Authors: Lawrence Robbins
RELAXATION AND DEEP-BREATHING EXERCISES
Far too many people discount the value of relaxation and deep-breathing exercises. Although considered totally unconventional just twenty years ago, these techniques have been successful in the East for centuries, and Western scientists have recently become more convinced of their powerful and beneficial physiological and psychological effects. They are now more widely accepted than ever before and are used in hospitals and clinics throughout the country as effective, legitimate, no-risk techniques.
If your pain is still somewhat mild, before reaching for a pill try just twenty to thirty seconds of a relaxation exercise, especially deep breathing and imagery techniques.
Relaxation in this context does not mean putting your feet up and reading the newspaper or watching TV. Rather, it is a technique to induce deep physical relaxation that reduces the body’s response to stress by quieting both the mind and body. Physiologically, it can relieve pain by lowering your blood pressure, breathing rate, and pulse; reducing muscle tension and muscle spasms in your head and neck; increasing blood flow; and even stimulating brain waves associated with peace and tranquillity. Psychologically, these techniques help reduce distress, anxiety, and depression and promote a greater sense of calm, all of which can reduce pain.
Deep relaxation can also help change your perception and experience of pain and your response to it. By learning how to reduce the ill effects of stress, including its contribution to headaches, you gain a greater sense of control and mastery over your response to the stress. That control may also boost your hope and optimism and make you less conscious of your pain.
Many studies have shown the beneficial effects of relaxation and deep-breathing exercises. For example, during painful procedures, such as bone marrow transplants, when people practice relaxation methods, they have significantly lower pain ratings and pulse rates than when they take a tranquilizer or are distracted by videos. At Duke University, it has been shown that relaxation can help relieve lower back pain. And at the State University of New York at Albany, relaxation has been shown to help directly with chronic headache. Nausea and vomiting, which sometimes occur with migraines and headache medications, can also be significantly relieved with relaxation methods.
Unfortunately, although more doctors are now convinced of relaxation’s beneficial effects, many people are unwilling to learn or to stick with these methods for very long. Some people resent being asked to try these techniques, believing they are mere mental tricks that minimize the legitimacy of their pain and suffering. Others feel silly or have no faith that they can help.
Yet if you acknowledge that pain escalates when you’re upset, then you can understand how the opposite can be true: pain can be soothed when you’re more relaxed. Also, because these techniques are safe, noninvasive, and have no risk of side effects, trying them can’t hurt.
A few cautionary notes, however, are in order. These exercises are skills and as such they must be learned, practiced, and mastered. They cannot be adopted passively. They will be most effective for mild pain and can often avert the need to take an over-the-counter analgesic. Don’t be discouraged if they don’t seem to help on the first try. It may take up to two weeks to feel comfortable with these skills and to produce a beneficial effect.
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ROMOTING
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ELAXATION
Various methods are commonly used to achieve deep relaxation, or what Dr. Herbert Benson has called the “relaxation response.” These techniques include breathing exercises, physical exercise, visualization, autogenic training, progressive muscle relaxation, and biofeedback. Different people prefer different techniques. Use the one that helps you most easily achieve a sense of inner calm and peace. If you are able and willing to use your imagination with confidence, you will achieve the best results.
At first, try these techniques in a quiet location, sitting or lying down in a comfortable position with your eyes closed. Listening to soothing background music may further help promote a sense of calm. Once you become used to these exercises, you may be able to do some of them at work or even while driving (with your eyes open, of course).
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ONTROLLED BREATHING OR MEDITATION
Focus all your attention on your breathing for at least twenty to thirty seconds. Optimally, breathe deeply, slowly, and rhythmically, through your nose, deep in the back of the throat so you can actually hear your breathing. Hold the breaths for several seconds and exhale very slowly, completely emptying your lungs. Try tensing different muscles when you inhale and relax them when you exhale. Start with the toes and feet, and work your way up to your head. Some trainers suggest that upon exhaling you say a calming word or mantra to yourself (such as “relax,” “peace,” “beauty,” or “love”).
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XERCISE
Any aerobic exercise, such as walking, biking, taking an exercise class, swimming, or playing tennis for at least thirty minutes, five times a week, can make a significant impact in preventing headaches. Regular aerobic exercise not only promotes the physiological relaxation response but boosts the production of endorphins (as does laughter and being in love), morphinelike chemicals that the brain produces. Endorphins give you a sense of well-being, raising your pain threshold as well as stimulating circulation, which bathes tissues in more oxygen and flushes out the body’s toxins more quickly. Exercise may also be important in countering the effects of taking pain relievers frequently, as some researchers believe that frequent use of these medications may impair the brain’s ability to produce endorphins. In addition to all its other benefits, exercise has also been shown to reduce stress, depression, and anxiety, which, in turn, can raise your pain threshold.
HEADACHE HELP TIP: BITS OF EXERCISE
You don’t have to jog or go to an aerobics class for an hour a day to help your headaches. Exercising for little chunks of time
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ten to twenty minutes
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can make a difference. No matter how busy you are, you can fit exercise into your life if you think about it this way. First thing in the morning, consider walking for ten or fifteen minutes or using a treadmill. Ideally, you should aim for twenty to thirty minutes on average, but ten or fifteen minutes will do.
