A Pain-Free Practice
By Claire Peterson, PT
Can we achieve it?
A pain-free practice requires a change in perception. It requires diligent observation of bodily sensations as well as seeing the body as it is—a system. The body is a beautifully interconnected system that responds and adapts to our environment. Most people are familiar with the Descartes Model—that is, human grabs a hot pan from the stove; human feels pain; human removes a hand from the hot pan—ouch!
Sound familiar?
This was my perception of the pain experience prior to physical therapy school. As yogis, we know that we have control over our reactivity. We have the ability to observe sensation as it is, “like clouds passing over in the sky.” We are taught to react appropriately to the stimuli we are presented with. However, pain is not a sensation. Our reaction to pain varies based on the knowledge that we hold. Knowledge is power and pain is modifiable. Sensation—or heat in this model—is the input, whereas pain is the output.
Let’s revisit the previous hot pan model: human grabs a hot pan from the stove; temperature receptors are activated; and danger-indicating heat signals are sent to the brain to bring attention to and analyze the area of heat. In other words, the surrounding area of the injured tissue sends signals to the brain to pay attention, followed by the brain telling the arm to remove the hand from danger. The whole system will react to protect the hand from further heat damage. This is truly a beneficial response.
If the system does not sense the heat or injured tissues, and if danger-indicating signals are not sent to the brain, the hand will continue to become injured by the hot pan. Altered or no sensation is known as paraesthesia, this is very bad for the body. People who are unable to discern when their body is being injured also cannot take the steps to prevent further damage to assist with the healing process. It’s appropriate for the system to increase the sending of signals to protect injured tissues, but these elevated signals should return to a “normalized state” once the injury has healed. However, when elevated signal sending continues beyond the phases of healing, this can become known as chronic pain.
Let’s make the previous hot pan analogy more yoga oriented. If you practice yoga with lower back pain, you may notice that some poses alleviate or aggravate the pain. Child’s Pose or Knees to Chest may alleviate it, whereas Upward-Facing Dog may aggravate it. Receptors within the joints tell the brain, “Too much compression in this area!” Danger signals are then sent to prevent the repetition of compression. The brain will react by telling the body to protect this area with modification, a completely different posture, or rest. (We like this response in the yoga practice.) In order to reduce pain, it is important that we do not ignore these internal signals, that we do not push into pain, and that we do not add fuel to the proverbial fire. It is important to be aware and to make smart, safe bodily choices.
Essentially, chronic pain is the result of a ramped-up nervous system; when this occurs, any sensation—including temperature, vibration, pressure, or even light touch—can activate the pain response. This heightened state becomes the “new normal,” and our reactivity to stimuli changes because of the new state we are in. This is similar to the yoga practice; a stressful experience can affect how we hold Asana or the depth of the breath.
There’s good news, however!
An elevated nervous system CAN return to normal. This means that pain can be addressed with appropriate treatment, typically requiring a more personalized approach.
A ramped-up nervous system can be caused by physical, mental, or emotional stress. Pain can be experienced differently when a person is under duress. Everyone reacts differently to stress. Everyone responds to stressors in their own way. For instance, Yogi A is going through a divorce, Yogi B had an injury, and Yogi C spent 8 hours preparing for their final, and they are all experiencing lower back pain. Each Yogi may benefit from a different treatment approach.
It is important to organize a daily schedule to implement behaviors or movements that assist in reducing pain. This requires an investigation into the causes of lower back pain by considering the self holistically. During this time of social distancing—whether it be working from home or focusing on self-care—we have a unique opportunity to apply personalized behaviors or mindful techniques into our daily lives to reduce or “re-normalize” the pain response system. Some techniques to address chronic pain are deep breathing, meditation, yoga, tai chi, walking, reading, journaling, resting, sleeping, eating well, and drinking plenty of water.
Oh! And call a physical therapist if you have any questions. We’re here to help! ☺
