Two Roads Diverged
Welcome to “Illuminate”, our Blog Newsletter that comes out around the first week of every month. The purpose of this newsletter is to shed light on topics that we find essential in achieving true health and wellness. Knowledge is power. When it comes to healing, the more we know and understand about our bodies, the more effective we can be.
We have come to the final segment of our “pain talk”. Over the past months it has been our goal to teach you new ways of looking at pain. To understand how pain becomes pain, to understand why sometimes it doesn’t just go away, and to consider new ways of treating your pain. It is a solid and concerning fact that the prevalence of chronic pain is rising. More and more people are experiencing pain that is sticking around. In many circumstances pain has taken away quality of life, joy, and a sense of belonging to family, community, and friends.
When dealing with this pain, we are all familiar with the road well traveled. If you have pain you can take pain medication. If the pain stays, something must be wrong with your body and you get an Xray or MRI. When the Xray or MRI shows something, that must be what is causing your pain so you might have surgery. Sometimes this works. Sometimes it doesn’t. As a society we need to stop thinking that pain meds and surgery are a quick and dependable cure. Pain meds mask what your body is trying to tell you and surgeries are invasive and can be ineffective if implemented in a situation that is not appropriate.
We recently had a client come to us seeking help. She had already had surgery to try and alleviate her pain. She said, “My doctor says that I am healed, but I do not feel recovered. They’ve discharged me because they fixed what they saw but I’m still in pain and I still can’t do the things I need to do.”
As we have covered in our previous Illuminate newsletters, pain is very complex. Because of this there is no single solution for all pains. Pain, like a person, is a unique interwoven product of the body, mind, and spirit as well as your environment and community. When you truly start to look at chronic pain for what it is, I’m not sure how anyone can reasonably expect a medication or a surgery to unravel and repair the contributing roots of it. Ongoing research into effective pain management tools has narrowed in on key tools that are consistently shown to be helpful and effective - Education, Understanding, and Movement. These tools require action, consistency, awareness, time, and the willingness to learn and adapt. It becomes easy to see why this road might be less traveled but I can tell you it certainly is consistently more effective. All great accomplishments take work, patience, and determination. The care and healing of our bodies to the point of relief, recovery, and eventually thriving requires no less.
So where do you start?
Seek out a skilled examination and evaluation.
Don’t scroll the internet, don’t take advice from a friend who knows a friend with the same symptoms, and don’t take a diagnosis from someone that is not qualified to give one. Please go see a real life, in person, licensed medical practitioner who has the training to thoroughly screen and give you a starting point from which you can begin to inform yourself and make decisions. Once you get the information you need, I would encourage you to pause before taking any course of action. This is the point where you need to find the practitioner(s) that will work with you to look at all of your options for managing what you have discovered. That’s right! You need to shop around. Health professionals have models of framework on which they base their work. This is very important to remember so that you understand the knowledge base and belief systems behind what they will recommend. However it is also very important to note that within this framework there are very different kinds of practitioners who have gone into the profession for different reasons and who work from different motivating sources. Please do not assume that every doctor or every physical therapist is the same.
Be careful and take control. Expect to take some time to find your “team” that will support you in the way that you deserve. I highly recommend that you avoid total dependence on any one health professional so that you get a multidisciplinary view of your condition. Good clinicians should be compassionate, engaged, and informed. They are experts. They should take the time to listen to you and they should be willing to stay open to new ideas. They should be a partner to you and equally invested in your care.
Educate Yourself.
Once you have found your person, they should have no problem taking the time to sit with you and go over your questions. These are good questions to ask,
What is happening in my body and what is the science behind what you are saying?
These are my long term goals, do you think they are reasonable and how long will it take to achieve them?
What are all of the options for management? Based on science, what will most likely help, what might help, and what won’t help?
What other health professionals would you recommend in creating a well-rounded team for my care?
What can you do to help me with my treatment?
What do I need to do as part of my treatment?
Could you please go over my xrays and blood tests in detail. I want to know what these things mean and I want to know about borderline considerations, not just what is considered in the abnormal range.
Understand Yourself:
Get to know yourself. From all angles and in all ways. Stop thinking of pain as a physically induced event only.
Identify threats: remember that pain is protective and once sensitized can be triggered by anything that is perceived as threatening you.
Do you have fear avoidance? This is related to anxiety about making the situation worse. As a result you start to avoid anything that you have identified causes pain or that you think will cause pain. With this, your quality of life is reduced. This change in lifestyle feeds into more anxiety and fear and you avoid even more. This is a vicious and deteriorating cycle. Working with a great clinician and education/knowledge can get you off of this runaway pain train.
