Pain Management/PROM/Relaxation
Techniques co-treatment with Physical and Occupational Therapy
submitted by Anna Martin,CTRS
of Magee Rehabilitation on August 6, 2006
Size of Group: Ideally 1:1 within group. No more than 2:1 ratio
in group
Equipment: Relaxation script,
Music (classical/jazz/earth sounds)
Objective: Program goals:
1. Decrease pain 1-3 points on 10point scale. (0=no pain and
10=extreme pain).
2. To increase patients awareness of relaxation techniques
3. To have patients id episodes for relaxation techniques
Description/Procedure:
Instruct PT/OT’s prior to session
that they will be starting PROM upon your cue during session
as you will continue
to do relaxation techniques throughout session.
Setting patients up in semi-circle explain purpose of session.
Tally pain levels of patients (level and location of pain).
Have patients ID when they may need to use pain management
or times they are in pain and sources of stress. Explain benefits
of pain and stress management.
Having patients close eyes and begin music. Let patients listen
to music for a minute of so. Give them a chance to relax, themselves.
Relaxation Script:
(to be spoken calmly, softly, and slowly)
I have written as it works for our specific group. I suggest
going at the pace that is best for your group.
Now close you eyes. “I’m going
to count to 10 and as I count, you are going to become more
and more relaxed.
1...2..your mind is clear of all thought and stress. 3..4.
Get comfortable in your seat (or bed) sinking deeper, relaxing
your shoulders, becoming more and more relaxed. 5..6..imagine
that you body is hollow and weightless, relaxing your arms.
7..8.. You feel as though you are floating freely in midair.
9...10..you are now completely relaxed. “
Pause…. checking to assure patient’s
eyes are closed.
“Get comfortable in your chair (or
bed). Keeping your eyes closed. Pay attention to you breathing.
Pay attention
to the rise and fall of your chest as you breathe in and
out. Pay attention to the rhythm. If you are breathing rapidly,
focus on decreasing the pace of your breathing to a slow
deep,
rhythm, feeling your chest rise and fall slowly. As you inhale,
image you are breathing in clean, relaxing air, replacing
stress and tension. As you exhale, imagine you are blowing
out your
stress and tension-erase all distraction from your mind”
Pause.
“Keeping your eyes closed, pay attention
to the colors and shapes you see on the back of you eyelids.
Imagine that
all the colors and shapes have disappeared and now you see
nothing. Now, start to imagine your favorite place to go when
you want to relax. It may be a place outdoors like the beach
or the mountains. It may be a special room, or a place you
used to visit. Allow you mind’s eye to take you to that
place. Imagine that colors of your surroundings. It may be
an assortment of colors from a sunset or sunrise green landscapes
of a forest or the colors of the walls and furniture of what
special room you like to go to. You see the colors of your
surrounding. Imagine the textures of your surrounding. It may
be a soft cotton cushion or blanket in your favorite room;
wind blowing through your hair from an ocean breeze, the warmth
of the sand on your feet from a walk on the beach or the warmth
from a camp fire burning in the night. You feel the textures
of your surrounding.
Now, imagine the scents of your surroundings. It may be the
familiar scent of that room, the smell of the morning dew on
the trees and grass of a forest, the smell of ocean water by
the shore. You smell the scents of your surrounds.
Now, try to exclude the noises you hear in this room and listen
to the noises of your surroundings. Hear the leaves blowing
in the wind, ocean water breaking on the shore, maybe relaxing
music you enjoy playing, or you may prefer complete silence.
You hear the noises of your surroundings. Take a few moments
gadget completely relaxed, hearing, seeing, feeling, smelling,
your place of relaxation”
Pause…Motion of PT/OT to begin PROM
Pay attention to you breathing. Pay attention to the rise
and fall of you chest as you breathe in and out. Pay attention
to the rhythm. If you are breathing rapidly, focus on decreasing
the pace of your breathing to a slow deep, rhythm, feeling
your chest rise and fall slowly. As you inhale, image you are
breathing in clean, relaxing air, replacing stress and tension.
Progressive muscle relaxation (may need some extra cueing
to participate with task)
“Feel the muscles in your face.
Feel your eyebrows. Tighten your eye brows as tight as you
can. Hold (pause)….and release. Feel your eyelids. Tighten
your eyelids as tight as you can. Hold. (pause)…and release.
Feel your lips. Pierce your lips as tight as you can. Hold.
(pause)…and release. Feel your jaw. Tighten your jaw.
Hold. (pause)…and release. Feel your shoulders. Shrug
them up, as high as you can. Hold. (pause)….release.
Pause.
Pay attention to your breathing. Pay attention to the rise
and fall of your chest as you breathe in and out. Pay attention
to the rhythm. If you are breathing rapidly, focus on decreasing
the pace of your breathing to a slow deep, rhythm, feeling
you chest rise and fall slowly. As you inhale, image you are
breathing in clean, relaxing air, replacing stress and tension.
Pause.
“Remain relaxed and still. Keeping your eyes closed,
you are going to slowly return to this room. In a few moments
I’ll count to 10, slowly. 1...2..you start to feel the
temperature of the room. 3...4..you’re beginning to hear
the noises in the room. 5...6.. Feel the texture of you chair,
(or bed). 7...8..you’re becoming more aware of your surroundings.
9...you’re relaxed. 10...open your eyes and return to
the room”.
Give everyone a minute to become more alert.
Tally Pain levels.
PT/OT continue PROM as needed.
Group processing:
1. Can someone ID source of stress or pain that we discussed?
2. What did you learn that was new?
3. Where was your place of relaxation? (shared if they wish)
4. How do you feel now, as compared to how you felt prior to
the relaxation exercise?
5. What techniques will you use when you are in pain or in
a stressful situation?
Contributor:
“ How You React to Stress”, The Relaxation & Stress
Reduction Workbook
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