Unhelpful beliefs about LBP are associated with greater levels of pain, disability, work absenteeism, medication use and healthcare seeking. Unhelpful beliefs are common in people with and without LBP, and can be reinforced by the media, industry groups and well-meaning clinicians.”
The purpose of the editorial (made free due to popular demand, read it here) and the infographic is to “identify 10 common unhelpful beliefs about LBP and outline how they may influence behavioral and psychological responses with pain”.
The authors are also “calling on clinicians to incorporate these into their interactions with patients.”
This is so important. It’s why I always include a touch of education and information as part of my Pain Care Yoga classes. When people are in pain, it’s difficult to understand why it might be safe to move, how important it is to move and how movement “doesn’t mean you are doing harm – FACT #5”.
I hope these FACTS will bring some curiosity to your beliefs. I hope you might consider what you believe and how they might influence your experience of pain, either positively or negatively.
Sometimes, however, information is not enough. I, we, can give you all the ‘FACTS’ but often until you experience that you CAN move without pain it’s difficult to change beliefs.
As called for in the editorial, I am personally committed to bringing evidence-informed information and education to the people I work with and hope to provide a new experience to get you moving again, with confidence.
Foster NE, Anema JR, Cherkin D, et al. Prevention and treatment of low back pain: evidence, challenges, and promising directions. The Lancet 2018;391:2368-83.
Buchbinder R, van Tulder M, Oberg B, et al. Low back pain: a call for action. The Lancet 2018;391:2384-8.
 Louw, Adriaan & Zimney, Kory & Puentedura, Emilio & Diener, Ina. (2016). The efficacy of pain neuroscience education on musculoskeletal pain: A systematic review of the literature. Physiotherapy Theory and Practice. 32. 1-24. 10.1080/09593985.2016.1194646.
What if you could learn how to move safely? To live your life again, with more ease.
What if you could learn how to tune into your body’s signals in a way that can best guide you?
Pain is definitely complex and there can be a whole range of contributors to your individual experience of pain. It’s usually not just one thing which is why looking for the ‘thing’ to fix the pain doesn’t usually work. Particularly over the long term.
What if you had a safe place to practice what yoga offers?
gentle movement practice
meditation or mindfulness practices
What if you had a community of others to be with who face similar concerns, uncertainty and questions, while you explore this?
What if you could learn that you are capable of changing or modulating your pain.
What if you could learn a little more to understand pain, what might be contributors, and what might best help to change your experience of pain?
What if you could learn how to work with your breath to help modulate your pain?
What if you could learn to notice stress and muscle tension which may contribute to your pain? Often, these lay just under your current level of awareness.
What if you could learn ways that might help you to sleep, as we do know sleep is often a factor in the experience of pain.
What if you could learn more about your nervous system and your brain and how adaptable these are? What part they play and how this means your pain is adaptable as well.
If any of this is of interest, resonates with you or you’re curious to find out more there is still time to register for the next series of Pain Care Yoga Classes. You can find more information here, or feel free to send a question here or by emailing me at firstname.lastname@example.org
** Tuesdays and Thursday mornings in Stittsville, starting November 5th.
How might we blend yoga with science to provide pain care to people? A new book just released provides a way forward.
“Our vision is for this book to improve care for people living in pain, whether acute or chronic pain. We believe health care professionals and yoga therapists can enhance care through deeper understanding of pain, science and evidence-informed interventions. We also believe that professionals can enhance their work through integrating yoga concepts, practices and philosophies. As such, this book is meant to bridge yoga, pain science and evidence-informed rehabilitation … and will inform those committed to helping people with this largely undertreated issue that causes so much suffering in the world.” – Preface, Yoga and Science in Pain Care; Edited by Neil Pearson, Shelly Prosko, Marlysa Sullivan
The first chapter by Joletta Belton is about the “Lived Experience of Pain” highlighting to me the need to listen to, acknowledge and consider first, the person and their experience.
“The authors provide an integrated, in-depth understanding of how yoga therapy can be incorporated within a modern understanding of pain as an experience. The book encompasses perspectives from people living with pain, summarises research progress in the field, debates theories of pain and pain management, considers the many different yoga practices, describes pain biology, self-regulation and examines breath, body awareness, nutrition, emotions and response to pain, and above all, integrates concern for practitioners and people in pain as humans sharing an intangible experience together. The authors write about how yoga therapy can provide a uniting and compassionate approach to helping people learn to live well.”
– Bronwyn Lennox Thompson, PhD, MSc, DipOT, Postgraduate Academic Programme Leader, Pain and Pain Management, Orthopaedic Surgery and Musculoskeletal Medicine, University of Otago, Christchurch, NZ
There are a lot of yoga books on shelves these days. Yoga for this, yoga for that. You name it; it’s being written about. The trouble with this and certainly when talking about pain is the approach is about the condition, the problem, the illness or disease. What’s often left out is the person. Which may be one of the reasons why we fail in helping people.
