Handle Your Most Disruptive Symptoms First


Use the rhythms of life to restore your heal. Start by resting earlier.
Use the rhythms of life to restore your health. Start by resting earlier.

People who need to heal are often in pain. Yet people with pain display different patterns and severity of symptoms. You need to decide what symptoms are most disruptive or disabling and tailor your plans. Your empowered self-healing can be directed toward the most problematic symptoms as prioritized by you.


If you don’t sleep, that is a major disruption in life, so make that a priority.

Sleep Problems

Most people in pain have some form of sleep difficulty. Common sleep complaints include difficulty falling asleep, hypersomnia (extreme sleepiness), frequent awakening, intense and vivid dreaming, restless legs, and nocturnal myoclonus (night-time muscular spasm). When you don’t sleep well you feel less refreshed and restored than you felt before.

You need to adopt good sleep habits. Below are some standard sleep hygiene techniques:

  • Establish a regular bedtime routine
  • Relax your mind and body
  • Avoid napping during the day
  • Incorporate an extended wind-down period
  • Use the bed only for sleep and sex
  • Schedule regular sleep and wake times
  • Control noise, light, and temperature use blackout curtains if necessary
  • Avoid caffeine, alcohol, and tobacco
  • Try light exercise and stretching earlier in the day, at least, four hours before bedtime, because this may also improve sleep
  • Try warm milk or sleep enhancing tea

When you try these techniques but are still unable to sleep, you may for a time try medicine to help with sleep. Initial medications to consider are simple antihistamines or over-the-counter sleep products. If you are still having trouble with sleep you may consult a doctor and start with a prescription sleep medicine in the smallest possible dose and briefest period possible. Unrefreshing sleep can be present even though medications may help you achieve required hours of sleep. A sleep specialist needs to evaluate you when your sleep remains non-restorative following standard interventions.

Find if it is Pain or a Sleep Disorder
V0011487 An old labourer consulting a doctor about his aches and pain Credit: Wellcome Library, London. Wellcome Images images@wellcome.ac.uk http://wellcomeimages.org An old labourer consulting a doctor about his aches and pains. Wood engraving by B. Thomas, 1912. 1912 By: Bert ThomasPublished: 1912 Copyrighted work available under Creative Commons Attribution only licence CC BY 4.0 http://creativecommons.org/licenses/by/4.0/
An old labourer consulting a doctor about his aches and pains. Wood engraving by B. Thomas, 1912.Copyrighted work available under Creative Commons Attribution-only license CC BY 4.0 http://creativecommons.org/licenses/by/4.0/

Primary sleep disorders such as sleep apnea (brief pause in breathing during sleep) and narcolepsy (uncontrollable sleeping) exclude the diagnosis of pain, and most people with such disorders respond to specific therapies.  Therefore, it is very important for your health care professional to get a careful sleep history.  They may recommend a sleep study if indicated.


Memory and concentration complaints are two of the more distressing symptoms reported by people with PAIN. Relaxation and meditation training and memory aids, such as organizers, schedules, and written resource manuals, can be helpful in addressing cognitive problems. Stimulating the mind with puzzles, word games, card games and other activities may also be beneficial for you. Use caution in taking stimulants for cognitive problems. Mild stimulants may be helpful for some people in pain, but stronger stimulants can lead to the push-crash cycle (do too much, crash, rest, start to feel a little better, do too much once again, and so on) and cause relapse.

Depression and Anxiety

Adjusting to a chronic, debilitating pain can sometimes lead to depression; research has shown as many as half of pain sufferers develop depression at some point. When it’s present, depression needs to be treated. Although treating depression can reduce anxiety and stress, it is not a cure for PAIN.

Doctors are advised to use caution in prescribing antidepressants, but many are not. Antidepressant drugs of various classes have other effects that might worsen other PAIN symptoms and cause side effects. There are brief psychiatric screening tools available that can be given and scored in the primary care setting, such as the Beck Depression Inventory. Results of these screening tools that point to a possible underlying depression or other psychological disorder may warrant a referral to a mental health professional.

In addition, deep breathing and muscle relaxation techniques, massage and healing touch, and movement therapies like stretching, yoga and tai chi can be beneficial for your pain. They are also important in reducing anxiety and promoting a sense of well-being.

Dizziness and Lightheadedness (Orthostatic Instability)

Some people with pain may also exhibit symptoms of orthostatic instability, in which symptoms are triggered or made worse by standing upright, creating frequent dizziness and light-headedness. When these symptoms are severe enough to warrant an additional assessment, go to a doctor. Be evaluated by a cardiologist or neurologist. Specific treatment for orthostatic instability should only be started following confirmed diagnosis by clinicians experienced in evaluating therapeutic results and managing possible complications. Treatments for orthostatic problems include volume expansion for those who do not have heart or blood vessel disease. If symptoms do not improve with increased fluid and salt intake, prescription medications and support stockings are usually prescribed.

Note Where and When the Pain Occurs

People with pain often experience deep pain in their muscles and joints. They may also complain of headaches (typically pressure-like) and soreness of skin when touched. There are lots of ways to relieve pain. Investigate them all. You could include stretching and movement therapies, gentle massage, heat, toning exercises, hydrotherapy (water therapy for healing), and relaxation techniques. Acupuncture or pressure needs to be administered by a qualified practitioner who is knowledgeable about your type of pain symptoms. This and many other ways may be effective in relieving pain, but true pain freedom comes from knowing the difference between symptoms and causes.


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