The chicken or the egg?

This question about what comes first. The onset of chronic pain (and/or other conditions) from sleep disturbance or the relevance of sleep disturbance due to chronic pain?

Here’s some of what we know about sleep …

Sleep complaints are present in 67-88% of chronic pain disorders and at least 50% of individuals with insomnia – the most commonly diagnosed disorder of sleep impairment – suffer from chronic pain. Further, both chronic pain and sleep disturbances share an array of physical and mental health comorbidities, such as obesity, type 2 diabetes and depression.” 1

One study found that “women who endorse frequent, “sleep problems,” defined as frequently difficult falling asleep or having a sleep disorder, were significantly more likely to develop fibromyalgia 10 years later.” 2

Also, in another how “sleep disturbance temporally preceded increases in pain, … in “temporomandibular disorder (TMD).” 3

Similar research is being conducted in terms of cancer pain, for depression, PTSD and ageing (including Alzheimer’s and dementia).

I knew poor sleep to be a contributing factor for people who live with chronic pain. What I didn’t know was how it affects not only physical health but mental health.

What’s piqued my interest is in new studies where a trend has emerged suggesting that sleep disturbance may be a stronger predictor for pain than pain of sleep disturbance.” 4

…several longitudinal studies convincingly demonstrate that insomnia symptoms significantly increase the risk of developing future chronic pain disorders in previously pain-free individuals, whereas existing pain is not a strong predictor of new incident cases of insomnia.” 5

Not just a stronger predictor for pain, but also in terms of mental health conditions.

This bidirectionality or said another way, “what came first, the chicken or the egg?”

Lots of studies to examine obviously, but here’s one on the positive side “Quality sleep has also been shown to predict chronic widespread pain symptom resolution over 15 months.” 6

Researchers will continue to find out more and doctors will refer out to specialists in many areas. Pretty much the gold standard for treating insomnia now is CBTi or Cognitive Behavioral Therapy for Insomnia.

Yet, there are things you can learn to do for yourself, that will help.

Curious about this? Exploring some practices, tools and gaining resources that can support you in getting a better night’s sleep. What stress and the nervous system have to do with sleep? Or how you might find rest during the day?

I’m offering a 4-week workshop starting Feb. 16th at 7:30pm ET.

You’ll have some time and space to explore, experience what might be helpful for you all in the comfort of your own home. Online. Change into some comfy clothes, grab a warm cup of herbal tea and join in. Anyone can follow along. We’ll be rolling on the floor a little, expending energy maybe by rocking and swaying, taking some breaths together. And learning “all the things your parents/doctors/friends/colleagues never told you… about sleep.” There’s a lot more to it than just laying your head down on a pillow, each night.

References:

  1. Finan PH, Goodin BR, Smith MT. The association of sleep and pain: an update and a path forward. J Pain. 2013;14(12):1539-1552. doi:10.1016/j.jpain.2013.08.007
  2. Mork PJ, Nilsen TI. Sleep problems and risk of fibromyalgia: longitudinal data on an adult female population in Norway. Arthritis Rheum. 2012 Jan;64(1):281-4. doi: 10.1002/art.33346. PMID: 22081440.
  3. Quartana PJ, Wickwire EM, Klick B, Grace E, Smith MT. Naturalistic changes in insomnia symptoms and pain in temporomandibular joint disorder: a cross-lagged panel analysis. Pain. 2010 May;149(2):325-331. doi: 10.1016/j.pain.2010.02.029. Epub 2010 Mar 31. PMID: 20359824.
  4. Finan PH, Goodin BR, Smith MT. The association of sleep and pain: an update and a path forward. J Pain. 2013;14(12):1539-1552. doi:10.1016/j.jpain.2013.08.007
  5. Finan PH, Goodin BR, Smith MT. The association of sleep and pain: an update and a path forward. J Pain. 2013;14(12):1539-1552. doi:10.1016/j.jpain.2013.08.007
  6. K. A. Davies, G. J. Macfarlane, B. I. Nicholl, C. Dickens, R. Morriss, D. Ray, J. McBeth Restorative sleep predicts the resolution of chronic widespread pain: results from the EPIFUND study. Rheumatology (Oxford) 2008 Dec; 47(12): 1809–1813. doi: 10.1093/rheumatology/ken389