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ISUALIZATION
This technique can be added to the deep-breathing exercises. Visualization, also known as imagery, involves conjuring up a pleasant picture, imagining that you are in a beautiful garden, for instance, feeling soothed and relaxed. Visualization may also involve using your mind to imagine that physical changes are occurring. Pretend, for instance, that a magic wand is passing over your painful swollen blood vessels and causing them to constrict.
Many studies have found that there is more to these techniques than just taking your mind temporarily off the pain. By concentrating on pleasant scenes or magic wands that produce change, you can actually stimulate the same parts of the brain that are activated when you are experiencing the tranquil scene in reality, producing beneficial physiological changes that help promote relief for mild to moderate pain.
VISUALIZATION EXERCISE TO PROMOTE RELAXATION
Get as comfortable as possible and close your eyes.
You are on a tropical beach, and warm, soothing breezes are flowing over you. Imagine that you are floating dreamily on a raft in crystal-clear turquoise water. Feel the sun warming your body as the raft gently rocks up and down.
Imagine that the heat of the sun is warming your fingertips, your arms, your toes, your legs; it is bathing your painful forehead in its healing light.
Feel the bobbing motion and try to feel as weightless as possible.
Breathe slowly and deeply. Soon you are floating higher and higher, up to a large, beautiful cloud, drifting through the sky.
Imagine only calmness, warmth, and peace.
Other images to try are a crackling fireplace or a cool expanse of luxurious lawn
.
Rather than focusing on relaxation only, you can also use a similar exercise directly on a painful area.
VISUALIZATION EXERCISE FOR PAIN RELIEF
Breathe slowly, deeply, and evenly. In your mind’s eye, imagine that a magic wand is coursing over your head, bathing it in healing energy. As you inhale, pretend that you are bringing in warm goodness and healing energy. Hold your incoming breath as long as possible, and during that time imagine that you are squeezing and tightening the painful blood vessels in your head. Then imagine that the blood is flowing from your head, where all this pressure is, to your fingertips. As you exhale, imagine that pain, tension, and poisons are flushed out with your breaths.
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UTOGENIC TRAINING
This technique is relatively simple. Repeat self-affirming statements involving warmth, heaviness, and calmness. By repeating the statements over and over, you lull yourself into a sense of calm and tranquillity, thereby promoting the relaxation response. At the same time, you may be able to warm your hands and feet if they tend to get cold (as they often do with migraines).
EXERCISE FOR AUTOGENIC TRAINING
In a dark room, close your eyes and get as comfortable as possible.
Repeat each phrase four or five times. For example: “My forehead feels heavy and warm, very heavy and warm. My forehead is getting even heavier and warmer. My forehead is sinking, sinking down into the pillow.”
As you repeat your phrases, conjure up an image, as you
would in the visualization exercise, of a scene that brings warmth and pleasure. Repeat the phrases, each time substituting a different part of the head for “forehead” (eyes, sinuses, temples, top of the head, and so on), all the while breathing deeply and slowly. Your goal is to put your mind and body into a relaxed trance.
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ROGRESSIVE RELAXATION TRAINING
PRT involves tensing a part of the body, such as the hands or legs, for ten seconds, then releasing it from the tension. You squeeze each body part separately and sequentially, including every part you can think of, such as your forehead, eyes, and mouth, right down to your arms and fingers, feet and toes. After ten or fifteen minutes, you tense up the whole body and then allow it to go limp, releasing all tension.
Since many of us don’t realize just how tense we really are and where we hold the tension in our bodies (neck or shoulder tension often contributes to headaches), PRT can help you identify the location of the tension and force you to relax. Several studies have shown that PRT can significantly reduce the severity and duration of nausea for cancer patients before chemotherapy (anticipatory nausea), and thus it may be useful to combat nausea linked to headaches.
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ELF-HYPNOSIS
Self-hypnosis integrates the techniques already described, namely deep breathing, visualization, and progressive relaxation training, to achieve the same deep relaxation response, and imagery to transform the pain sensations. The goal is to achieve a floating or drifting feeling, similar to your state just before falling asleep.
EXERCISE FOR SELF-HYPNOSIS
Sit or lie down in a comfortable position. Close your eyes.
Relax your body as much as possible. Release any tension held until you feel limp and loose.
Then focus on your toes. Are they feeling limp? They should feel heavy. Be sure to release all tension. Then move to your feet. Do they feel limp and heavy
?
Move up your leg, letting tension go each step of the way. Keep moving through your body, concentrating on each part and releasing all the tension in it. Tell yourself you need to let go completely and relax.
Breathe evenly and deeply, trying to focus your mind on the rhythm of the breathing, on the sense of feeling sleepy and deeply relaxed. Your entire body will soon feel heavy, limp, and loose. When you're done, open your eyes, slowly sit up, and then stand.
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IOFEEDBACK
Biofeedback uses electronic equipment to monitor how successful you are with relaxation techniques to produce physiological changes. Biofeedback has been shown to help up to two-thirds of all headache sufferers who give it an earnest try. It is especially effective for teaching children and resistant adults that they can, in fact, exert some control over their body’s response to stress.