Having experienced chronic pain due to a serious back injury, this is a subject close to my heart. Chronic pain is exhausting, frustrating, frightening, and often there is no quick fix from the medical world – not because they don’t care, but because they simply don’t know. It is easy to give in to pain when you don’t know how to fight it, and that’s why it is so important to look for answers. Only by understanding what is happening to your body, and by understanding that you are not powerless, can you begin to change your experience of pain. That’s the beauty of yoga – yoga helps you put pain back in its box time and time again, and once you learn yoga, even just the basics, it is with you wherever you go…
when pain becomes a problem
For most of us, pain is a normal part of life, and unfortunately something that becomes more common as we grow older! Pain signals warn us of threats to the body, and teach us not to repeat things that have caused harm, and so we begin to avoid potentially harmful actions. When pain signals work properly they are valuable, but sometimes things go wrong, and the nerve cells that transmit pain messages become over sensitive, upgrading what should be minor threats into significant threats. This sends a pain signal to the brain, causing us to experience pain when perhaps there is no good reason, and turns pain into a constant rather than temporary experience. This is when pain becomes a problem.
Chronic pain is most commonly felt in the joints and bones, and can present as a dull and constant ache, as a sharp and sudden shock, as intermittent painful muscular spasms, or most likely as a combination of these different sensations. At its most extreme chronic pain can take over every moment of your life, whether awake, or asleep. Sitting and standing become only tolerable, while the simplest daily activities, such as bending to rinse your face at the bathroom sink, putting on socks, or driving to work, can become an exercise in perseverance. Chronic pain is defined as pain that lasts for more than 12 weeks, and living with it is no joke.
pain with no specific cause
While chronic pain can sometimes be attributed to underlying health conditions, more often it is non-specific, meaning there is no identifiable cause. This makes the issue difficult treat and manage. Pain is a very complex process, controlled by the nervous system, consisting of messages sent through your spiral cord to your brain via nerve cells. Doctors don’t really know why this system stops working efficiently, but they do know that once the pain pathway is switched on it is very difficult to switch off. A very real experience of pain can have no direct physical cause, and to further complicate this, any one symptom might have numerous potential causes. All avenues must be explored, and these explorations will take time. Meanwhile the pain is still present, with no apparent reason for being there, and the suffering continues. Because pain varies significantly from person to person it is difficult for doctors to gain a clear perspective, which means that although one of the leading causes of illness and disability across the world, and one of the primary complaints heard by GP’s in Scotland, there is no precise treatment path.
a growing epidemic
One of the most common types of chronic pain is back pain, and incidences of this are increasing across the world. It is so common that most people will experience back pain at least once during their lifetime, and many will have ongoing problems. The real issue is that we don’t use our backs very well, and this misuse begins in childhood – think heavy school backpacks, improper footwear, long hours sitting on sofas, driving, staring at phone and laptop screens, bending to lift heavy objects, exercising without stretching, and the list goes on, and on, and on. In the UK, lower back pain is a leading cause of chronic pain and places a huge strain on the NHS. It is estimated that around one in seven GP appointments relate to lower back pain. It is also a primary cause of work related absence and a huge challenge for employers.
The spine in the lower back, or lumbar area consists of five vertebrae which make up the curve of the spine just above sacrum, and pain can originate from a number of sources in this area, such as the soft discs between vertebra, the surrounding nerves, or the supporting muscles and ligaments. Pain felt all the way down the back of one or both buttocks, or legs, that often increases with sneezing or coughing, is a sign of sciatica, where a spinal nerve is compressed. First line treatment for chronic pain, including back pain, is usually medication, and possibly steroid injections. Injections often have limited success, and while a cocktail of drugs may diminish pain, they seldom eliminate it altogether. Surgery is a last resort treatment for extreme cases, and is unlikely to be offered unless pain is very severe, and ongoing, and has a clear and identifiable cause.
lowering risk and restoring mobility
While there is no standard method for treatment, current advice is to remain active, to continue with regular activities, and more and more often, doctors are recommending yoga. Yoga as a first line of defence for any chronic pain, including back pain, makes a lot of sense. Yoga is low impact, it helps build strength in weak areas and improve flexibility in tight areas, and it encourages full range of movement throughout the muscles and joints of the body. Moving the spine in all directions works to increase blood flow, and this helps to improve spinal health over time. Yoga has a strong focus on developing core strength which helps strengthen and maintain the muscles that support the spine in its optimum position. These core techniques can be applied not only during the yoga session, but also when carrying out daily activities.
On a physical level this regular and full range of strengthening and stretching can improve mobility and relieve tension, and all of this can improve the outlook for people suffering from back pain. Pain is a complex, individual experience, affecting both body and mind. It also takes many different shapes – sudden pain can be a sign of muscular tear, disc problem, or sprained ligament; ongoing back pain can be a sign of disc injury or disease, or an underlying medical condition such as fibromyalgia, osteoarthritis, or a vitamin deficiency; stomach and digestive problems can also lead to referred back pain. Pain that is worse in morning and reduces with movement and stretching can be due to muscle injury, or imbalance; pain that is worse at night, and not relieved by exercise can be from an underlying issue. All this means is that it takes time to work through the issues surrounding pain, and to learn the best responses.
owning your pain
Given the many potential causes it is important that pain is evaluated by a medical professional to rule out more serious causes, but it is also important to own your pain, to understand where it is coming from, and what you can do to change your experience. Yoga excels at giving you space to study your own individual experience, and the time to make those connections. Over time it also builds deep body awareness, an invaluable tool when dealing with a chronic pain condition. It is important that you choose a class to suit your condition and level of activity. Look for a class that does not move too quickly in and out of postures, one that gives you time to pay attention to the subtler details such as breathing and relaxation, an remember that moderate movement is more successful in promoting healing. In taking control of your pain, and learning techniques to help understand and manage your pain, you begin to walk the road towards a better place.
An often overlooked symptom of chronic pain is the feeling of vulnerability that comes with it. This vulnerability is compounded as more and more treatments fail to provide long lasting relief, and loved activities begin to be left behind. Yoga helps you realise that you can live with pain and that you can manage it. It helps you stay physically, mentally, and emotionally strong, to the best of your ability, and it provides tools for managing pain. It helps you to understand what triggers your pain, and it helps you to minimise with feelings of helplessness, anxiety and depression that come hand in hand chronic pain. When you feel your life beginning to revolve around your pain, yoga empowers you – it offers a way to take back control by teaching you how to react positively. Pain may still be present, but now it is on your terms.
If you suffer from back pain yoga can help. Find out more with the upcoming Yoga Therapy: Managing Back Pain 4-week course, held in a small group over 4 consecutive Sunday’s.
For severe and ongoing back pain always consult a doctor for advice.