You’re not sleeping either?

woman in red long sleeve shirt sitting on chair while leaning on laptop
Photo by Andrea Piacquadio on Pexels.com

Did you know “chronic insomnia is highly prevalent and affects approximately 30% of the general population?” 1

Or, that “approximately 40% of adults with insomnia also have a diagnosable psychiatric disorder – most notably depression?” 2

That “sleep complaints are present in 67-88% of chronic pain disorders?” 3

I was aware of the third statistic, that sleep can be a contributing factor for people living with chronic pain. But why my interest in sleep, generally? I had (mostly) been a good sleeper yet started to experience disruptions to my sleep patterns over the past few years. Along came menopause and similar to many others I found myself in a cycle of wakefulness around 2, 3, 4 in the morning and went looking for solutions.

Last fall, however, something else happened. On a Facebook page I belong to, the subject of sleep was brought up. Well, the lack thereof.

I was curious if it was only menopausal women who were struggling with sleep, so I created a random poll. Within an hour or so, there were hundreds of responses.

  • 404 responses
  • 74 comments about issues with sleep.
  • 224 neither menopausal or perimenopausal
  • 95 perimenopausal
  • 51 menopausal
  • 34 ‘other reasons’

Clearly a problem for many but I was surprised to learn that it wasn’t only my age group challenged by this issue. The poll wasn’t scientific and could just reflect the ages of people in the Facebook group. Yet, wow!

Of course people will at times need specific diagnosis, treatment and care from healthcare professionals. Yet, digging into some of the research and after some of the behavioral or environmental factors are addressed with general sleep hygiene information, a lot of what affects sleep has to do with stress and the nervous system (and other systems… circadian, homeostasis, etc.). Which you can learn to influence and modulate.

Would you be interested in exploring this thing called sleep? Safely, gently, with compassion and care you’ll get to experience and learn what might be helpful for you. In your own home, cozy in your pajamas … having some time and space to do so.

A 4-week workshop Rest & Restore: Strategies for Sleep starts Feb 16th!

What are the many factors or contributors that affect sleep? What does the research tell us? What can you do during the day, that will affect your sleep at night? What can you do when waking up from sleep? How might you find some rest in the day, if your sleep wasn’t that great?

If you’d like to join in, registration is now open.

I’ve tried to make it affordable at just $20 each week. If finances are really tight, reach out to me at info@yogatoolsforlife.com. If finances are plentiful, please reach out as well and look to sponsor someone else.

I’d love for you to join in. Experience and learn what might can be helpful, for you.

References:

1. Roth T. Insomnia: definition, prevalence, etiology, and consequences. J Clin Sleep Med. 2007;3(5 Suppl):S7-S10.

2. Roth T. Insomnia: definition, prevalence, etiology, and consequences. J Clin Sleep Med. 2007;3(5 Suppl):S7-S10.

3. Finan PH, Goodin BR, Smith MT. The association of sleep and pain: an update and a path forward. J Pain. 2013;14(12):1539-1552. doi:10.1016/j.jpain.2013.08.007

Pay attention, to what?

Let’s look at a couple more practices you might consider to use in the evening. And why.

If you’re ever in a class or a private session with me you will hear me speak about the brain and the nervous system. Which might be unusual, when thinking about pain. Normally people will talk about tissue, bones, structure. Research over the last 10-20 years tells us pain is much more complex than the state of these ‘pieces of your body’.

Your brain, which kinda runs the show in terms of keeping you alive, is all about your survival. Which is a good thing. The problem is, it tells us something is up but it doesn’t always provide specifics or what we might do about sensation or messages we receive.

Whether physical health or mental health, however, your brain is looking out for your best interests. Which is why when you can’t seem to take your attention away from your pain, suffering, concerning thoughts or stressors, it makes sense when you think about it. It is drawing your attention, purposely to these things. It wants you to act in some way. To do something.

