist heating pad. One can could use paraffin
baths using paraffin wax that's heated. There are a lot of different ways to do this, and it's just a matter of what people
find works for them.
The non-pharmacologic approaches need to be started, and they need to be started early. But nowadays we realize that
rheumatoid arthritis is a disease that can cause damage early and that one needs to add appropriate therapies with pharmacologic
agents or biologic agents early in disease. And it's not a good idea to let people just say, "Okay, I can tough it out a little
bit longer." There's no reason to tough it out.
What they need to realize is that while they're toughing out the pain, inside their joints are many little proteins that
cause inflammation, and the inflammation will often eat away some of the bone or eat away some of the cartilage, and that
would be a change in their x-ray or if one looked at their joint surgically which would be a change that you couldn't fix.
Before they get these changes that can't be fixed,patients need therapies which will slow down if not stop these kinds of
X-ray damages.
Comfort is important. The ultimate is that in five or ten years you want to be able to function as well as you can because
you've got joints that are as close to normal as they can be, but in the meantime, you want to feel well enough that you can
get up and go to work in the morning and earn, a living for your family or go out and do that things that you enjoy.
The
other thing is that often people have fatigue. And so if you control the disease process and you have less pain but also less
fatigue, you'd be more likely to live a full life.
Another important marker is sleeping. Often because people feel poorly, they have impaired sleep and, if you're tired
and have pain and you don't sleep well at night, it's pretty tough to enjoy what you're doing.
A well balanced nutritious diet is also very important. We may not feel like eating,at times,but we don't want to get
run down because of poor diet,and compound the situation at hand.
Keeping stress to a minimum is another important job. Set priorities for yourself. Organize your time so that you
do the things that are most important to you first. Let less important things go.
Identify things that cause you the most stress. Then, look for ways to get around them. For example, if you find traveling
stressful, see if you can make a phone call instead.
Concentrate on doing one thing at a time. Once you have
finished a task, take a moment to let yourself feel good about getting it done. Take a rest if you need it, and then move
on. If you are running late, or if you feel overwhelmed, cancel or reschedule your appointments.
Learn to say "no". Save your energy for the things that are most important to you. Get support. Don't try to do everything
yourself. Ask your friends and family members to help with some of your responsibilities.
Talk about your feelings with family and friends. Make sure you take time for social activities and exercise. You'll
be more prepared to deal with situations that cause you stress if you've taken time for fun! Plan ahead.
Think about which situations cause you stress. Then, plan ahead to minimize or avoid these predictable sources of stress.
For example, if waiting in line is stressful for you, bring a book to help pass the time. If you find the morning rush stressful,
get up 15 minutes earlier so that you don't feel so rushed.
Schedule breaks for yourself throughout the day. This will give you a chance to rest, and will also prevent the stress
that comes from getting "behind schedule".
Relaxation techniques should be investigated. self-meditation is a good examp;e,or deep breathing techniquew. There are
many ways to relax and avoid stress.
Exercise is of paramount importance in rheumatoid arthritis therapy. Keep joints moving and protect your joints by adaptaing
to your present conditiom, do what you can do now. Majority of patients will have to learn to adapt to their present
environment and condition.
Worry is a waste of time. The only thing we can control is ourselves,both medically and mentally. What will happen,otherwise,
will happen.
The patient may become less responsive to a pain medication but generally does not become "immune" to it. If the
cause of the pain is not changing, then you wouldn't expect that whatever dose of pain medicine somebody is taking would wear
off. If the disease changes and it gets worse, then the level of the dose of the drug may not be sufficient.
If there are other things contributing to the pain, whether it be a number of issues - emotionally, psychologically,
physically, etc. - then those things have to be dealt with individually
There are four stages of sleep and if you're coming out of Stage IV to Stage II, you're going to have what we call non-restorative
sleep. You're going to wake up tired and you're going to feel like falling asleep during the day. So the key is to make sure
that you're not having pain at night that's waking you up. If you're not getting adequate rest or adequate sleep, you're going
to have fatigue and you're going to feel like falling asleep during the day.
