How to Use Relaxation Techniques to Prevent Pain Flares: A Step-by-Step Guide

Deep breathing, muscle relaxation, and imaging are just a few exercises you can practice at home to ease anxiety and stress stemming from chronic pain flares, the pandemic, or both.

It has been established that there is a strong connection between mental health and pain. When people are anxious or stressed, their perception of pain may be disproportionally higher than the actual physical level of pain present.

Below are three simple techniques often recommended by healthcare providers to help manage anxiety and stress, along with step-by-step instructions on how to perform them to achieve maximum benefit. These techniques can be done from the comfort of your own home - or at any location - and should be part of your chronic pain management plan. They may be especially useful during the current coronavirus pandemic when emotions are heightened and to prevent and manage pain flares when they occur.

Deep Breathing

Many times, when people grow anxious, their breathing becomes shallow and irregular. This pattern can lead to an imbalance of oxygen in the body, which may contribute to multiple anxiety symptoms. For example, in cases of severe anxiety (such as with panic disorder), shallowed breathing leads to less oxygen intake, which can place stress on the heart and brain, leading to a faster heart rate and sometimes a feeling of light-headedness.

Deep breathing has broad applications and can be beneficial when these attacks occur; this practice has been shown to aid other respiratory conditions as well, including asthma.1


Follow these steps to practice deep breathing:

1.     Place yourself in a quiet environment, free of distractions (play background calming sounds if you prefer).

2.     Get into a seated or standing position that is comfortable for you (you don’t have to sit in the typical yoga position). Place one hand on your chest, and the other on your stomach. (Keep in mind: Monitor your hands for accuracy. The hand on your stomach should move out as you breathe. If the hand on your chest rises up, then you are not breathing correctly. Think of pushing the breath out of your stomach.)

3.     Take a deep breath from your nose or mouth, whichever is more comfortable.

4.     Breathe in for roughly 4 seconds and then gently breathe out for roughly 4 seconds. Focus on the motion of the air. Remember to push the breath out, the stomach should have the greatest amount of movement.

5.     This is a skill that takes time to master. It will be very useful to practice when you are not feeling anxious or over-stressed. For maximum benefit, this breathing exercise should be practiced for four minutes at a time, four times a day, for 1 week.

Here’s another breathing example from the University of Massachusetts. 

Progressive Muscle Relaxation

Progressive muscle relaxation is a technique that involves several groups of muscles in your body – these muscles are alternatively tensed and relaxed, with a progression from head to toes or vice versa. The goal of this technique is for people to notice the difference they feel in their bodies between the tension and relaxed states. You should spend roughly 15 minutes on this exercise.

In just 15 minutes, this technique should help to release any painful tension in your body. (Image: iStock)


Follow these steps to practice progressive muscle relaxation (from toes to the head):

1.     Find a comfortable place to sit or lay down that is free of environmental disturbances.

2.     Curl your toes as find trying to squeeze an object with them.

3.     Hold this tension for roughly 5 seconds and then relax back to normal position for 10 to 15 seconds. Then, tense again for 5 seconds and relax for 10 to 15 seconds. (You can do as many cycles per muscle group depending upon how much tension you feel the area has.)

4.     Next, point the toes down as if stepping on a gas pedal. You should feel tension in the calves. Repeat Step 3.

5.     To feel tension in the thighs, bring your legs out and point the toes up. Repeat step 3.

6.     Now, bring attention to the buttocks. Tighten the muscles and repeat step 3.

7.     Next, think of the belly. Bring your stomach in as if trying to push your belly button as close to your spine. Hold this position and repeat Step 3.

8.     Moving up, arch the back, feel the muscles start to tense. Repeat Step 3.

9.     Working further up to the shoulder. Shrugs the shoulders as if trying to touch the ears. Hold this position and repeat Step 3. Then, extend your neck and repeat step 3. Note, people tend to carry a lot of their tension in these areas so this step may be repeated multiple times

10.  Focus on the hands, squeezing as tight as you can. Repeat Step 3.

11.  Now, bring the lower arm as close to the upper arms as if curling the biceps at the gym. Repeat Step 3.

12.  With the face, clench down the jaw and repeat Step 3.

13.  Next, squeeze the eyes closed and purse the lips tight. Repeat Step 3

14.  The final step is to wrinkle the forehead as much as possible, hold and repeat step 3.


Imagery is a technique that elicits mental images to evoke feelings of relaxation prior to a stressful event. If you are anticipating a stressful situation, you can aim to pre-empt those feelings.

Use imagery for as long or as little as you need to achieve a calmed state free of stress. (Image: iStock)


Follow these steps to practice imagery.

1.     Close your eyes to block out any distractions from the environment.

2.     Try to think of a calming scene (such as an empty beach, trickling stream, or breezy field) or recall a pleasurable experience in your mind. The more details to the scene, the better.

3.     To improve your ability to relax, think of the smell, sounds, and sensations that are portrayed in the scene/experience.

This technique is typically practiced for a few minutes for maximum impact. However, note that each person is different. In the end, practice the technique for as long or as little as you need to achieve a calmed state free of stress.

There are many imagery apps, as well as online videos, available to help guide you through this technique as well. For instance: End Your Day Perfectly, Guided Imagery, Simply Being, and Creative Space.

As with anything, the more you practice the better you will feel. With proper focus, motivation, and effort, these techniques can be easily mastered and hopefully provide much-needed relief during pain flares - and during the pandemic.

Updated on: 10/15/20
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