Sometimes, you might know what to do and choose to take action. It’s obvious. If you pick up a hot pan without gloves, your brain is saying you should have put potholders on prior to doing so. If you have a broken ankle, it is telling you to seek treatment and take some time to allow for healing. If you need to have a difficult conversation with someone, your brain – and subsequently your physiology – will send some kind of signal. You might feel motivated, mobilized, prepared and confident. Or you might feel anxious, butterflies in the stomach, strain in your jaw, neck or shoulders. In each, you receive information about your state of being concerning what is about to happen or what has occurred.

The number one thing pain or any other sensation you might feel in your body is trying to do, is to get you to listen. To get you to pay attention.

Usually working in the background without any of your awareness at all, the brain is constantly monitoring your physiology and making adjustments accordingly as required. It’s releasing hormones, sending messages to move certain muscles, signals that tell you when to eat, or sleep. It adjusts your blood pressure, regulates your temperature. Creates enzymes to digest your food. Tells you when to poop. Well, it does right?

The thing about pain, however, is it’s sending a message but often you can’t figure out what’s up. What you’re supposed to do. It’s hard, it takes time to figure it out. To explore what’s needed or right for you.

But back to this paying attention. What can you do when you’re in the thick of it? Particularly when you’re trying to sleep at night (and let me just add that the correlation between sleep and pain is huge).

How might you distract your brain, how might you shift your focus onto something else? At least for the time being. Well, there is a longer explanation that involves the Homunculus Man (above picture) but I won’t delve into it too much here. Rather, offer a couple practices you might like to try.

This, using the sounds SaTaNaMa was taught to me a couple years ago and it combines the rhythmic movement of your breath with the rhythmic movements of your jaw and fingers and rhythmic sounds. You can check it out here. I’ve had clients tell me it can be quite helpful when they are really in the thick of a painful experience/episode, flare-up. Or if you wake up in the night and immediately feel pain.

You might practice something like nadi shodhana, or alternate nostril breathing, for 5-10 minutes before bed. You can practice it sitting up if preferred but you might also do so when laying in bed (or if you wake in the night), using your fingers to close the nostrils. This practice also engages the hands, breath, the face (nose).

All these areas send a lot of sensory information to the brain. Your senses are used to take in information, that helps with your survival. Think about noxious toxins you might smell, seeing danger, touching something dangerous, your sense of taste in terms of toxins or allergens particular to you, hearing a predator in the distance. The brain pays particular attention to these areas so if you can engage the brain, have it pay attention to a ‘safe’ activity it might, just might, change your pain. Allow for some calming, easier breathing. Switch from a danger, or mobilized state in your nervous system to a more safe, restful place.

Or maybe you use one of the Apps available like Calm or Insight Timer that grabs your brain’s attention. Listen to some calming, soothing music. Or perhaps use the smell of an essential oil that for you, might trigger a response that it’s time to sleep and safe to do so.

Let me know if you give any of these a try and how it goes. I hope you find them useful in some way.

Pain is weird and it can change

Do you know that you can experience a HUGE amount of pain, yet have no damage or injury in your body?

Have you ever heard of phantom limb pain? It’s when someone experiences pain, yet they don’t even have the body part? Think of someone who’s maybe had their arm amputated but still feels pain there. How can that be?

Or maybe you’re someone who has been diagnosed with fibromyalgia. No obvious damage or injury can be found yet absolutely, you feel pain.

Do you know the reverse is also true? You can have NO pain and yet have ‘damage or injury’ in your body?

Have you ever found a bruise on your body yet had no idea how it got there? Or maybe you broke a bone playing one of your favorite sports but didn’t really feel pain, until you got to the hospital? There was obviously tissue damage, yet no pain. At least at first, perhaps.

Maybe you’re someone who has disk degeneration, yet no pain. According to this study (brinjikji et al 2014) if you’re 60 years old, 88% of people whose back has been imaged will show disk degeneration, yet experience NO pain.  If you’re up to 70 years of age, it’s up to 95% who have what looks like damage or injury and yet has NO pain.

When you have a headache, think of a really, really painful headache, … do you think you have something broken or damaged in your head?  Likely not.

So why do we think that way about other parts of our body?

Pain is weird, for sure. And complex. And our understanding of it does not always match with what’s going on. Often, we are confused by it, don’t know what to do about it and just live with it.

