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This month’s theme is one of my specialties: pain management. There’s so much I could write about dealing with pain, but the fact is the approaches that are of greatest benefit to most people don’t need much explanation. As with most simple things, they’re easy to dismiss because we put so much value on complexity. Now that we have mapped out the human genome and can control the weather with our iPhones, who’s going to believe that the simple approach is the best?
Interestingly, many of the complex health-related developments don’t entail much involvement by the user. Just swallow this pill, which is the culmination of years of work by people much, much smarter than you. The simple interventions, on the other hand, often represent more work and/or lifestyle change by the user, but by the same token, they stand to heal you in a way that few pills could.
Now, let’s get down to business. I’d like to teach everyone to understand the meaning of pain from the perspective of Chinese Medicine. One of the most fundamental principles of this medical system is that all pain is due to some form of stagnation. When things move freely we feel good, and when they don’t we feel bad.
If we overeat and food is stagnant in our digestive tract, it feels bad. If blood stops moving through the vessels in our heart, it feels bad. If our muscles are irritated and taut (i.e., stagnant), they feel bad. If a joint is damaged and inflamed (stagnation again), it feels bad. If we broke up with someone but we keep fantasizing about them or replaying our conversations, this is mental and emotional stagnation, and it feels bad. If we’re attached to life being a certain way but it’s not that way, and we don’t accept it, it feels bad. Guess why. No matter what kind of pain you’re in, restoring healthy movement or flow will make you feel better.
Now for three important sub-principles. First, all parts of us are interconnected, so stagnation on one level can readily lead to stagnation on another level. For example, if we’re chronically angry, tense, or sad (emotional stagnation) this can eventually show up as, say, a tension headache or lower back pain (physical stagnation). Vice versa, living in a tight and inflexible body (physical stagnation) can contribute to a lack of mental flexibility – rigid thinking, frustration, depression, etc. Physical stagnation is easier to cure in this case, as emotional stagnation needs not just a treatment, but also your willing to get well. There is the natural product that can help to reduce stress and improve your emotional state.
Second, clearing stagnation on any level tends to promote healthy flow on all levels. For instance, physical exercise is beneficial for depression, because moving the body moves the mind. Likewise, using the mind to imagine energy and blood coursing freely through a painful area of the body can often be as effective as painkillers. For the same reason, if we’re in physical pain, it is always worthwhile to look inward and see if there’s some story or emotional pattern we need to let go of.
Third, you can’t argue with reality. Resistance produces stagnation. So, resisting pain doesn’t help. Acceptance does. Accept your pain (and everything else) and let it go.
Almost everything that benefits pain does do by mobilizing stagnation. We’ll explore a handful of the most beneficial interventions this month.
Let’s start by addressing conservative care for injuries. For several decades, the standard has been RICE: Rest, Ice, Compression, and Elevation. All of these tactics are aimed at inhibiting movement, based on the notion that the inflammatory process in injuries is somehow a mistake by the body. We’ve been taught that it’s vital to stop the influx of immune cells that causes swelling. As for Rest, it’s a good idea not to cause more damage, so avoiding activity that could be injurious is smart, but total immobility can slow the healing process. Contracting the muscles around an injured area gets the congested fluid (lymph) moving out of there. Controlled, low impact movement speeds healing.
The use of ice is the subject of fierce debate. In Chinese Medicine (and thermodynamics), cold is considered a contractive force. It inhibits movement. Therefore, if the goal is to get fresh blood into the area and clear out lymph and particles of damaged tissue, we need to keep the vessels in this area open. Cold constricts vessels, while heat opens them. Cold blocks pain signals, but inhibits healing. In fact, emerging research shows it may contribute to increased tissue death and slower healing. If you really love the refreshing feeling of brief cold application after minor strain (like working or exercise), I don’t think it’s a problem. But for healing pain, heat almost always works better.
Compression is meant to keep an area from swelling, but again, the influx of fresh blood to nourish damaged tissue and the immune macrophages, cells that clean up debris, are beneficial. We don’t want to restrict this response; we just need to keep things moving. Although there are some cases in which compression is useful, I generally advise against it for acute traumatic injuries.