After all, your pain is not the same as my pain. Not only is the physical aspect different, my body different, my genetics, my structure. Almost more important is the rest of ‘me’ that’s different from ‘you’.
My life history is different from yours. My environment is different from yours. My stressors are probably not your stressors. My understanding of pain probably differs from yours. My expectations, beliefs and thoughts about my pain will be different from yours. My social structures, friends, family, work-life will all be different. So how might we believe we can just apply this ‘fix’ to everyone who experiences pain? It just doesn’t make sense, when you think about it. Particularly when we understand that pain… is… complex.
We, therefore, should look to explore and be curious about all the things that might be contributing to your particular experience of pain. Similarly, individualize the care, tools, techniques and practices with what research tells us might be useful, to change your pain.
You may have had pain for years. Like 30+ years or more. Still, there is an opportunity for change based on what we know about pain and how it works. There is much still to learn but we can change the nervous system, We can change the brain. We can change physiology and most likely all three of these have been changed if your pain has been ongoing.
Pain can change. There is hope. I will keep saying this over and over and over again …
If you’re the type that likes read and learn about this yourself, order a copy of the book, here.
If you’re the type that would like to learn from me in person or in a class setting with others, check out my updated schedule for the fall, here. New classes starting in September!
Joletta Belton, as noted above, writes a blog “My Cuppa Joe” about the lived experience of pain. Among other things, she is a speaker, educator and advocate for people in pain. You can read her blog, here.
Bronwyn Lennox Thompson also writes a blog “Healthskills: For health professionals supporting chronic pain self management.” An exceptional resource for information, research, and discussion. You can check it out here.
When people want help with a problem (like pain) they most
often want to know
How to fix it
How long it will take
My last few Instagram posts were shoulder movements that you
might have found helpful. So, if you came to me asking for help in regards to
shoulder or perhaps neck pain, would I choose to have you do them as thething for you?
Maybe. Maybe not. It
You see, the thing for you is likely not to be the thing that helped me or someone else for that matter.
Which is why looking to find the thing or the fix for chronic pain often leads to frustration. Or further
along the line, a sense of hopelessness.
There are variables between you and I not only in our
physical structure, but also other areas that affect what we might feel or
experience in any moment, on any given day. Particularly when it comes to pain.
And most often, it’s usually not just one thing.
Over the last couple of months, I offered up some movements specific to feet, hips and shoulders that you might have found useful. Whether you’re seeking greater mobility, ease, gaining more awareness or perhaps you’re trying to overcome some issues with regards to chronic or persistent pain that you experience. It can take some time to make progress, or it can actually be rather quick in learning what does, or does not provide relief for you or at least the ability to move with more ease.
I find it most hopeful to know there many things we can try along the way.
And no, it’s not just cherry-picking, or somehow blindly choosing, either. What’s been learned over the years in regards to pain is quite different from our understanding of the past in terms of causation and most important, what might be effective treatments.
It’s now understood that long-term pain is poorly correlated to tissue health and science shows us that it is both complex and often has a multitude of factors. We do feel pain IN our body. However, it is often a nervous system issue… which often increases our sensitivity to pain. We can affect our nervous system. We can affect change. We can affect our physiology. Which is what makes this a hopeful message.
For the most part, any movement you add into your day and into your life will be of benefit. What’s key while moving is for you to build awareness of what works and what doesn’t for you. What feels right and what doesn’t, for you.
If you learn to pay attention to even the most subtle of sensations, you’ll begin to notice and learn all kinds of things about your body and your self which will lead to the other things, that often play a part in your unique experience of pain.
So it’s not just one thing. Or the thing. Or your thing. Or my thing.
What are the other things, that might be contributing to your experience of pain? More to come…
Summer has officially begun and soon many will be on their long-anticipated holidays. Most likely, it will involve some travel. And at some point the dreaded ‘are we there yet?’ You might think it to yourself or maybe your little travel companions repeat the phrase. On the hour. Time seems to drag. on. forever.
Why is it we dread the getting to, and coming back from, our trips?
Sure there can be unexpected delays or surprises that inevitably happen. But typically it’s the thought of sitting in our vehicle driving for 4, 8, or 12 hours to our destination. Or being crammed into the airplane for hours on end. Uncomfortable, to be sure. Not only being seated for so long but also waiting to eat on someone else’s schedule or getting to the bathroom when the need arises.
Most of us sit, for hours, all day long. Why then, does it feel different or more noticeable when we’re traveling? In an airplane, it’s not so easy to move around, to shift in our seats, when discomfort arises. In our cars, perhaps it’s a little easier with more room and not so many eyes watching us.