What is your coping style? Active versus Passive. There is a large amount of research that shows that active is more effective than passive. Recognize that good coping skills can be learned and improved.
Active: seeking knowledge and better understanding; find new ways to move and do things; nudge the edge of pain, don’t push through it and don’t avoid it; stay positive; set small attainable goals and move towards them; set longer and bigger goals and stay patient in the process and the practice.
Passive: avoid any activity that might cause pain; do nothing and just submit; rest; wait for it to change and go away; wait for someone else (doctors, therapists, etc) to change it.
What is your attitude towards pain and your relationship with it?
Avoiding pain: associating pain with a certain activity and discontinuing it. These discontinuations begin to accumulate and lead to physical decline.
Working with and respecting pain: because you have taken the time to learn about it you can now identify the difference between harming and hurting. You can now make educated choices as to when you should stop what you’re doing and when you can nudge onward.
Beating the pain: you feel pain, you get angry and frustrated and you push right through it causing more damage and more pain in the end. This is when I tell my clients, “The body will eventually shut you down if your mind continues to abuse it.”
Movement.
We are designed to move and the body with all of its systems needs to move. Who hasn’t heard the saying, “Motion is lotion”? The trick about pain is that you know you need to move, you understand that it is good for you, but moving is painful. Many people feel trapped in their pain. They become inactive in a situation that requires action in order to change. This is where working with a movement specialist, someone that knows how to work with specific diagnoses and has the body knowledge to adapt, modify, and manipulate movement sequences is imperative. This is why at SHW we love Pilates so much. It was developed and designed to be for every body. The Pilates equipment allows for an extreme range of versatility in assistance, support, and challenge when necessary to create positive movement experiences. It is through positive movement experiences that the body and nervous system and our beliefs and fears begin to change. This process does some pretty amazing things to your brain.
Here are some baseline ideas that we use when designing a individualized plan:
What is it that you want to do more of or something you want to get back to?
Figure out the starting point. At what entry point can we begin the process of building back up to that activity. In what situation will the body and mind allow that to happen without pain exacerbation.
Lay out small progressive goals. Once we identify the starting point, it’s important to expect to take baby steps from that platform. The biggest problem we encounter is that clients often expect too much change in too short of a time period. This is exactly why traditional time frames of 4-6 weeks or 8-12 weeks often fail. With chronic pain it’s going to take longer. Every time you do a little more with success you elevate your “pain threshold” a little higher. Essentially you are desensitizing your sensitized system. This process takes time.
Don’t get pushy and exacerbate your pain. This is a result of impatience and unrealistic expectations.
Don’t assume you’re doomed if you do exacerbate your pain. Healing is never a straight climb upward. It’s a roller coaster ride with dips and turns. With a sensitized system it’s pretty hard not to have an occasional flare up. Just learn from these moments, understand them, and recognize when they don’t last as long or they don’t seem as severe. This is progress!
It’s a lifestyle change. Resolution of chronic pain requires a willingness to explore your body, mind, and spirit. To unravel the tangles. What works only continues to work if you keep doing it. It’s the creation of a new habit, a new approach. And honestly, we don’t see many clients who would do otherwise. So often we hear clients say they never realized how bad they felt until they remembered what it was like to feel so good.
I’m sure we can all come up with many valid reasons as to why the rate of chronic pain is increasing. While medication, injections, and surgery certainly have their place in medicine, they should not be your first step to addressing pain. How you react to pain is very important, but being proactive is the best way to ensure a pain free life. The irony is, that the proactive process looks a lot like the reactive process we just listed above; educate, understand, and movement. It is important to remember that the occurrence of pain is rarely the starting point of a problem. It is the threshold where the body can no longer tolerate the stress of whatever has been happening to it. If you’re curious about where your physical health stands, consider working with an expert. While you might think you are doing the “right” things, imbalances and wear and tear can catch up with you. I can’t tell you how many clients I see who have been crashing through exercise with no core strength, no movement awareness, and no knowledge that they were doing more harm than good.
Our next Illuminate newsletter will be taking a different path, a lighter and more inspiring one. After all, taking that first step and making that first phone call seems to be the hardest part. If you would like to see past issues of this pain series go to our website, www.sakashhw.com. I hope that you have found this pain journey to be valuable in transforming your relationship with pain. As always, please feel free to reach out and share your own thoughts and feelings as you read these emails. We love hearing from you and talking with you. Be well and enjoy the day!
Shellie