For energy during the day, there is an herbal supplement that is called N-A-D-H and that stands for Nicotinamide Adenine
Dinucleotide Hydrochloride. A brand name is Enada. I have my patients take the 5 milligrams for about a week, see what kind
of response. If no response, then increase to 5 milligrams twice a day.
A rheumatologists response to complementary therapy:
I have naturopath doctors that I refer patients to. I have chiropractic doctors I refer patients to. I have acupuncturists,
I have massage therapists. But guess who's in control? I am. As a rheumatologist, I feel that I know more - and I should know
more - about arthritis than the other providers. But I'm in control and those people that I refer my patients out to, they
give me feedback and there's that constant communication.
But when the patient decides that, "Oh, I don't want those bad medicines that everyone associates with RA-I'm not going
to get my liver killed", or "I'm not going to do this, and I'm not going to do that…" But guess what? When you look
at a hundred patients, maybe two or three out of the hundred might have a problem, so you've got to look at it from an optimistic
standpoint.
Have a balanced integrative approach from the start and be open. Patients can talk to their rheumatoligists
about supplements and whatever complementary therap they are complementing of taking,but the key is to talk it over with the
physician. Make sure it does not interfere with current therapy.
Side effects depends on the kind of medications
that you're using. Often patients on methotrexate, hydroxychloroquine or Plaquenil -- they feel sick. They feel nauseated.
And seemingly, it doesn't go away. And if you take, say for example, enteric-coated type, they don't feel sick. So there are
some people that just don't tolerate certain medications very well that can contribute to that feeling.
Enteric-coated medicines have a coating that prevents them from dissolving in the acid chemical environment of the stomach,
but they dissolve in the "base" environment of the small bowel. That may help to avoid irritation and nausea caused by exposure
of the stomach to the drug.
And two natural things that physicians often use to kind of help with that to maintain
or to keep the methotrexate and the Plaquenil is what is called diglyceride ginger. And the other supplement, other than the
ginger, is glutamine. Those two tend to help settle.
Patients using methotrexate; A vitamin called folic acid is almost always prescribed with that. That does help to abate
some of the nuisance side effects, and if that's not sufficient, there is a more potent vitamin like it called leucovorin
that can be useful.
To begin as just some background, we need to recognize that foods themselves are not nutritious by themselves, but a
balanced or a nutritional diet is one that meets certain criteria, such as it should be adequate in essential nutrients such
as fiber, nutrients and energy. It should be controlled in its energy allotment, so we need to think in terms of what an individual
person's needs are in terms of calories, and a variety of foods should be eaten in moderation. That's just a general, global
view of what is considered a nutritious or balanced diet.
A balanced diet helps support your immune system. And one might ask, why is this important for people with rheumatoid
arthritis? Well, one, the very important reason is that a balanced diet helps support your immune system. And it's already
in the face of rheumatoid arthritis in what one might refer to as high gear, working to combat the increased number of inflammatory
cells that are present. Therefore, to have a good dietary intake such that it maximizes the functioning of your immune system
is very important.
The second is the fact that one should try to maintain an appropriate weight. And of course weight is based on an individual's
height, and it's desirable to not to be either over or underweight if you have RA. It's not uncommon for some patients with
RA to have poor intake, and they have poor appetite that can persist over a long period of time. Of course, this is due to
the fact that RA is a chronic disease, and the loss of appetite and poor nutritional intake can result in the development
of malnutrition that can in turn decrease a person's or an individual's immune function. It can also lead to the loss of muscle
mass and cause muscle weakness, making a patient with RA at increased risk for falling and possible fractures, such as the
hip.
Now, in the opposite direction, excessive weight increases the burden on joints, especially those weight-bearing joints
such as knees, ankles and feet. So, eating a variety of foods daily in adequate amounts that permits the maintenance of a
desirable weight is a dietary goal that patients with RA should work to achieve.
