Rest and relaxation to help manage pain and fatigue

This resource has been produced by the pain management therapy service for children with chronic fatigue syndrome ME.

Why take time to rest and relax?

Making time in the day to take a break from activities helps your body to recover physically, and gives your brain space to simmer down and think more clearly.

Taking breaks also means that your body is not pushed into high levels of pain and exhaustion which we know can keep people stuck in the ‘pain cycle’.

Some people find it hard to take time out to rest and worry that they will not be able to do everything they want. Others are afraid that once they stop they will not be able to get going again. Resting and pacing play an important part in getting better, and over time will help you do more without making your pain worse.

Good resting is about:

• setting aside regular times and planning your day around them
• resting in short chunks of time
• having a place to rest that is warm, quiet and comfortable
• making the space more personal by using a different cover on your bed or chair
• switching off your phone and letting people know not to disturb you
• turning off the computer or other screens
• finding a comfortable position laying down or propped up by cushions
• knowing ways of relaxing that work for you

Rest is important, but resting too much, or a lack of meaningful, interesting activity causes lethargy and reduces motivation, so people who rest a lot often feel like doing less.

This is because your body adjusts to how much you do, a bit like a reverse fitness programme. If you exercise and practice daily your body will become stronger and better at the activity. If you do less your body will become weaker and less able to do what you want. This is called ‘bioplasticity’ and is part of the way we grow and develop.

Reducing or stopping activity, and spending lots of time in bed or at home also plays a part in low mood and can cause anxiety about doing things, going out or meeting new people.

In pain management, we look at ways that you can balance activities with rest. This helps to stabilise the ups and downs of daily pain, and enables you to gradually build up the amount of activity you can manage.

Understanding breathing

When people feel stressed or frightened their breathing tends to be quick and shallow, and only uses the top part of their chest.

This is called hyperventilation and is part of the body’s stress response. Other symptoms can include:

• dizziness
• pins and needles
• fast heart rate
• chest pains
• headaches
• tummy pains
• upset digestion

It makes people feel agitated and restless because it is designed to give you extra energy to deal with danger.

Unfortunately coping with increased pain can also cause the stress response to flare up, causing many of these extra symptoms. It can be very hard to relax during these times, so learning to breathe more deeply is an important way of calming the body and mind. It helps you to switch from a state of alertness (‘fight or flight’) to feeling calm and more able to switch off (‘rest and digest’).

How do you breathe?

Put one hand on the top of your chest and the other on your tummy. Which hand is moving up and down the most when you breathe?

Try breathing in slowly through your nose and into the bottom of your lungs. You should feel your tummy rising while your chest only moves slightly.

As you take a breath in, count to 5 and then breathe out slowly, gently pushing out all the air, again counting to 5. Do this 5 times, going at your own pace.

Keep focused on your breathing as best you can, just thinking about how it feels as the air moves in and out. Does breathing like this make you feel any different?

There are some ideas for resting on the next sheet. All of them use breathing to help you focus your mind and relax your body.

Mindfulness has been shown to help people with both physical and emotional difficulties. A focus on breathing is a key part of the approach.

Ideas for good resting

Using your senses

We all know about our 5 senses including hearing, seeing, smell, taste and touch (as well as temperature awareness).

There are 2 other senses called proprioception (knowing what position each part of our body is in) and the vestibular sense (tells us where our body is in space).

Our senses send information to our brains to help make sure we stay safe and able to do things as best we can. If we are too hot, off balance or cannot concentrate because it is too noisy, our senses prompt us to make changes (for example, take off a jumper, adjust our position, or turn down the TV).

We all have different likes and dislikes when it comes to senses, and some are more important to us than others. For example some people like lots of noise, others are afraid of the dark, some people like cuddles, others do not like being touched.

We can use this personal information about ourselves to help us find ways to relax and calm down.

Feeling calm and safe will also affect how much pain you feel, how well you sleep and help improve your concentration.

Below are some sensory ideas to use as part of your pain and activity management:

Hearing

• using music on headphones
• choosing to have silence can help feel calm

Vision

• using coloured light, a lava lamp or disco ball during rest period
• watching fish in a tank or following clouds in the sky

Smell

• scented oils on a tissue near your pillow or plug-in room scents
• if you are with an adult, you can try candles or oil burners safely

Touch

• wrapping yourself in a blanket or throw
• cuddling your favourite soft toy or pet

Temperature

• make sure you are just the right temperature when you rest, and not too hot or cold
• taking a warm bath can help you feel relaxed

Body scan

Start by focusing on your breathing aiming for slow, regular breaths. Count in and out if that helps.

Close your eyes and think about your feet. Imagine how they look and notice what they feel like.

Some people like to think about breathing in refreshing or soothing air right into each part of their body. You could make the air your favourite colour. As you breathe out imagine that all the tension and aches and pains are flowing away.

Gradually move up your body bit by bit, focusing as best you can on your lower legs, then your knees, upper legs, hips, tummy, back, chest, shoulders, arms, neck, head and face.

As you move to the next bit of your body, breathe out and imagine that part is getting heavier and sinking comfortably into the bed. When you have reached your head, imagine your whole body laying still and calm.

Visualisation

Visualisation helps you focus your mind by using your memories and imagination. The focus allows other worries or busy thoughts to drift away so that your brain can calm down and help you fall asleep.

Start by focusing on your breathing aiming for slow, regular breaths.

Imagine that you are going on a walk to your favourite place (maybe a beach, forest, park or town). As you go notice what you can see along the way, the smells, sounds and warmth of the sunshine. Imagine laying down and listening to the birds or the sea.

Other ideas might be taking an imaginary journey round your old school, or a house you used to live in. You could also make up a place that you ‘visit’ when you are resting. The more you use that image the more quickly you will feel relaxed when you think about it.