Pain into Presence Creating awareness in your body may help decrease chronic pain by Dr. Meggie Smith
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ne of the best parts of my profession as a chiropractor is reevaluations. After about a month of providing chiropractic care, I sit down with patients. I pull out the notes that I took on their first visit. I ask them about the symptoms that brought them into my office. At least half the time, patients look at me confused when I ask them about those symptoms. “Did I have back pain?” they ask me. “Yes,” I say. “It’s why you started chiropractic care.” People heal. Some heal so fully and completely that just a few weeks after seeking chiropractic treatment they have forgotten they ever had pain. These people forget that they couldn’t turn their neck far enough to parallel park. They forget that they couldn’t get into downward dog without pain in their wrist. They are healthy again. And then there are people like Jennifer*. Jennifer hobbled into my office in 2008. Unable to stand up straight due to intense pain in her low back, Jennifer was almost in tears from taking the train to my office. In her mid-20s, she exercised as often as a person with a toddler can. She had been seeing chiropractors and massage therapists since college. Her back pain flared up from time to time, and when it did, she could barely walk, care for her young son and get out of bed. I provided her chiropractic adjustments, and after a few days, the pain went away. Temporarily. Jennifer has continued to hobble into my office, unable to walk, nearly in tears, a few times a year since 2008. On one occasion she called me from the hospital, begging me to give her a chiropractic adjustment in her hospital bed. A few days later the pain went away, but it keeps coming back. Jennifer does yoga a few times a month. She runs and bikes. She eats a plant-based diet. She chases around after her kids far more than she sits in front of a computer. So why does Jennifer keep having pain? If she had a more rigorous and deep yoga practice, would that help?
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’ve noticed that those who have deeply committed to a long-term yoga practice are more resilient. Skilled yogis, the ones who have made their practices a part of their life, heal faster and more completely than other patients in my practice. They know how to heal because they have a deep awareness of their bodies. They recognize that communication, acceptance and understanding are all as vital on a physical level as they are on an emotional, mental and spiritual one. People who heal better and faster have an intimate relationship with their bodies, and they have cultivated that relationship over time. These yogis listen when their bodies speak. They are not scared of the dialogue, and they do not seek to control what their bodies say. They notice a tight muscle, a contraction in their chest, a restriction in their knee. And rather than pushing past it, they feel more deeply into it. This may sound metaphorical, but it is actually neurological. Pain and healing are, at their core, neurological processes. Your brain and your nerves create, process and experience pain. Your brain even decides how strongly you will experience pain.
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ecreasing pain requires increasing awareness of the body. A 2007 study in Clinical Neurophysiology suggests that people with less awareness of their bodies experience pain more acutely. Another 2008 study in the Journal for the International Association for the Study of Pain has shown that when people increase their body awareness, their brain actually processes pain less strongly. Improving awareness simply requires curiosity. It can be done by noticing your balance in a pose. Is it even on both sides? Which muscles do you notice engaging in the pose? The process of increasing awareness requires listening: to hear your body and to accept what your body is telling you. Is one side always tighter? Does your knee always tighten, or sometimes does your foot tighten more? Do not rush in immediately to fix the problem or create symmetry in the pose. Notice what your body is doing, then ask your body what else it wants you to know. You may be surprised by the response. It may tell you that tightness in your foot is due to dehydration, or anger at your colleague. It may be trying to get your attention about something seemingly unrelated to your foot. It may take days or weeks to get any sense of why your foot is tight. You are embarking on the conversation of a lifetime. Do not feel like you must get all the answers immediately.
That said, do not stay in an uncomfortable position for too long! Proper alignment is important to prevent future injury. There is a balance between feeling into pain and disregarding pain. If your body tells that you are harming it, listen. However, if it is telling you about tightness, ache or restriction, get more information. Getting answers from your body is far less important than having the conversation. When you start the conversation, you start a neurological process of your body relaying information to your brain. This process of relaying information will actually reduce your pain levels in three different ways: First, when your brain is more aware of your body, it processes pain less strongly. The more nuance you can feel in your body, the less pain your brain will create. Like a child who cries every time his mother is out of the room but is calm whenever he can see her, your brain is more calm when it can feel your body. Secondly, the more awareness of the position of your joints, the less pain. Again there is an inverse relationship between awareness and pain. When your nerves are communicating about the movement in your joints, they cannot communicate about pain. It’s almost like your nerves are a phone line. They can only have one conversation at a time. They prioritize a conversation about joint motion over a conversation about pain. Thirdly, when you have pain, the muscles in that area turn off. You must turn them back on, by noticing and using them, or risk re-injury. If your nerves aren’t communicating with your muscles, your muscles can’t engage. If they can’t engage, they cannot provide the structure, safety and support that you need in your practice. Becoming pain-free in your life and in your yoga practice does not come from more flexibility or less arthritis. It does not come from more strength or less age. It comes from awareness of your body. It comes with deep presence and engagement. That's where the magic happens. Get to know your body. The simple process of listening will help you heal. *Name and minor identifying characteristics have been changed.
Dr. Meggie Smith practices chiropractic and energy medicine at Chiropractic First in Evanston. WINTER 2016