Pain: A Natural Occurrence
*My goal is to help you find an alternate, sustainable way to process and move through pain. That said, first and foremost, it’s important to consult with a doctor or medical professional before engaging in alternative methods of healing. I honor traditional medical approaches to pain managements and the information in this post is not intended to be, nor should it be construed as, a substitute for professional medical advice, diagnosis, or treatment.
Chronic pain is an epidemic that impacts over 100 million people worldwide and interconnects with a second epidemic, the opioid crisis. It’s a complex issue with no one-size-fits-all-solution but one thing is becoming more clear among health care experts: long-term use of opioids is not the answer.
So what is? I believe at the core of coping with pain, there’s deep insight that athletes and chronic pain patients can share with one another. As a life-long athlete - and recent patient of chronic pain - I thought my personal experience might help answer the question.
First, I want to emphasize that pain is a highly personalized experience and each person’s experience is valid, to be heard and respected. According to the International Association on the Study of Pain (IASP), the concept of pain is unique and different for everyone, and empathy helps us understand our own pain and the pain of others. I have empathy first and foremost for all those suffering from chronic pain.
So before we go further, a few helpful definitions:
Pain: An unpleasant sensory and emotional experience associated with, or resembling that associated with, actual or potential tissue damage. (IASP)
Chronic Pain: Usually pain is regarded as chronic when it lasts or recurs for more than 3 to 6 months. Chronic pain is a frequent condition, affecting an estimated 20% of people worldwide and accounting for 15% to 20% of physician visits.*
…pain is a highly personalized experience and each person’s experience is valid, to be heard and respected.
How it Started
I’ve had a balanced relationship with pain for most of life - it’s neither good nor bad but a natural occurrence in life that you work through. I’ve also been a high-level athlete for most of my life, always in competition with myself and others in ways that challenged me physically, mentally and emotionally.
I was raised to handle discomfort and turn towards unpleasant sensations - like getting repeatedly thrown off a horse, running sprints in 90+ degree weather, or pushing myself to the point of physical exhaustion - because that is a natural consequence of being an athlete, especially a competitive one.
However, my relationship with pain changed several years ago when chronic low back pain (compounded by years of heavy weight lifting in college and a failed attempt at snowboarding) translated into herniated discs in my spine that left me incapacitated like never before. I was unable to stand or walk for more than a few minutes let alone bend over.
That notion I heard tirelessly in the athletic world, “no pain no gain,” was completely uprooted.
It was a new experience, one that I couldn’t physically work through or “just wait for it to pass” like a sore muscle after an intense training day, and would forever shift my training mentality. Rather than sit in my anguish, wondering “why me at only 30?!" (well, only for a few weeks), I adjusted my training regimen and dove into my yoga practice as therapy to try to move through the physical and very mental process of experiencing and coping with pain.
The athlete mentality that’s etched into my soul has given me the capacity to move through pain without engaging in an emotional battle with myself over “why” or “what if.”
So, while my relationship to pain was challenged, I didn’t allow it to trigger a vicious cycle of negative thoughts and self-talk which would undoubtedly increase muscle tension and physical pain, not to mention induce the negative mental and emotional response that coincides with suffering.*
Like the old adage says, “Pain is inevitable; suffering is optional.”
I dove into my therapy with an attitude of “I will manage this pain and get back to an athletic way of living.” And I did, thanks to solid yoga practice and the foundation of yogic teachings which promote self-efficacy.
But as I continued to see more chronic pain patients in my wellness practice, athletes and non-athletes, I became fascinated with the difference in how the two groups approached therapy and coping strategies.
What was it about the physical, sensory and mental experience of pain that landed differently for the two groups?
What was the underlying ‘ah-ha takeaway’ that both athletes and non-athletes could use when faced with pain and more specifically, chronic pain, and what were the most effective coping strategies?
How could the “inner athlete” mindset help those who were currently suffering?
Again, I wholeheartedly believe that pain is a highly personal experience and each person’s experience is valid, to be heard and respected.
The Athlete vs. Non-Athlete
So the question on my mind - can athletes really tolerate more pain?
A recent study published in the journal, Frontiers in Psychology, found that athletes have higher pain thresholds compared to non- athletes with a generally better ability to tolerate and sustain painful experiences. The exact reason as to why is yet to be determined, but a possible explanation is that repetitive exposure to low intensity pain - sprains, muscle aches, sports-induced fatigue - might bring about stronger physical and mental tolerance for pain.
Basically, all those years of uncomfortably hard training days could be the reason why many athletes are primed to move past pain - without attaching particularly strong meaning to it aside from “I can get past this and recover.”
A recent study published in the journal, Frontiers in Psychology, found that athletes have higher pain thresholds compared to non- athletes with a generally better ability to tolerate and sustain painful experiences.
I wanted to hear from experts in the field, so I spoke with Ben Rawson, DO, from Charm Medical Clinic, a center for regenerative healing, who works daily with chronic pain in athletes and non-athletes. He put it into greater context:
“Pain is an emotional and sensory experience with the emotional component giving meaning and context to the sensation. All athletes experience pain in some form. This can be analogous to running into the wind on a hot day. Although unpleasant, these factors can be viewed as yet another challenge that the athlete endures, and pushes through for ultimate success.”
Dr. Rawson speaks to the natural unpleasant consequences that come with being an athlete and the ability to push through these challenges in order to succeed.
So the question remained, how can non-athletes invoke this same mentality and make the switch from “this is unbearable” and “I can’t stand it” to “this is a challenge and yet I have the self-agency to push through and greet this head on”?