Don’t get me wrong. You NEED pain. Otherwise you would likely not survive. You need a mechanism to tell you something is up and you need to attend to it.  

It’s the persistent chronic pain that seems to be the trouble. In Canada and most places around the world, 1 in 5 people live with it. If it were an easy fix, we would have done so by now. Two areas that the evidence tells us seem to be most helpful are: understanding pain and movement. We’ll cover both.

Well, there is more to it but if you’re curious to know how you might change, how you can influence your own experience of pain, I’d love you to join a new 6-week online program starting July 22, 2020.

Advantages of this being online?

  • anyone can take it in the privacy of their own home,
  • at their own pace
  • all the content is yours to keep forever, and
  • I’ve made it affordable and accessible so anyone can enroll. $25 week, for 6 weeks (both a payment plan and options are available).

 If you or someone you know might benefit, click the link below for all the details.

Or you can always contact me here, to ask any questions.

Eating, breathing, naturally?

@thedailypalette Vancouver, BC

Such a beautiful tray of food. No wonder eating comes naturally to me. Rather like breathing. But it may not be so for you and I suggest that perhaps our breathing is not always natural either, but is rather responsive and adaptive.

I experience this in other areas of my life, as well. For instance, everything about being a mother did not always come naturally for me. It began with a struggle to breast-feed our first born. I became anxious, stressed and upset when this did not go according to plan. I had to make a call for support and learn from someone. All was well, soon enough.

Next, however, was being home alone all day in the dead of a cold Canadian winter with a baby, requiring so much time and attention. Not only exhausting (compounded by sleepless nights) but the social isolation I experienced was new to me as well, and did not come naturally. Knowing what to do, how to best raise this human being was a challenge. Parenting as being ‘natural’? In some ways, yes, of course. In many ways, not so much. When it didn’t feel natural, I felt like I failed, somehow.

Back to food and eating though. As I said, it does come quite naturally to me. In fact it comes to me far more often than I might need. Hard to resist when images like the one above, presents itself.

Mostly, we don’t pay much attention to these natural things we do until they become a problem, an issue somehow, in how we might like to live our life.

For today’s exploration let’s combine breathing with eating. How might that go?

Much to my family’s dismay I have a tendency to choke, fairly frequently, when eating. Part of it, I’ve noticed, I’m often rushing. Second to that, I’m often talking. Our dinner time is ‘family time’ and usually consists of our coming together prepared for much debate about the events and/or news of the day. When given the opportunity, I do as well, love to talk. Rather similar to the eating thing.

Meanwhile, what’s more important to survival than breathing?

Breathing is going to sneak in ‘as needed’ whether we want it to, whether we make time and space for it, or not. Whether we’re conscious of it or not.

I wonder how eating might go for me if instead of paying attention to what I eat, how much I eat, or when I’m talking, I might just notice how I breathe when I eat.

What might that bring to my awareness?

Perhaps there is something around eating that might be noticeable for you. Maybe instead of choking like me, perhaps you have a tendency to over-eat, or it could be you under-eat. Or perhaps you have some digestive issues.

Try this: Set aside one meal a day in which you do not feel any time constraints. Let yourself breath slowly as you eat. Notice how it feels to allow your belly to release as you chew and swallow your food. Monitor your breathing if you can. Notice what you feel during and after your meal. Again, try not to judge anything. Perhaps there is nothing to notice or perhaps there is.

Curious, isn’t it?

Check back on Friday when we’ll do one more exploration and it is a worthy one, I think. Also, I wonder how the movement and breathing exploration went for you, from earlier this week. You can sign up below to get all these posts.

Also, just to let you know, I’ll soon be announcing a new 6-week online course where breath is one of the things we’ll be exploring and working with. One piece of the puzzle, when we explore various aspects to consider if you experience pain. You can learn more about the ‘Creating New Pathways’ program by clicking the link below.

What outcome, or benefit might you expect from attending Pain Care Yoga classes?

don't lose hope picWell, much like anything, it depends. The answer is rarely straightforward and definitive.

As mentioned in the last post everyone comes in with their own experience of pain,  history,  individual, unique life circumstances. What might be helpful for one, will not likely be the same for another.

