Chronic pain : Tools of trade

Over the course of several years that I've spent in dealing with chronic pain, I have discovered a number of items that helped to reduce the pain and keep me functional. Here is a list of 10 items that I use frequently:

• Thermotex infrared heating pad. (Video review) I have used this since 2007 and it is still working very well. At the time I bought this, I thought it was pretty expensive. Now that it has been 9 years and the pad really reduced the need of pain medication on several occasions, I think it has paid for the investment several times over. I have mainly used it for abdominal muscular pain. There were times that I have wrapped it around the abdomen and slept at night. The main advantage of infrared is that it penetrates deeper and does not heat up the skin like a conventional heating pad. A good side effect of using it on the abdomen is that it reduces my tendency for constipation. It is also been very useful whenever I had any pathology n the rectum like an anal fissure. I actually sit on it for several minutes and it will reduce the pain due to the fissure.

• Neck and shoulder wrap microwavable: This is convenient because you can heat it up in the microwave for several seconds and it will stay warm for about 10 minutes. However, I have not had success with it when I had 24 x 7 pain. It is mostly useful to me when there is slight stiffness in the muscles  in the morning. Also, you need to make sure that it is kept symmetrically folded in the microwave so it heats uniformly. I use it mainly for the muscles in the upper back - namely the upper trapezius and rhomboids. For heating the neck muscles, I use a similar item listed below. 

• Extra long neck wrap microwavable: I heat it  for a similar period of several seconds just as the neck and shoulder wrap. One of the problems is that there is no way to strap it so either I have to lie down or use hands to keep it in place. A better solution is use a hot water bag like this, but then it takes a lot of time to heat the water plus you have to be careful while putting water inside or you can burn yourself. 

• Dragon NaturallySpeaking : This is a speech recognition system available on Windows and Mac. This is the only way now that I am able to work on the computer. It has got better over the years and I recommend version 12 or later because it will work with web browsing also. There is a very helpful community hosted by a company that has built a product on top of Dragon NaturallySpeaking. However, I could not get good voice recognition accuracy out of the box from Dragon NaturallySpeaking. So on the recommendation of several power users, including the ones on the community listed above, I purchased a noise reduction USB soundcard available here. I then plugged it into a wired headset and it has been working fine so far. Before purchasing the soundcard, I did try using an android phone into which I speak and then using Dragon NaturallySpeaking app available on android play store, my voice is digitised on the phone and then transmitted wirelessly to the computer on the same network. This arrangement also works but there was a significant delay in my dictation and the words appearing on the screen. It may be useful for you if you just want to test Dragon NaturallySpeaking. The main point of using a mobile phone is that it has got a better microphone with  noise reduction already built in. A desktop microphone does not have any built-in noise reduction. A  few tips to keep in mind: Use a boom type of microphone so that it can be kept close to the mouth. Speak softly into the microphone so that you do not strain your vocal chords too much. Frequently sip water to reduce the strain on the vocal chords.

• Backjoy: (Video review) this is a seat which adjusts your pelvis to reduce the strain on the back muscles. It is very portable and lightweight. The cushioning is a bit less for me but possibly it is because I'm already having pain in the rectal region. I have found it very useful in the car seat. However it does not reduce the pain if I sit on a normal chair. 

• Book holder for tablet: To reduce the strain on the neck and shoulder muscles, I usually use an android tablet for whatsapp communication and limit the mobile phone to only phone calls. I found this book holder very useful to hold the tablet vertically while I use Google voice in conjunction with the Google voice access product to communicate on whatsapp. The book holder can be put into an inclined position and also has stoppers to prevent the tablet from falling forward. It can be conveniently folded into a compact form for easy transport.

• Self massager: There are a number of massagers available though I I think the original concept was developed by Theracane. There are several videos on YouTube that explain the use of  massager especially for reducing muscular pain.  It does reduce the tightness in the muscle a bit. It is more useful if another person is massaging you with the massager and he / she needs to apply force for example while massaging the abdominal muscles. 

• Mobile stylus: it has been very difficult for me to use mobile phones with the touchscreen because the index finger pains a lot. The stylus has been very useful in operating the mobile phone. However, it breaks easily. It is easy to lose it also. So I have learnt to make a stylus at home using aluminium foil and a pencil or with the help of a cotton bud. The sensitivity of the commercial mobile stylus is definitely more than the home-made ones though.I use this when I need to work on the mobile phone for longer periods. 

• Mobile holder: These are very fragile and break easily. However, they always break  near the joint of the clip to the table and the arm.After a few trials, I learnt to use adhesives such as Fevikwik to join it back. It has worked well for me for several months now. I usually mount it  on a side table and position the mobile arm so that it is near my face when I am on my recliner chair. That way I can use Google Assistant  to launch Google Voice Access and then control the  mobile with my voice. You can do the same on iPhones with Siri.

• Fitbit Flex: There are cheaper devices available  on Amazon costing about $10.  Though Fitbit has inferior hardware as compared to the cheaper devices,  its software is far better with much more user-friendly features. The one which I really like is a weekly email summarizing your progress. Maintaining a goal of say, 10,000 steps, is very important for homebound patients because we need to maintain our activity levels despite all medical restrictions. I usually get up every hour and walk 250 steps at least to remain active. Without Fitbit, it is inconvenient and almost impossible to keep track of maintaining 250 steps every hour. Also, I can forward their weekly summary emails to my health care provider. This enables me to have a more focused conversation on activity levels.