The treatment of rheumatoid arthritis is really the treatment of the patient with rheumatoid arthrit.We need to think
about the patient's intake. Many patients with rheumatoid arthritis actually lose weight because they're spending so much
time and energy making all this inflammation and immune-mediated cytokines or proteins. As a result, one does need to consider
all of these issues. But diet alone, nor anything alone, really is the treatment for rheumatoid arthritis.
There are really two goals that rheumatologists have when they take care of a patient. One is to make them feel better
and carry on their activities of daily living such as taking care of their children, going to work and school, or whatever
else they need to do. And again, diet may give them symptomatic relief.
However, the other thing with rheumatoid arthritis is it's a disease that can cause crippling and deforming changes and
x-ray damage even if the patient on the outside is feeling reasonably well.
Checking with your physician and making sure that one doesn't need a disease-modifying treatment that would actually
stop the bone and cartilage damage in addition to either diet or other medicines or treatments that would be making the patient
feel better is very important.
Having already mentioned about added stress to the joints that can occur as a result of obesity, especial those weight-bearing
joints, obesity is not only detrimental in terms of this added joint stress, but it can contribute to many additional diseases,
many of which individuals with RA face. And these include diseases such as chronic heart disease, stroke, elevated lipid levels,
and diabetes, to name a few. And we know that obesity is in epidemic proportions at the current time here in North America.
An 11-pound weight loss is beneficial in terms of reduction in joint pain. It's also noteworthy to think about that no
matter one's initial weight that an 11-pound weight loss is beneficial in terms of reduction in joint pain, specifically those
that may have osteoarthritis, a different form of arthritis than rheumatoid. But it also can lower lipid levels. It can reduce
blood pressure and also blood glucose levels. So, even a modest amount of weight loss, such as an 11-pound weight loss or
five kilograms, can be very beneficial. Therefore, working to achieve and maintain weight loss is desirable from many health-related
viewpoints, including arthritis.
Another point is that people with rheumatoid arthritis get what we call secondary osteoarthritis, meaning the rheumatoid
gives them wear-and-tear arthritis sooner than they would for their age, and again, watching one's weight is very important
for the weight-bearing joints there. Some of the therapies that are used for rheumatoid arthritis such as prednisone or cortisone
will change the lipid level or the blood sugar level in our patients, so again one needs to take care of the whole patient,
both with looking at the medications as well as with the diet.
Fatigue is really a common daily occurrence for many people, and for individuals who are healthy, fatigue can result
from strenuous physical activity, a busy day at work, some stress, or tension. But typically for people who are well, if they
get some rest, if they follow a good diet, they actually get relief from their fatigue, and so they find out that the fatigue
is really short-period, and they can move on with their life. But for people with chronic illnesses, in particular people
with rheumatoid arthritis, the fatigue that they experience really doesn't get relieved so quickly. The fatigue lasts much
longer, and it impacts their function in a much broader way.
There's probably multiple causes of fatigue,there is probably not just one single cause of fatigue. I think when we're
looking specifically at rheumatoid arthritis, we're looking at things such as pain, the inflammatory process itself, depression,
other chronic illnesses that may not be treated or even diagnosed, and sleep problems. All of these can contribute to the
fatigue, as well as being deconditioned, that people with rheumatoid arthritis experience.
Many patients with rheumatoid arthritis have what's called the anemia of chronic disease. As people with rheumatoid arthritis
know as well as their providers, probably pain and fatigue are the two most common symptoms that people experience,and they
frequently go hand in hand. Patients have said,they would actually rather have the pain than the fatigue because with the
pain they can find different ways of doing things, but with the fatigue, they don't even have enough energy to mount a certain
effort.
What happens when people are in pain is they spend a lot of energy doing everyday activities. The pain interferes with
their sleep, and therefore they feel a lot more daytime fatigue. The pain also makes people carry their body in different
positions. As the result of carrying their bodies in different positions, that can be more fatiguing for them.