Below are a few comments made during a recent class, which illustrates this difference, for each person.

“I slept so much better all last week.”

“I’m not really using my cane anymore. My leg feels stronger, and I have no pain.”

“My back went out last week for a couple of days. I was flat on my back, so I used one of the (breath-awareness-distraction) practices and it really helped me get through it.”

And your back now? – Me

“It’s fine, now.”

“I’m so surprised. Normally I cannot walk around without my shoes on.”

Did you feel pain, while we were doing this (walking exploration, practice)? – Me

“No, I had no pain at all.”

I can’t say what will happen for you, or for another. Most often though, people will begin to experience feelings of calm, safety, less or no pain during class. And, some will begin to transition those responses and feelings into their daily lives.

Like most things in life, what we do, what we practice, we get better at. I would say the same, in this case. If you only practice during our class, for an hour a week, you may not see as much progress, notice as much difference. However, if you do a little, each day, I bet your experience will be similar to these others.

What I highlight to people, from both their comments and experiences is that something changed. To get curious about that, and realize they created the change.

It wasn’t something done to them.

From there, they begin to feel some hope. Perhaps a little empowered and more able to start exploring and learn to self-manage or resolve their persistent pain.

If you’re interested in how this might work for you, the next 6-week series of Pain Care Yoga classes begin at the end of February. I’m also available for one-to-one in-person or ‘zoom’ online sessions and would love to hear from you.

 

What do you do, in yoga classes for people living with chronic pain?

one thingThe second question people often ask me about Pain Care Yoga classes, after “who is it that comes to these classes” described here, is “what do you do in them”?

Pain is never just about one thing. You want to know what’s wrong. How you’re going to fix it. And how long it’s going to take. And rightly so, as having long-term pain often changes everything for you and how you live your life.

When it comes to pain, however, it is usually not that simple which is why searching for ‘the thing‘ usually doesn’t work in the long-term. Particularly if you’ve had pain for a long time. Which doesn’t mean to say that it can’t change. It can. We know what can help to bring about change, the best practices research points to.

Two key aspects, education … and movement, are important. So that’s what we do in these classes.

EDUCATION

Some kind of education piece, usually at the start of the class, is provided. I only spend a few minutes on this, but it’s important to do so. One of the most common things I see with people in pain is the fear of moving. If I can help you to understand why it might be safe to move and why it’s important to do so, that’s a good place to begin.

“Current evidence supports the use of pain neuroscience education (PNE) for chronic musculoskeletal (MSK) disorders in reducing pain and improving patient knowledge of pain, improving function and lowering disability, reducing psychosocial factors, enhancing movement, and minimizing healthcare utilization.” [1]

PRACTICE

Then, you practice. You get to experience how you might move, with guidance and guidelines, to learn what’s right for you. Which often won’t be the same as others in the room.

Movement

This is not a typical yoga class with sun salutations, downward dogs, lunges, forward folds, backbends. It is not even what I would call a ‘gentle yoga class’. Yes, we use slow, gentle movements. Yet, sometimes you might begin by just imagining the movement if you don’t yet feel safe to do it. Or you might practice it in your mind, plan out how you might go about it and if it feels right for you. It is always your choice to do or not do anything presented in class. You always get to decide how to move, how far to move, by using a slow, mindful exploration along with guidelines and principles utilized.

Most movements are fairly simple and modifications are always available. You’ll experience a lot of repetition, and rhythmic movements. Movements that cross the midline of the body. Movements that challenge your brain as well as challenging your body.  You, anyone, can really begin wherever you’re at. With what’s right for you.

Breath

There will always be some kind of breathwork or a breath awareness piece in the practice. Again, it’s not so much about controlling the breath, rather what you might notice about your breath. How breath can be an indicator of your physical and emotional state at any given time. Also, learning how breath can help to bring about change to your nervous system, physiology, which can then change your experience of pain.

Awareness

Like breath, awareness is key. So often when you are in pain the last thing you want to do is pay more attention to your body. But in fact, this paying attention is your guide to changing pain. It is in this noticing that you can begin to explore what the signals (or sensations) you feel might be indicating, what might be your unique contributors to pain, what might be the reasons for flare-ups. This practice is not only about noticing your body in class but then also paying attention to your whole self in your environment, in the larger world you live in.