Of the four RICE interventions, I find Elevation the least objectionable. It’s meant to reduce gravity’s contribution to swelling and to improve the return of blood to the heart through veins. The thing is, most of the fluid swelling in trauma is lymph, not blood, and lymph moves through lymphatic vessels, not veins. Gravity alone isn’t going to help much in moving that lymph. Instead, the muscles around these lymphatic vessels need to contract to squeeze the fluid along. Again, this is why controlled, low impact movement is vital.
So, next time you get injured, try slow, low impact movement and heat application. Next week I’ll discuss more strategies for alleviating this and other forms of pain. Stay tuned and keep moving.
Be well,
Dr. Peter Borten
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[post_content] => The other day, an adventurous friend of mine sent me a picture of himself immersed in slurry of icy water. The photo was taken on a rooftop, on a cloudy winter day, with empty ice bags scattered around the metal tub. His eyes were closed and he looked serene, as if in deep meditation.
If you took a photo of me in such a scenario, my facial expression would be a little different – more of a blend of shock and torment. Having a strong aversion to cold water, I’d need a tremendous incentive to voluntarily get into an ice bath. But as I stared at his picture for a while, I felt unease, fascination, and admiration.
It reminded me of my own work in pain management. When a cold stimulus passes a certain threshold, it becomes “noxious cold,” which is interpreted by the brain as pain. Figuring out how to stay comfortable in a tub of ice water is fairly similar to the task of managing severe pain without drugs, which is exactly what I endeavor to teach people.
The arrival of my friend’s picture was a bit of a coincidence as I was recently challenging myself in cold water also. Admittedly, the comparison is laughable, since my version of “challenge” was swimming in a cenote fed by an underground river in the Belizean jungle. The water temperature was probably around 60 degrees, but cold is subjective, and to me, it was pretty uncomfortable. My daughter was already splashing around and demanding that I join her, so I decided to put my “equalization” technique to the test.
I set a foot in the water and felt the skin over my whole body tighten up. I was immediately aware of the inequality – the conflict – between my body and the water. And my reaction to this conflict was physical and psychological resistance, which only intensified the situation. If you’ve ever had a panic attack, you’ve experienced firsthand how unhelpful resistance is.
So, my first step was to stop resisting. And to prove to myself that I wasn’t resisting, I dove completely underwater. Instantly, the experience of conflict between my body and the water was magnified tremendously. I put my attention on my skin – the “frontier” of the conflict – and began to equalize the internal with the external.
As I told myself, “Equalize. Equalize. Equalize,” I imagined that the temperature difference between the interior and exterior of my body was getting smaller and smaller. The interior and exterior were coming together to meet each other, to harmonize. I actively let go of my resistance over and over, softening and relaxing that frontier. Dissolving the conflict.
Normally, I would have been shivering, teeth chattering, skin covered in goosebumps for at least a minute and perhaps for as long as I stayed in the water. But this time I was at ease within about fifteen seconds and I swam contentedly for about an hour. I had a few moments when I felt uncomfortably cold again, but this resolved when I brought my attention back to equalizing the temperature differential once more.
I’ll write more about this process next week, but in the meantime, I encourage you to try it in the simple way that I’ve presented it here. When you experience physical discomfort or outright pain, first, stop resisting. Second, visualize the painful place in your body in the context of the experience surrounding it, and intend to equalize the experience inside the pain with that outside the pain. You can also utilize this technique with a psychological or emotional issue by bringing the issue to mind and then allowing yourself to experience it in your body – there’s always a physical expression to every psychological conflict.
Imagine a fish tank with a removable panel dividing it into two sides. On one side the water is dyed blue; on the other it’s clear. If you shift the panel it becomes porous, and the two waters mix, resulting in an even color. See if you can apply this image to your inner experience, allowing for an equalization between a restricted part of yourself and your greater self, or between yourself and the world around you. See what happens.
