Active and Passive Pain Management

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Active and Passive Pain. Roy Hsu / Getty Images

Pain management can come in many forms, such as adopting an exercise routine or seeing a pain specialist. But did you know that there are different classifications to the various types of pain management actions you take?

In fact, at the broadest level, pain management techniques can be broken down as either active or passive treatments. Ideally, having the right mix of both types will be of the most benefit.

What is Active Pain Management?

With active pain management, the pain sufferer must actively participate in the pain relieving or pain managing activity to see the benefit. For example, here are some active pain management techniques [i]:

  • Yoga. Yoga combines both physical and mental techniques to calm and strengthen the body. Yoga is just one example. Some people prefer Tai Chi or other similar techniques. Practicing yoga or tai chi can improve balance, coordination, strength, stamina, and flexibility—all of which can contribute to pain reduction. They also can help individuals to mentally relax and reduce stress levels.
  • Breathing techniques. Beyond yoga, there are other special deep breathing techniques that can be used to relax the body and reduce pain. Breathing exercises can also calm the mind, which can help reduce pain flare-ups and stress levels.
  • Active distraction. While this technique does not remove pain, it lessens the experience of pain by purposefully distracting ourselves from the pain. This provides temporary relief. Some people find that simply thinking of something pleasurable or something calming can provide a reprieve from pain.
  • Exercise. This one seems counterintuitive to many because having chronic pain makes exercise difficult—especially in the beginning. But exercise has been shown to reduce pain over time and help keep pain levels lower. Even a simple walking program can have significant benefits in pain reduction and better joint movement.
  • Stretching exercises. Besides yoga and tai chi, simple stretching can have a marked improvement on pain levels, depending on the cause of the pain.
  • Strengthening exercises. Naturally an exercise that involves strength training should be discussed with your doctor, but for many people it is crucial to regain function and to avoid overstressing painful or injured body parts. For example, a stronger core can mean better spine support and less back pain.
  • Relaxation techniques. This includes both physical and mental relaxation. Muscle relaxation might not sound active, but it does require an individual to actively think through the technique they are using and perform movements that will relax the body. This can reduce tension. Mental relaxation can come in the form of meditation, guided imagery, or other quiet contemplation.

What is Passive Pain Management?

Passive pain management, on the other hand, typically is an action that is performed by someone else rather than by the patient. This means they don’t require the patient to expend energy during the treatment.

For example, some common types of passive pain management [ii] include [iii]:

  • Physical therapy modalities. This might include things like:
    • Heat packs or ice packs.
    • Medical massage treatments. This includes deep tissue massage.
    • Ultrasound to heat the deep layers of tissue.
  • Chiropractic adjustments. Spinal realignment treatments can help reduce pain for many individuals, depending on the source of the pain.
  • Acupuncture.
  • Pain relieving medications such as:
    • Over the counter pain relievers
    • Opioids
    • Nerve pain medications
    • Anti-inflammatory medications
  • TENS (transcutaneous electrical nerve stimulator). A TENS unit sends electrical pulses through the tissue, which can interrupt the pain signals and relive the feeling of pain. This treatment can be done in a medical setting or the TENS device can be used at home.  
  • Cortisone injections. Steroids can be injected into painful, swollen joints or around inflamed spinal nerves near a herniated disc.
  • Hypnosis. Hypnosis is a form of pain distraction. It can help individuals reduce their level of pain and reduce the need for some other types of treatments, like medications.

With passive treatments, often the effectiveness wears off soon after the treatment ends (or within a matter of days or weeks), so the treatment needs to continue to be effective. Active treatments are often designed to have longer-term effects, but may take more time to see a benefit. As you can see, all of these types of pain management activities have their place in a thorough pain management plan. Ideally, mix both active and passive techniques to get the most benefit and truly increase your quality of life.

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[i] http://www.health.harvard.edu/blog/pain-relief-outside-the-pill-bottle-201206184896

[ii] http://psychcentral.com/lib/can-relaxation-techniques-help-chronic-pain/0001088

[iii] http://www.theacpa.org/treatment/passive-therapies--physical-modalities

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