Relaxation

There are many reasons, purposes and benefits to practice relaxation techniques. In most yoga classes this is done at the end of class. Though we’ll also do some kind of formal relaxation practice at the end, relaxation or creating a state of calm is facilitated right from the start.

It is when you are in a place of safety, when you are calm and relaxed, that change is likely to occur. It is this place of calm (a parasympathetic state) when you might first experience a change in your pain. Without this, it’s no different than trying to stretch, exercise, push through and strengthen your pain away, which seems not to work out so well.

If you’re interested in learning more, have any questions or would like to sign up for the next series of classes starting at the end of February, please get in touch here. I’d love for you to experience, how you might learn to change your pain.  Or, if you prefer a one-to-one session, information can be found here.

[1] Adriaan Louw, Kory Zimney, Emilio J. Puentedura & Ina Diener (2016) The efficacy of pain neuroscience education on musculoskeletal pain: A systematic review of the literature, Physiotherapy Theory and Practice, 32:5, 332-355, DOI: 10.1080/09593985.2016.1194646

 

You are not too old. It is never too late, for your pain to change.

Yes, it’s my 58th Birthday today!

Like many people my age, we’re not looking so much to get more stuff. Rather, we’re hoping in some small way, we might make a contribution. Help others.

What does this mean for you?

Here’s the thing,

Do you suffer from persistent or chronic pain? Or know someone else who does? Are you tired of finding only short-term relief from pain?

Most people think that pain is inevitable as we age. I used to think so. Now, I know that pain can change. I see it all the time in the people I work with. Science, also tells us this is true. You can learn a bit about my own story of pain and how it changed a little later, but first here’s the deal FOR YOU!

Starting today November 25th until December 2nd, receive 30-40% off my regular pricing. See how you might change what is getting in your way, limiting your life, the contributing factors to your experience of pain. Check this out!

$58 for an initial 90-min session (approx. 40% discount) if you book this week!

$58 for a follow-up 60-min session (approx. 30% discount) if you book this week!
(All appointments to be scheduled between Nov 25th, 2019 and Jan 15th, 2020)

  • Book your first 90-minute session for $58 (regular price is $95)
  • Book a follow-up 60-minute session for $58 (regular price is $85)
  • Book a package of 4 sessions, 1-90 min and 3-60 minutes for $280 (regular price is $335)

BONUS:  You’ll also receive a FREE audio recording of a slow, guided awareness practice. With the usual busy, stressful holiday season soon upon us, this can be used for relaxation, to help guide you into to sleep or rest or just notice what you feel, what you might need on any given day.

GIVE BACK:  I will donate $5 to *Chrysalis House for each session booked, whether a first or follow-up session. Chrysalis House provides a safe and secure shelter to aid in helping and support those affected by domestic violence. Which tends to escalate around the holiday season. Together, helping others.

Email me at info@yogatoolsforlife.com or you can contact me here to book a session or for further information. To learn more about individual sessions, click here.

NEW LOCATION I have a new location for my private 1-to-1 sessions. Various opportunities presented themselves but when I heard about this space called “Comfort Corner” it sounded just right. Thanks to my local community for providing all the leads and contacts in/around the West Ottawa area when I went looking for recommendations. People helping people.

Pain is surely complex. Which is why looking for the ‘thing’ to ‘fix it’ usually doesn’t work.

You truly are unique. Each person I work with comes from a unique background with unique experience and their own history, body, circumstances and environment. We’ll work together in partnership to

  • explore what might be contributors to your pain,
  • how you might change things up,
  • create new patterns of moving without pain,
  • learn to move with more ease,
  • experience how YOU CAN modulate your pain

My goal is to help you learn to ‘be your own best resource. So you don’t have to rely forever upon me, or other health care professionals. You’ll have the tools, resources, information and practices to help you through the inevitable journey of life’s ups and downs. To live a meaningful and purposeful life, no matter your situation or condition of health.

I would love to work with you!