Be well,
Dr. Peter Borten
P.S. If you’d like to learn more about equalization and many, many, many more techniques for resolving physical and emotional pain, check out my new online course, Live Pain Free.
[post_title] => The Equalization Technique for Resolving Discomfort
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For the holidays we gave our eight-year-old daughter a set of indoor monkey bars. That meant I spent a day with my arms above my head, screwing eye bolts into her bedroom ceiling. She can now get from the doorway to her bed without setting foot on the floor, which is useful because she tells me it’s made out of molten lava.
At bedtime I reached out to turn on a faucet and suddenly my mid-back locked up. It was incredibly painful and I felt unable to move without worsening it. I made the mistake of bending down to touch my toes, thinking it would help, but was then frozen in that position.
I’ve treated this same condition in countless patients. Often this type of back spasm is crippling for at least a few days – meaning missed work or travel – followed by a lingering stiffness and pain for a week or more. Frequently the locked area, even as it begins to release, is prone to getting retriggered if we move or sleep the wrong way.
Luckily, I knew what to do. I started locating and massaging effective acupuncture points on my hands and arms that began to release the locked up muscles. Meanwhile, I used certain visualizations and breathing techniques that facilitated the loosening of my back. Eventually I could move enough to lie on a small ball to put pressure on the muscle spasm while continuing with the breathing, visualization, and self-acupressure. I went to bed about an hour later than I intended, but with my back feeling 80% better. The next day I released the rest of the tension.
Several times throughout the process I thought, “This would be so much worse if I didn’t know how to do this.” I would have to find a practitioner and wait for an appointment. But what kind of practitioner, and which one? What if they weren’t available during the holidays? Would I have to be immobile during our holiday party? Would I be reliant on pharmaceutical painkillers? Would I be in a daze? Would I find it hard to get off them?
This conundrum is why I created an online course called Live Pain Free. It started with the advice I found myself giving hundreds of pain patients in my office over the years – and the realization that I didn’t have time to explain everything I wanted to teach them. Little by little, the course grew to include virtually all of the techniques and lifestyle modifications I have found useful for self-treatment of pain. It’s more comprehensive than anything else I’ve found.
Are there other things like it? Yes, of course. There are plenty of books and courses that teach pain relief techniques, some of them very useful. But most feature a single approach to pain, and I’ve never found a single method that works for all – or even most – pain. Even for a given individual, some things work one day and not the next. This is because there are many “ingredients” in pain, especially long-term pain – our history, psychology, lifestyle, body mechanics, etc. – so we need a blend of multiple approaches.
During the years I spent crafting this course, I discovered that beyond helping people to make their pain go away, much of what I wish to share deals with releasing ways of thinking that are restrictive and keep us trapped in discomfort. Although pain management is the issue that often leads people to look deeper, the ultimate resolution may be something so much more than mere physical relief: liberation from our resistance to life, the opportunity to accept and live in the present moment, the recognition of patterns that have held us back, and more.
The feeling of gratitude I had the other night – I want that for everyone. If you deal with frequent pain, if you would like to help a loved one with their pain, or you just like the idea of being prepared and knowing a wide range of strategies – some based in modern science others in Eastern medicine – check out Live Pain Free.
Be well,
Dr. Peter Borten
[post_title] => The Gift of Knowing How to Manage Your Own Pain
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This month’s theme is one of my specialties: pain management. There’s so much I could write about dealing with pain, but the fact is the approaches that are of greatest benefit to most people don’t need much explanation. As with most simple things, they’re easy to dismiss because we put so much value on complexity. Now that we have mapped out the human genome and can control the weather with our iPhones, who’s going to believe that the simple approach is the best?
Interestingly, many of the complex health-related developments don’t entail much involvement by the user. Just swallow this pill, which is the culmination of years of work by people much, much smarter than you. The simple interventions, on the other hand, often represent more work and/or lifestyle change by the user, but by the same token, they stand to heal you in a way that few pills could.
Now, let’s get down to business. I’d like to teach everyone to understand the meaning of pain from the perspective of Chinese Medicine. One of the most fundamental principles of this medical system is that all pain is due to some form of stagnation. When things move freely we feel good, and when they don’t we feel bad.