Research really has shown that there are different things that people can do. First of all, they really need to identify
the causes of their fatigue. Someone who may be seeing a rheumatologist and be getting appropriate management of their inflammatory
process associated with the disease may still have other causes like pain or depression or anemia or other conditions such
as thyroid problems.
People must look at ways to enhance their energy in their life. Look at things such as doing some what's called "cognitive
restructuring" where they re-think things. They think about themselves differently than they did before. This is called "re-normalizing,"
where they look at themselves differently; having different skills and different talents than perhaps what they had before
they had the disease. There's a whole piece about constant comparisons where people really look at themselves relative to
other people, and they feel like they really aren't that bad, that they really have some strengths.
There are things such as energy audits, where people really take stock of how much energy they have and what activities
they've yet to do, and they see how much energy they need to use for the activities remaining in the day. And it's very much
like a dieter may do in regards to counting calories. They actually count their fatigue level, or energy level.
The inflammation when it's been controlled, such as with drugs like Enbrel or methotrexate, patients' fatigue often gets
better as does their pain and swelling of their joints. Too often patients, spend too much energy thinking arthritis and not
enough having a good time, and that does contribute definitely to their fatigue.
Rheumatoid arthritis and anemia go hand in hand. Sometimes thyroid problems can go hand in hand with rheumatoid arthritis.
There are other medical conditions that often are part and parcel of the inflammation that cause fatigue in patients.
Also,not just a clinical depression but a subclinical depression where people may feel a little like they're losing interest
in some of their activities. They might feel a little blue, but they may or may not have an actual full clinical depression.
That feeling of being blue can really contribute to people's fatigue and vice versa. The fatigue can contribute to someone's
feeling really sad and very low. Those two are wound up and depending upon the level of depression may require someone to
go seek counseling, or they may figure out some strategies that they need to change in their own life about how they see themselves
and what they can do as far as what they can accomplish.
People who have rheumatoid arthritis and are at least not blue about it, then they possibly might need a psychiatrist
because rheumatoid arthritis can be a depressing disease. We have fabulously great treatments nowadays, a lot of new treatments
for this disease. But still we don't have the cure, and it's a disease thats "ongoing" -- but it is a chronic disease. So,
depression is or at least feeling blue about having this, having to come to the doctor, having to take medication, is very
common.
What physicians try to do is address the issue because many of these people are depressed or blue mainly because they
can't do the kinds of activities of daily living that they want to do such as going to work, taking care of their kids, playing
golf or doing the vocational and avocational kinds of things that they want. And people in pain get down and depressed as
well.
One of the things that patients do is they learn to use fatigue as a signal, and so they start to reinterpret it.
And if they have otherwise been well and their rheumatoid arthritis has been well managed, when the fatigue comes back,
they can use it as a signal. And when you use it as a signal or as a cue, you can say, "Ah, my disease may be flaring again,"
and they use that sort of as an advance warning to do something about it, and that's very empowering for them that they can
be in tune to their body and the symptoms like that.
Its a known fact that exercise has many benefits for all of us, whether it's cardiovascular, whether it's for the musculoskeletal
system, whether it's for bone strength, weight control. There's multiple ways that exercise helps us, and it also can help
people with rheumatoid arthritis.
Sometimes what people initially feel if they've been sedentary and they do start on an exercise program under the supervision
of a physical therapist or an exercise specialist is they may initially get tired because they are really having to work their
muscles harder. But in fact they find out that they begin to sleep better and that their pain actually improves, and we have
plenty of research that really shows the benefits of exercise for people with rheumatoid arthritis. It's clear then that people's
fatigue levels actually can be improved as they build up a program that gets them more fit.
We have plenty of research that really shows the benefits of exercise for people with rheumatoid arthritis. And again,
it's increasing one's overall physical activity, not necessarily just an exercise program. It's getting people to walk around
the block. It's getting them to maybe park a little bit further in the mall parking lot and walk to the mall. And then it's
getting them into a regular program, whether it's at a YMCA, whether it's to an Arthritis Foundation swimming class, whether
it's mall walking, but building up so that one can get much more physically active and fit.