On most any day, we tend to listen to the hunger and thirst signals our body sends us, while other ‘discomforts’ such as simply moving, tend to be ignored. Why do we respond to some and not to others?
People often sit at their desk, laptop, TV, or plugged into a smartphone with their earphones in. Listening to music, podcasts, videos on YouTube, working, or whatever.
As an experiment, the next time you put your earphones on, don’t ‘listen’ to anything except your breath.
It may not be as noticeable if you’re on the bus, driving, in an airport or a similar noisy environment. But, still, I think you’ll find it to be … telling.
How are you breathing?
Are you breathing fluidly?
Is there equanimity on the inhale and exhale. Or is one shorter or longer than the other?
A pause in between may be good. But do you find that you’ve actually stopped breathing? As in not breathing altogether of course, but that your breathing is not fluid. Easy. Continuous. That there is a long pause, perhaps, between the two. That you fail to begin the inhale, until long after the exhale.
Why might that be?
How do your neck muscles feel, while you’re noticing ‘this’ breath?
How does your torso or trunk feel?
How does your abdomen/belly feel?
Do you notice or feel anything at all?
Do you sense anything?
What might this noticing, this awareness tell you?
In the meantime, try this.
Inhale, and exhale, along with the shape below. Expansion, contraction.
I’m curious to hearof your experience.
I can say for sure, I noticed a few things about my own breathing patterns.
When there is quiet, what do I hear?
(Though we’re in the midst of a cold winter, I find I can ‘listen’ more clearly to my breath when swimming or floating in water, similar to listening with earphones in as above. Or if I submerge myself in bathwater. So choose what’s best for you, whatever might be your season.)
The bumper sticker on our last Yoga Tool was to recognize that just as we take a drink when we are thirsty, eat when we are hungry, we need rest when we are weary. All of which requires first, awareness of a particular sensation in our body.
There are signs and signals speaking to us all the time, but are we really listening?
Are you like me in that you eat regularly on a schedule or do you listen to the signal telling you when you’re hungry? Do you sleep only at certain times of the day or are you paying attention to the signs that you need to rest? These are two indicators built into the survival mechanism of our body. Similarly, if you enter a room with a smell so strong it seems toxic you know to immediately step out again. If you are suddenly ill bringing up something you ate, again a signal. Your brain’s number one job is to keep you safe and protected.
Below is a quick and easy Tool to begin learning to sense information your body or your brain, is providing. I often use it in the beginning of a yoga class, to bring some awareness to what we’re about to do.
Lie with your back on the floor. Bend your knees and place your feet hips-width apart. Let your knees gently fall towards each other, resting easy and comfortable.
To sense what you feel in terms of your body’s contact with the floor. What parts of your body are in contact with the floor? Is the surface of the floor hard, soft? Are you comfortable? Do you feel the support of the ground below? Lean in. Feel grounded. Feel supported.
To feel your breath moving through your body. Where do you first notice your breath? In your chest, your lungs? Your nostrils? In your belly perhaps? Does the air feel smooth flowing in, and out? Does it feel forced, soft, cool, warm? Can you sense movement, in tune with your breath, elsewhere in your body?
To notice the tone of your muscles. Are your muscles at rest, tense, or sore? Where in particular do you notice any tension? Where might you find softness? Can you soften the areas around your eyes? Let your jaw, feel relaxed. Your tongue loose and soft in your mouth. Can you contract a muscle somewhere and then for contrast, let it go?
To pay attention to your heartbeat. Can you sense it? Can you feel it? Where do you feel it?
Going even deeper, can you feel or sense the blood flowing through your body?
If you can’t feel a particular sensation, just notice that. Without judgement. Just let it be.
Body / Breath / Musculature / Heartbeat / Bloodflow
*Note: If you’re typically a doer, go-getter, Type-A, cannot sit still type of person, consider doing this AFTER a workout, brisk walk, end of your day, when you’re more likely to be at ease with the sense of quiet and stillness this exercise asks of you.
I’ve also learned it seems we may have been ‘wrong about stretching‘ insofar as we’re not really stretching or lengthening muscles. At least not as much as we once believed. Rather, we’re changing our response to a stimulus via the nervous system.
Our brain is naturally going to respond in a protective manner to anything it perceives as dangerous. If we are trying to re-train flexibility or just movement in the body and do so with strong, forceful pressure or stimulus … the brain/body will react by saying … stop! No! Don’t go there. It will send a (pain) signal to safeguard our movement.
However, if we move in small incremental ways within a safe and pain-free range of motion, the nervous system will react by saying … this feels okay. Safe. I’m happy to explore this.
This is a somewhat simplified way to explain all that’s going on, but it’s a starting point we can work from. We can even begin by just imagining movement and still create changes in the brain and our nervous system. So we can, really, start anywhere.
By learning to pay attention, moving in a way that allows your nervous system to adapt and create new patterns while it feels safe, you will make progress.