Group Classes are helpful for chronic pain but this 1-to-1 work can make all the difference. Why not see if it’s right for you? Or if you have family, friends or colleagues who you think might benefit, please share with them as well.

Email me at info@yogatoolsforlife.com or you can contact me here to book a session or for further information. To learn more about individual sessions, click here.

*Chrysalis House is a safe and secure 25-bed shelter in Western Ottawa. It is a place where a woman can go to protect herself and her dependants from violence and abuse. In this supportive environment, a woman can focus on her personal needs and choices, as well as on her dependants’ needs.

Taming the Beast, that is pain

Professor Lorimer Moseley explains how pain scientists are making amazing discoveries that can help you understand your pain, the first step in taming the beast.

As you’ll see, pain always involves the nervous system and how your nervous system can be retrained.

  • “How do you know if your pain system is being overprotective?”
  • “How do you retrain your pain system to be less protective?”
  • “How do you know if you’re safe to move?”

Learning a little about pain neuroscience education can be helpful. [1]

What complements this is not only learning but experiencing how YOU can change or modulate your nervous system.

Use the tools yoga has to offer; gentle movement, breath and awareness practices… to soothe and calm the system. To ‘Tame the Beast’.

You can find more information and resources at TameTheBeast.org.

[1] 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.

The Person in Pain

Often, when someone has persistent or chronic pain, what’s almost forgotten amidst the assessments, tests, diagnosis, and treatments, is the person. This person is not just a body with all these parts. Rather, someone who has a unique story, history, perspective and perception about what is happening with them. How pain affects almost every aspect of their life. Their worries, concerns, uncertainty about the future.

The International Association for the Study of Pain (IASP) launched it’s Global Alliance of Pain Patient Advocates in 2018, stating “this initiative seeks to better integrate the patient voice to inform pain research and its translation into new interventions to treat pain.” Below, Joletta Belton, tells her story:

I’ve been following Joletta for a long while now. Not only an advocator for the person in pain, she writes a blog over at mycuppajo, and co-founded Endless Possibilities Initiative (EPIc), which is a “nonprofit organization intent on changing the way people get access to science-based information about pain.”

Joletta also wrote the first chapter in Yoga and Science in Pain Care: Treating the Person in Pain which I’ve mentioned here before on the blog.

She writes “My protective responses not only affected my breath, but my movement too. My muscles would tense up, my joints would become stiff, my movement braced and rigid. Being rigid and stiff affected the way I moved, the way I walked, the way I sat. The way I existed in the world. The tenser and more guarded I was, the more pain there was, so I started moving less. The less I moved, the more painful movement became. Fear of more pain, of more damage, made me move even less. A vicious cycle.”

She goes on to share what helped her most over the years. The first two, on her list:

  • “feeling heard and believed, supported and empowered
  • feeling understood, as well as understanding and making sense of my pain.”

“When we live with pain, it changes who we are as people. It changes how we see the world and how we relate to that world. We protect ourselves through isolation and withdrawal, through guarding and tension, through altered thoughts, beliefs, and movements. We disconnect from the people, places and activities that are meaningful to us.”

“It is hard.”

In her conclusion, she also goes on to say “… I want you to know it takes hard work to get out of those dark places, too. I want you to know that change is possible, but it’s not easy. It takes time and persistence, compassion and courage.
… there is so much that is possible, so much that can be done, no matter how long someone has lived with pain, no matter how many limitations they may have.”

Jolette also recently contributed, wrote, the first chapter in the Meanings of Pain, Volume 2, released last month. The interdisciplinary book – the second in the three-volume Meanings of Pain series edited by Dr Simon van Rysewyk “aims to better understand pain by describing experiences of pain and the meanings these experiences hold for the people living through them”.

In my work as a yoga therapist and Pain Care Yoga teacher, probably the most important part of my work is to listen to what the person in front of me is saying about their pain, their story, their life. Provide safety and support, work to empower the person in pain as they might learn to move, breathe and renew their own sense of meaning and purpose in the world.

If you are someone who suffers from chronic pain, know that there are people out there willing to listen. There is hope. Your pain CAN change.

Let’s all continue to advocate for, educate and push for more services and support for the 1 in 5 Canadians who need it most. Each and every person, in pain.