If we overeat and food is stagnant in our digestive tract, it feels bad. If blood stops moving through the vessels in our heart, it feels bad. If our muscles are irritated and taut (i.e., stagnant), they feel bad. If a joint is damaged and inflamed (stagnation again), it feels bad. If we broke up with someone but we keep fantasizing about them or replaying our conversations, this is mental and emotional stagnation, and it feels bad. If we’re attached to life being a certain way but it’s not that way, and we don’t accept it, it feels bad. Guess why. No matter what kind of pain you’re in, restoring healthy movement or flow will make you feel better.
Now for three important sub-principles. First, all parts of us are interconnected, so stagnation on one level can readily lead to stagnation on another level. For example, if we’re chronically angry, tense, or sad (emotional stagnation) this can eventually show up as, say, a tension headache or lower back pain (physical stagnation). Vice versa, living in a tight and inflexible body (physical stagnation) can contribute to a lack of mental flexibility – rigid thinking, frustration, depression, etc. Physical stagnation is easier to cure in this case, as emotional stagnation needs not just a treatment, but also your willing to get well. There is the natural product that can help to reduce stress and improve your emotional state.
Second, clearing stagnation on any level tends to promote healthy flow on all levels. For instance, physical exercise is beneficial for depression, because moving the body moves the mind. Likewise, using the mind to imagine energy and blood coursing freely through a painful area of the body can often be as effective as painkillers. For the same reason, if we’re in physical pain, it is always worthwhile to look inward and see if there’s some story or emotional pattern we need to let go of.
Third, you can’t argue with reality. Resistance produces stagnation. So, resisting pain doesn’t help. Acceptance does. Accept your pain (and everything else) and let it go.
Almost everything that benefits pain does do by mobilizing stagnation. We’ll explore a handful of the most beneficial interventions this month.
Let’s start by addressing conservative care for injuries. For several decades, the standard has been RICE: Rest, Ice, Compression, and Elevation. All of these tactics are aimed at inhibiting movement, based on the notion that the inflammatory process in injuries is somehow a mistake by the body. We’ve been taught that it’s vital to stop the influx of immune cells that causes swelling. As for Rest, it’s a good idea not to cause more damage, so avoiding activity that could be injurious is smart, but total immobility can slow the healing process. Contracting the muscles around an injured area gets the congested fluid (lymph) moving out of there. Controlled, low impact movement speeds healing.
The use of ice is the subject of fierce debate. In Chinese Medicine (and thermodynamics), cold is considered a contractive force. It inhibits movement. Therefore, if the goal is to get fresh blood into the area and clear out lymph and particles of damaged tissue, we need to keep the vessels in this area open. Cold constricts vessels, while heat opens them. Cold blocks pain signals, but inhibits healing. In fact, emerging research shows it may contribute to increased tissue death and slower healing. If you really love the refreshing feeling of brief cold application after minor strain (like working or exercise), I don’t think it’s a problem. But for healing pain, heat almost always works better.
Compression is meant to keep an area from swelling, but again, the influx of fresh blood to nourish damaged tissue and the immune macrophages, cells that clean up debris, are beneficial. We don’t want to restrict this response; we just need to keep things moving. Although there are some cases in which compression is useful, I generally advise against it for acute traumatic injuries.
Of the four RICE interventions, I find Elevation the least objectionable. It’s meant to reduce gravity’s contribution to swelling and to improve the return of blood to the heart through veins. The thing is, most of the fluid swelling in trauma is lymph, not blood, and lymph moves through lymphatic vessels, not veins. Gravity alone isn’t going to help much in moving that lymph. Instead, the muscles around these lymphatic vessels need to contract to squeeze the fluid along. Again, this is why controlled, low impact movement is vital.
So, next time you get injured, try slow, low impact movement and heat application. Next week I’ll discuss more strategies for alleviating this and other forms of pain. Stay tuned and keep moving.
Be well,
Dr. Peter Borten
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