Chronic Pain - Strategies
When pain persists a different approach may be required. Pain science suggests that the nervous system becomes wound up when it 'perceives' a sense of threat - this results in amplified pain and pain with normal movement. Sensitivity in the nervous system can be addressed in a variety of different ways.
A biopsychosocial (in yoga Pancha Kosha) assessment will identify physical factors - weakenss, tightness in muscles and joints; but also physiological and psychosocial factors that may be contributing to 'perception of threat'. For instance having an understanding of how the body heals and what you personally can do to address the issue is empowering also for your nervous system. Pain and injury can be stressful or can happen on top of other daily life stresses and how you manage this will also impact on your pain. Yogaphysio makes sure everything is addressed - we tackle the problem from all angles.
To address these factors a variety of treatment strategies may be useful.
- Provide you with an empowering understanding of how your body heals.
- Awareness based meditation (mindfulness) helps your to manage your own pain relieving hormones - the best drugs
- Self study (in yoga Svadhyaya) is bit of an integration of cognitive therapy - helps you to identify where you might be inadvertently limiting yourself - for instance the tendency to push on, when you should rest or too rest too much when you need to push on. Not always easy to judge. .
- Graded motor imagery, visualisation and other techniques that involve activates nervous system directly, without activating a pain pathways.
Value directed goal setting is important so that these approaches are practical and relevant.
Another western psychological therapy that informs our approach is that of Acceptance and Commitment therapy (ACT). ACT is a practical therapy that can be very helpful when pain persists and starts to interfere with life. The way we respond to pain is often that we stop doing the things we want to do – working, socializing; it can impact greatly on our relationships with family and friends. Trying to avoid pain and struggling with it may become the focus of life. We seem to no longer have the time or energy for the things that bring self fulfillment and nurture.
Although it may be difficult to imagine how life can go on in the presence of pain, ACT does not aim to eliminate pain. Instead it helps to turn the focus back to what we want our life to be about – meaningful relationships, satisfying contribution in society, workplace or family, regained fitness and general wellbeing. What is really important to you?
Practice of Observing
If you are willing, notice your pain and notice all the things that your mind tells you (it doesn't matter if they are true or not). Expecting that some of these thoughts will be negative and indicative of the concern you feel in your current situation... notice how dwelling on these thoughts makes you feel?
Training in 'noticing' is a minfulness therapy; if you are able to just notice.. your pain, tension, thoughts you have already stepped a little to the side of your suffering. Practice with such techniques helps you to feel more empowered to manage your pain and get on with your life. Techniques that work on the unhelpful thoughts and meditation based treatments help to bring about an experience of peaceful acceptance of pain (that cannot be changed) and other unpleasantness.