All protocols

Particularly important for vulnerable people because NSAIDs can have side effects and adverse consequences.

Acetaminophen dosing guidance depends on good liver function and not abusing alcohol.

Prescription COX-2 inhibitor that works similarly to ibuprofen and naproxen but is less irritating on the stomach.

Discuss with clinician if NSAIDs are effective but cause GI issues; other medications can reduce those GI side effects.

Discussed as a pain-reducing response supported by studies, though not framed as carte blanche to swear constantly.

For minor acute pain or injury, sensory input such as rubbing the area, shaking the injured extremity, or running it under water can activate touch fibers and reduce nociceptive signaling via spinal modulation; for running water, the effect is attributed to the sensory input rather than whether the water is hot or cold.

Transcutaneous electrical nerve stimulation device with electrodes placed over the painful area; creates a buzzing sensation that activates touch fibers and modulates pain in the spinal cord.

Do not leave an ice pack on an extremity for too long due to frostbite risk; for local cold application, it is reasonable to cool the painful area to the point of numbness and then remove the cold pack to allow blood flow to return.

Use distraction to reduce pain by engaging specific brain networks; examples given include reading a book, going for a walk, and spending time with friends and family, particularly in the community.

Use a nonjudgmental, accepting awareness of pain; notice pain without judging it as good or bad. Described as effective for anxiety, depression, pain, and more; takes some time to learn and has no side effects.

Determine whether pain signals something harmful that needs medical attention now or soon, and whether continued activity worsens tissue injury.

Identify and avoid foods that trigger pain symptoms. Example given: complete avoidance of onion-family foods such as onions, shallots, chives, scallions, and leeks as a practical strategy for preventing severe abdominal pain.

If stress is contributing to pain, identify and address those stressors.

Guest's personal strategy when stress manifests as pain: go work out, go for a walk in the forest, and take some time away from the computer.

Mixed evidence; some studies show benefit for low back pain and some do not. Lower-velocity approaches were viewed more favorably than fast high-velocity neck manipulation.

For therapies like acupuncture, chiropractic, or massage, ask whether the benefit lasts long enough to justify the effort, rather than only feeling good briefly.

Do not become sedentary if pain is not causing harm; continuing to move was described as the fastest route to recovery.

Avoid boom-bust cycles of overactivity on good days and inactivity on bad days; set small goals and increase activity gradually in baby steps. Example: if you can walk one block comfortably, walk that block; the next day add about 50 feet, then another 50 feet. Even on good days, do not greatly exceed the plan; set thresholds by time or distance. On bad days, some rest may be needed, but restart the next day where you were.

Even natural or over-the-counter agents are not automatically safe; educate yourself about side effects, adverse events, and interactions.

Some over-the-counter agents can inhibit platelets and increase bleeding; be cautious before surgery.

Listed as one of the psychological tools used in pain management.

A brief two-hour intervention designed to deliver effects similar to eight weeks of CBT; presented as an additional tool, not a replacement for CBT.

When viewing low-solar-angle sunlight, blink as needed to protect the eyes.

Using sunglasses in the middle of the day is acceptable, especially because overhead sun carries greater cataract and macular degeneration risk if overexposed.

Skylights improve indoor light exposure for circadian and mood-related pathways compared with standard windows.

Use an evening simulator as an artificial aid when access to natural low-solar-angle light is limited. Some companies are beginning to make effective evening simulators that work.

Use a TUO light bulb developed by University of Washington biologists to mimic low-solar-angle light contrast. It is noted as not particularly expensive.

If awake before sunrise but wanting to remain sleepy or asleep, keep indoor lights dim, then get outside once the sun starts to come out.

For hospitalized patients, especially with brain injury or stroke, get them near a window and try to control their sleep-wake cycle as much as possible.

When traveling, bring a red light bulb for nighttime lighting.