When you are under stress, your muscles become tense. This muscle tension can increase your pain. A vicious cycle of
stress, pain, and depression may develop. However, if you learn how to manage stress, you can help break that cycle.
Some of the body's reactions to stress are easy to predict. At stressful times, the body quickly releases chemicals into
the blood. This sets into motion a series of physical changes. These include a faster heartbeat and breathing rate, higher
blood pressure, and increased muscle tension.
These physical changes give the body added strength and energy. They prepare the body for dealing with stressful events
such as giving a speech, aiding an accident victim, or fighting or fleeing from an attack. When stress is dealt with in a
positive way, the body restores itself and repairs any damage caused by the stress. However, most of the time, people don't
deal with stress in a positive way. Thus, stress-related tension builds up and, with no outlet, takes its toll on the body.
The mind's reaction to stress is harder to predict. These mental reactions vary according to the situation and the person.
They may include feelings of anger, fear, anxiety, annoyance or frustration. A small amount of stress can help people perform
their best--during an exam, an athletic event, or on stage. With too much stress, people may become accident-prone, make a
lot of mistakes, and may not be able to function. Stress can be compared to a violin string. If the string is too loose (not
enough stress), it won't produce music. If the string is too tight (too much stress), it will break. Some degree of stress
is necessary to function properly.
Realize that people respond in different ways to events and situations. Some people like to be busy, with lots of activity.
Other people may prefer a slower pace, with less activity. What one person finds relaxing may be stressful to another.
Managing stress begins with learning the signs and symptoms of stress. Tiredness/exhaustion -Muscle tension -Anxiety
-Indigestion
Nervousness/trembling -Sleeplessness -Cold, sweaty hands -Loss of or increased appetite -Grinding teeth/clenching
jaws -General body complaints, such as weakness, dizziness, headache, stomachache, or pain in the back or muscles.
It's possible that some of these symptoms may be caused by problems other than stress, such as the flu. Ask your doctor
about symptoms that last for more than a week. If your doctor decides that stress is the problem, you can work together to
understand and relieve it.
Make stress work for you. The key to managing stress is to get stress to work for you instead of against you. A complete
program for managing stress has three parts: -Learn how to reduce stress. -Learn how to accept what you can't change. -Learn
how to overcome the harmful effects of stress. Remember that relaxation will help you gain better control of the demands
made on you. If you devote time to relaxation, later you'll be able to do more and enjoy yourself more.
From time to time it may seem impossible to stop and relax. You may find yourself in a rut--tense because you're so busy,
and too busy to relax. If this happens, start wherever and whenever you can. If you're waiting in traffic, take a few deep
breaths, and let the air out slowly. If you're at work, take a short break in the rest room, lounge or snack bar.
Close your eyes, breathe deeply, and try to forget about everything, except your breathing. Notice which muscles are
tense--perhaps your neck, forehead or shoulders--and relax them.
You may think that a high level of body tension means that you're "in control," and that feeling relaxed seems like a
loss of control. Realize that muscle tension drains your energy and can increase your pain. Relaxation actually helps you
gain control over your stress and pain.
It takes time and effort to learn a new skill. Therefore, don't give up before you have a chance to reap the benefits!
Knowing how to relax can become part of your life. Remember, like any habit, learning to relax takes time to become automatic.
Practice every day, even for just 15 minutes. A new habit must be repeated often until it begins to feel as though it's
a part of you. Choose your favorite methods. Be creative. Remember, there is no one, best way to relax. Work in
short relaxation breaks during your day, whenever you can. Try using very simple methods such as deep breathing for even a
minute or two.
Managing stress can help you have less pain and feel healthier. It can also help you cope with the extra demands made
on you by your disease. By following these suggestions, you may be able to get stress to work for you instead of against you.
Learn to identify those situations you can do something about and those you can't. Work at reducing the cause of your stress
by communicating better, and respecting your limits of energy and pain. Simplify your life, "look on the bright side," and
develop and keep a sense of humor. Prepare for stressful events by getting extra rest.
