3 Rules To Reduce Chronic Pain

I was sedentary for the first, oh, 20 years of my life. My only exercise was lugging my backpack, dense as a neutron star, from class to class because I was too lazy to make the detour to my locker.

I had back pain. Good lord did I have back pain, and it was ever so mysterious.

Poor kid.

That’s me about 15 years ago, taking a “before” picture (I think I was planning to start lifting weights… didn’t happen). Please realize that I thought I was in a completely neutral stance, feet even, shoulders relaxed, etc., and please notice how completely I failed. One foot was forward, one hip was hiked, one arm was rotated inward, and my entire torso was displaced 2 inches to the left.

Our bodies do the best they can with the stimulus that we give them. While our brains have access to a ton of information, the body will get limited cues, such as “needs to walk short distances,” “needs to sit for long periods,” and “needs to occasionally haul heavy loads.” Based upon these inputs, our bodies adapt. Mine had decided that I needed to be shaped a certain way to meet the needs of playing lots of lots of video games.

Rule #1: Change the messages you send your body, and it will adapt.

There’s a reason your muscles grow when you start lifting heavy weights. There’s a reason your ankles and feet become stiff and inflexible when you stand for 10 hours a day. There’s a reason your posture changes when you sit for months on end.

These reasons can be kind of mysterious, but the body seems to have its own logic. The muscle growth is an easy one, but why the stiff and painful feet from standing all week? Well, your body has received the message that you need to be stable in an upright, static position. You’re constantly using the small muscles of your low legs to keep yourself in a very specific ankle posture, so your body (in its infinite wisdom) decides to tighten those muscles in a more permanent fashion.

Sure, this can lead to intense pain after your day of standing, or to the inability to engage in certain things you used to be able to do, but your body received your message loud and clear: My survival depends on extended periods of standing. What else are your legs supposed to think, based upon their limited information?

So, change the message. If you need to sit at a computer all day, you do what you gotta do, but get up often, and venture completely out of your C-shaped sitting posture whenever you can. Change the message from “needs to sit for hours” to “needs to sit, then needs to do cartwheels and the YMCA.”

Really want to send your body an interesting message? Do yoga. That doesn’t just tell your body that it “needs to be flexible,” it proves something to your brain.

Rule #2: Prove to your brain that you can move painlessly.

There’s an interesting phenomenon that takes place when you’ve had pain for a while: Pain increases. Yeah, chronic pain increases your sensitivity to pain. How screwed up is that?

Well, from a survival perspective, it makes sense. You receive painful stimulus often, so your brain kind of perks its ears up and listens really hard. Things that used to be painless are now unpleasant, because the brain is paying extra attention to any possible sources of damage or danger. This actually accounts for most of the pain in osteoarthritis: It’s not how much cartilage you’ve lost, it’s how hard your brain is listening to those creaky joints.

Your brain is acting like an overprotective parent, forcing you to take more breaks, stay inside, and not do the potentially dangerous things you used to do. How? By using pain as a lever. Feel like shooting some hoops after recovering from ankle surgery? Enjoy your back spasms, human.

So, we’ve got something to prove to our squishy gray friend. This hypersensitivity likely plays a part in all chronic pain conditions, so we need to dial it down a bit. If pain cranks it up, then periods of painlessness will damp it back down. Specifically, periods of painless activity.

This means moving gently, even when everything hurts. Especially when everything hurts. One of the best treatments for osteoarthritis is walking, as crazy as it seems. It means stretching as far as you can while staying within your pain threshold, and receiving massage that doesn’t hurt. It means getting active in a way that challenges your current notion of what you’re capable of.

It also means not torturing yourself. Stretching in a painful way, receiving deep tissue massages that leave you aching for days, “pushing through the pain” when you work out: These all increase your pain hypersensitivity. Prove that you’re capable, but don’t be a masochist.

Rule #3: Handle your stress.

This is the hard one. Getting up and stretching occasionally isn’t so hard. Walking even when you don’t feel like it is doable. Reducing stress is a tall order, complex in ways that we’re still learning about.

Stress-management includes addressing how you sleep, your interpersonal relationships, your financial situation, and lots of other stuff. While there are some tricks to reducing your stress levels, like meditation, and working out, and maybe even getting on some medicine, only you know the major sources of stress in your life. As we go forward, we’ll keep addressing this problem, but in the meantime, realize that stress and anxiety influence your perception of pain, and they can even cause mysterious pain (and other symptoms) in your body.

Oh, by the way, I no longer get the crippling back pain episodes, or the neck “cricks,” or the knee pain. My torso is no longer displaced 2 inches to the right, and my hips are level. I started moving, and lifting things, and doing fun stuff like capoeira.

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My feet are still flat as hell though.

10 thoughts on “3 Rules To Reduce Chronic Pain

  1. Add boobs, hips, and less flat feet to that picture and you pretty much get me (Well, almost). Ages ago, a tattoo artist noticed that one of my shoulders slopes more than the other. This probably has something to do with me trying to cower in the corner my whole childhood. Making myself unnoticeable always involved lots of hunching.

    I’ve since decided that I don’t want to end up looking like Quasimodo or suffer unimaginable back pain later in life. I can attest to the posture building powers of yoga, as I practice nightly. I not only carry myself differently (better) because of it, I can also see those weird little muscles in my arms again. I am not out of the woods yet, but definitely on my way.

    Very good article, by the way : )

    1. Having mentally added hips and boobs to the picture, I find myself aroused in the most unpleasant way.

      Oh, and I think it’s about time that I start practicing what I preach and actually… do yoga. I’m a huge advocate because of the dramatically different postures (and weirdly relaxed muscles) I see in my yoga-loving clients, but …. I’m scared of yoga places.

      Do I need my own mat???? MYSTERIES UPON MYSTERIES!

      1. Heh, it’s the narcissist in you that wants to like it.

        I’ve never stepped foot into a yoga class. My main resource for instruction is Ekhart yoga on Youtube ( http://www.youtube.com/user/EkhartYoga ). They place a lot of emphasis on correct body positioning which is important if you don’t wish to hurt yourself. I’d imagine trying to explain a dislocated hip as a “yoga related injury” to the ER doctors would result in them winking and saying, “Yeah. Yoga. Mmmhmm”.

  2. I have a question for you. There are two massage facilities where I live. One does a postural assessment followed by deep tissue massage. The other does an active release type therapy. Which would you recommend I try for jaw, neck, shoulder, and back pain stemming from 25 years of shit posture?

    P.S. I hope your project hasn’t killed you yet.

    1. This… is a sticky one. Recommending any given massage therapist is hard because most massage therapists suck at what they do. They don’t ask good questions, they cause pain because they think they’re supposed to, and they might not be precisely sure what the rotator cuff… is.

      I like the idea of the place that does a postural assessment, but run away if they “dig” and try to fix you. A more body-friendly approach is to use the posture as a guide, engage the relevant tissues, and let whatever happens happen. It doesn’t sound very medical, but massage seems to be more about engaging the nervous system than fixing “adhesions” (I’m looking at you, Active Release Therapy) or whatever the buzzword of the day may be.

      Sigh. I don’t want to discourage you, because massage seems to work regardless of the practitioner’s theoretical orientation, but don’t let them hurt you or sell you any bullshit.

      1. Man, this would be a much easier decision if I lived closer to Florida. I appreciate your realistic view of things. When you say “dig” do you mean physically digging in too much or, like, sticking their nose where they don’t need to? I guess all I can do is pick one and see what happens. Hopefully it doesn’t end up sticky. I hate sticky.

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