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There’s No Magic Bullet for Chronic Pain (but yoga helps!)

 

time-heals-all-wounds-3130248_640

Does time heal all wounds?

I’ve told the story in my classes before – but never here — that I discovered yin yoga during a particularly painful bout of lower back pain in my 30s when I was teaching vinyasa and I thought that should be helping my back but instead it was making things much worse. I would wake up in the morning and have trouble putting on a pair of jeans. In addition to feeling like shit physically, I felt like a total loser – who’d  would want to take yoga from a person whose flexibility precluded her from wearing pants?

I tried everything – acupuncture and chiropractors and zero balancing and tai chi in the park and sessions with shamans who insisted that we both had to be naked for the treatment to be effective and orthopedic doctors who suggested I wasn’t bad enough for surgery and helpfully recommended that I continued doing yoga.  I went to weekly meditation classes and read as much as I could about the pain body (Eckhart Tolle) and healing back pain (John Sarno) and just about anything friends and strangers would recommend and took supplements recommended by my integrative doctor and spent hours writing and conversing with friends about the metaphorical aspects of spinal pain as well (who had my back? did I feel supported in life?).

Sometimes the best I could do was smoke pot a few times a day to numb the edge. When that didn’t help, a bit of scotch could help. And, like carrying the cross, that was a perfectly fine strategy for the proverbial three days – until I realized I hated my lethargy and I was botching up my day job. I needed to find something that wouldn’t affect my mind (or at least drive) quite so much.

A woman named Mary, who I’ve never seen since, offered a two-hour Yin Yoga workshop at the studio where I taught. I took it and hated it immensely. I remember grimacing through sphinx pose – the compression on my sacral joint increased the intensity of the pain – and the other positions, I didn’t much like either.

But sometimes brilliance comes after the clean up. I walked home and went about my life. Within a few hours, I realized that I had been completely pain free. I felt light.

spine-957249_640The thing about constant pain is that even if it’s low level, it (1) still hurts, making it hard to think clearly about anything else, and (2) starts to mess with your naturally sunny disposition. When you’re in pain, so many internal resources have to go toward dealing with the pain – or pushing through it so you can get shit done – that you’re often spent at the end of the work day. And with low energy comes depression (doesn’t it for you too? Even when you just have a mild cold or fever for a few days, doesn’t your perspective begin to look a bit more grim?). It’s a shitty place from which to make decisions, including around how to help yourself heal.

I started incorporated the Yin poses l learned from Mary into my home practice, using a real pomodoro timer I had gotten when my Aunt Julie died. (I wouldn’t recommend this; the horrible buzzing it makes to announce your five minutes are up is a buzzkill.)  And things started improving: my back didn’t feel as rigid when I woke up. The accompanying sciatica all but disappeared. I still had pain but it was manageable.

I searched around and found a 100-hour training for teachers offered in Napa (not exactly my go-to place) being co-facilitated by two teachers I had never heard of (Paul Grilley and Sarah Powers). This was in 2007, and after spending ten days with them, I did an hour of Yin Yoga a day for about six months, at which time my back pain had become faint and manageable enough that I returned to my more active practices. I became a bit evangelical in my teaching, at first offering yin poses at the end of my regular vinyasa classes and pretty soon after, teaching a Friday night yin class.

Wouldn’t it be terrific if this was the end of the story? And everyone’s pain was gone and they lived happily ever after?

I have no doubt that chronic pain is often related to trauma. And if you treat one, the other comes along for the ride. (You can read the backstory to my achy back – pun intended – here.)

Pain rewires our brains in such a way that even when the pain stimulus is long gone or healed, we still feel pain. Any threats – physical or not, perceived or real – get read by the body as pain.

chronic pain cycle

To break the pattern, you have to help the brain and nervous system “unlearn” what it thinks of as pain.

In the words of Drs. Jane Ballantyne and Mark Sullivan in the November 2015 New England Journal of Medicine “The intensity of chronic pain can’t be reliably predicted from the extent or severity of tissue damage, since chronic pain is not determined primarily by nociception. Functional neuroimaging studies and other prospective clinical studies have shown that what feels like the same pain is initially associated with the classic sensory “pain matrix” brain regions but is later associated with brain regions involved in emotion and reward. Thus, over time, pain intensity becomes linked less with nociception and more with emotional and psychosocial factors.”

Dr. Timothy McCall, a board-certified internist and author of Yoga as Medicine distinguishes between pain and suffering this way: “Pain is the physical or emotional hurt, whereas suffering is how our mind reacts to that pain…Suffering—just like pain itself—can keep the body in a state of stress, which in turn can worsen sleep, promote weight gain, aggravate inflammation, and generally make your underlying physical condition worse.”

Suffering – which we can use interchangeably with the word “stress” — can be a cause of chronic pain. And chronic pain can also cause stress. So anything that decreases stress levels can be very helpful in rewriting the brain’s narrative about your pain (and I am really talking about the brain, rather than the mind). And maybe, you’ll feel better soon.

Even though I know something about chronic pain and had done a fairly good job getting my core, gluts and hips strong (key for any back issue), as well as working actively with my mindset (to observe when I was feeling low energy, shame, or resentment and shift how I was framing those things), the pain recently revisited me with a force that physically laid me up and had me psychologically down.

Turns out my particular flavor of pain is congenital, likely caused by a lack of sufficient movement in utero, which was caused by my mother (and therefore me) being excessively drugged up. And sometimes, no matter what I do, the old pain comes by for a cup of tea and stays for weeks .

While down and out this month, I binged “Frankie and Grace.” There was something satisfying about seeing other people limp along, accept aging gracefully, and agree to a knee replacement only to blow the good one out.  (Plus I admire those ladies so much. Did you know that the only reason why Jane Fonda did those workout tapes in the 1980s was to raise money – we’re talking tens of millions of dollars — for the California Campaign for Economic Democracy? Turns out she was trying to beat Lyndon LaRouche at his own game – he used earnings from his computer business to host virulently anti-gay actions. She decided to beat him at the electoral level.)

In January, I offered a workshop in Yin & Forgiveness. As part of my prep, I came across the work of Fred Luskin, the director of the Stanford Forgiveness Project, who defines forgiveness as “the act of being at peace no matter what happened” five minutes or five years or five decades ago. He refers to forgiveness as “the creation of peace in the present,” and says that in objecting to our own life — wanting a yes and getting a no – we cause ourselves physical, emotional and spiritual turmoil.  Forgiveness is therefore the resolution of our objection; making peace with some situation or experience when you didn’t get what you want.

Since then, I’ve been working on accepting what is, including pain.  I’ve allowed myself more rest and more time in saunas and hot showers. I’m even coming to appreciate how being limited physically can force me to be more creative (kinda like writing in form vs. free verse), more organized (you need a plan b when your energy levels won’t rise in the morning when you do), and more compassionate to others who have their own unique pain signature.

As always, would love to hear your thoughts!

This entry was posted in: ramblings

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I'm a yoga therapist and coach who is fascinated by the ways in which scientific inquiry has converged with wisdom traditions in concluding that our physical, psychological and spiritual well-being are intrinsically connected. I try to use this knowledge to help people feel more resilient, courageous and alive.

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