And my findings… there is not one best way to cope - mentally or physically - because coping means different things for different people.
But there is a dynamic approach to chronic pain management rather than one “correct” method or specific strategy.
The Holistic Approach
From a holistic perspective, we are interactive, layered beings and just as pain has distinct biological and psychological components that interweave multiple layers of our being, it can be approached as such.
So here are a few strategies to try on, recognizing that coping with pain is a dynamic, ever-changing process that can vary from day-to-day or moment-to-moment. But with these strategies you can start to:
Explore a new, fresh approach to your pain
Lower your chance of dependence on traditional pain medications
Strengthen your physical and mental health
Keep Moving:
A natural tendency when experiencing painful sensations is to stop moving, which can stop the pain… temporarily. But this can lead to long periods of inactivity that can actually make the pain worse and cause your muscles to become stiff and overly contracted, creating an imbalance in how you move and feel in your body.
Studies suggest that regular physical activity is associated with specific alterations in pain perception*. So instead of resisting the pain altogether and falling into a sedentary lifestyle, find a movement style that challenges your body to adapt to small amounts of pain (like low impact cardio, yoga, or walking) while slowly building your pain tolerance in order to keep your body moving and muscles active.
Pain experts speak to the notion “hurt does not mean harm;” it’s okay to feel some pain and recognize you’re likely not doing more harm to your tissues. Getting comfortable with an appropriate amount of stress in the physical body is crucial for overall healing and returning to optimal performance.
Yoga and Mindfulness:
Since physical pain and emotional pain are closely related, it is important to incorporate strategies that are geared towards mitigating stress and dis-ease (discomfort), not only in the body but in the mind.
Studies show that mindfulness practices such as yoga, breathing, and meditation focus attention on the body and breath as it is moment to moment, without judgment, which can decrease feelings of pain and lessen discomfort. Mindfulness practices also cultivate an attitude of empathy and compassion which leads to deeper understanding of our own pain and the pain of others.
I recommend starting with breathing practices that move energy through the body and work into meditation that allows for the mental processing of painful emotions. Overall, mindfulness practices can bring the system back into a balanced, calm state allowing the mind to process the pain and shift into a more objective approach towards healing and recovery.
These practices can be one of the most powerful ways to cultivate that “inner athlete” mentality and transform your relationship with pain.
Behavior changes:
Again, because we are multi-layered beings, how we treat ourselves in one area of life will translate over into others.
I went back to the experts for this one and spoke with PT, DPT Amy Hooper of Eastside Movement Company, a holistic-focused physical therapy clinic, who speaks to the importance of getting enough sleep and rest! We’ve all heard “you need 8 hours per night,” but here’s what matters for those experiencing chronic pain.
“Getting insufficient sleep increases our nervous system's sensitivity and our brain's perception of painful stimuli. You need to be aiming for 8 or more hours of sleep per night, which means you should be aiming to spend about 9 hours in bed since the average human has about an hour of restless sleep or awake time per night.”
There are also numerous studies that show what you eat - like whole, fresh foods - is a modifiable lifestyle factor that can reduce inflammation in the body and both treat and minimize chronic pain. If you’re unsure where to start, think whole and fresh.*
Food and nutrition are not to be overlooked if your goal is greater health, well-being and less pain.
Other common alternative treatments for chronic pain:
Physical Therapy
Non-surgical Regenerative Medicine
Massage
Cognitive Behavioral Therapy
Acupuncture
Herbs/Remedies
Chiropractic
Group Therapy
Music Therapy
Pet Therapy
Summary
When all is said and done, you have to find what works for you. The process of coping and mitigating your pain is not a linear process.
What works one day may not work the next because coping is context-driven. The point is to have an arsenal of tools that you can draw upon and that will actually help, so that you can greet the day with more grit, courage and joy.
In my experience, it’s about trusting in the healing capacity of your body and engaging in holistic strategies that address the whole you, not just the site of your pain as a quick fix. This can be emotionally taxing to do on your own and where the guidance of an expert can help you get where you want to be sooner.
A holistic coach can help you build your coping toolbox, tailored with strategies specific for you, and teach you the fundamentals of pain management. If you’re looking for support in coping with chronic pain and not sure where to start, send me a message. I’d love to help you find the right approach and path for you.
Bibliography
“A classification of chronic pain for ICD-11.” The Journal of the International Association of Pain, https://journals.lww.com/pain/pages/articleviewer.aspx?year=2015&issue=06000&article=00006&type=Fulltext
“Pain Is Inevitable; Suffering Is Optional.” Psychology Today, https://www.psychologytoday.com/us/blog/some-assembly-required/201401/pain-is-inevitable-suffering-is-optional
“Pain Processing in Elite and High-Level Athletes Compared to Non-athletes.” Frontiers in Psychology, https://www.frontiersin.org/articles/10.3389/fpsyg.2020.01908/full
“What are the most effective coping strategies for managing chronic pain?” Future in Medicine, https://www.futuremedicine.com/doi/10.2217/pmt.15.45
“Diet therapy in the management of chronic pain: better diet less pain?” Future in Medicine, https://www.futuremedicine.com/doi/full/10.2217/pmt-2019-0014
“The 5 Coping Skills Every Chronic Pain Patient Needs.” Practical Pain Management, https://www.practicalpainmanagement.com/treatments/complementary/biobehavioral/5-coping-skills-every-chronic-pain-patient-needs
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