Remember that you can't change others. Keep in mind that no one is perfect. Seek professional help for serious problems.
Practice relaxation methods to overcome the effects of stress that you can't avoid. Engage in hobbies and simple pleasures
that give you joy. Remember that managing stress is your job. With stress under control, it'll be easier to keep your
arthritis under control.
Learning how to relax is one of the most important ways to cope with stress in a positive way. Relaxation is more than
just sitting back and being quiet. Relaxation is an active process involving methods that calm your body and mind. Learning
how to relax takes practice, just as learning how to ride a bicycle takes practice. Once you know how, it becomes "second
nature."
Keep in mind that there's no right way to become relaxed. Whatever works for you is what's important. Try out different
methods until you find one or two that you like best. If you need help, seek professional help.
To begin with, try to set aside time in a quiet place, away from people, TV, radio and other distractions. Close your
eyes. Slowly tense and then relax muscles that feel tense. Begin with your feet and work up to your neck. Sit in a comfortable
chair with your feet on the floor and your arms at your sides. Close your eyes. Breathe in, saying to yourself, "I am . .
. ," then breathe out saying " . . . relaxed." Continue breathing slowly, silently repeating to yourself something such as:
"My hands are . . . warm; my feet . . . are warm; my forehead . . . is cool; my breathing . . . is deep and smooth; my heartbeat
is . . . calm and steady; I am . . . happy; I feel calm . . . and at peace."
Light a candle, and focus your attention on the flame a few minutes. Then close your eyes and watch the image of the
flame for a minute or two. Imagine a white cloud floating toward you. It wraps itself around your pain and stress. Then
a breeze comes. It blows away the cloud, taking your pain and stress with it.
Think about a place you have been where you once felt pleasure or comfort. Imagine it in as much detail as possible how
it looks, smells, sounds and feels. Recapture the positive feelings you had then and keep them in your mind. Don't make any
room for negative thoughts, stress or pain.
Imagine that you've put all your concerns, worries and pain in a helium filled balloon. Now let go of the balloon and
watch it float away. Sometimes simply letting your mind wander or "go on vacation" will help reduce your stress.
Here are a few suggestions. Watch a sunset. Take your shoes off and walk in the grass. Sit in a park on a warm, sunny
day and listen to the birds. Sit in front of a fire in the fireplace. Gaze at fish in an aquarium.
To overcome barriers to relaxation, you must really want to learn to relax. Some common "stumbling blocks" to relaxation
include these: Feelings of guilt for taking time from your busy schedule Being made fun of by others Not being able to stop
and take time Fear of "loss of control." Remember that relaxation will help you gain better control of the demands made on
you. If you devote time to relaxation, later you'll be able to do more and enjoy yourself more.
From time to time it may seem impossible to stop and relax. You may find yourself in a rut--tense because you're so busy,
and too busy to relax. If this happens, start wherever and whenever you can. If you're waiting in traffic, take a few deep
breaths, and let the air out slowly. If you're at work, take a short break in the rest room, lounge or snack bar. Close your
eyes, breathe deeply, and try to forget about everything, except your breathing.
Notice which muscles are tense--perhaps your neck, forehead or shoulders--and relax them. You may think that a
high level of body tension means that you're "in control," and that feeling relaxed seems like a loss of control. Realize
that muscle tension drains your energy and can increase your pain. Relaxation actually helps you gain control over your stress
and pain.
It takes time and effort to learn a new skill. Therefore, don't give up before you have a chance to reap the benefits!
Knowing how to relax can become part of your life. Remember, like any habit, learning to relax takes time to become automatic.
Practice every day, even for just 15 minutes. A new habit must be repeated often until it begins to feel as though it's
a part of you. Choose your favorite methods. Be creative. Remember, there is no one, best way to relax. Work in short
relaxation breaks during your day, whenever you can. Try using very simple methods such as deep breathing for even a minute
or two.
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