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Early in my practice, people told me I should choose one area of medicine to specialize in, but I was resistant to it because of the lack of variety. Also, it seemed that the natural specialization for me would be pain since I have a knack for treating it, and that sounded, well, kind of boring.
But I gradually began focusing in that direction, and over the years my understanding of pain broadened. I became interested in the whole human experience of suffering, which was like finding a loophole because it’s a pretty vast spectrum.
Suffering is fascinating.
As much as humans hate suffering, we have a curiously complicated relationship with it. We watch movies and read books about it for entertainment. We ache when we see others suffer, but we kind of like the ache. We try it out intentionally (ghost peppers anyone?) and we’re compelled to learn the graphic details of a tragedy just so we can feel it more richly. Often we simultaneously generate it and resist it. And sometimes, we turn it into an incredible, life-changing blessing.
To an extent, it seems that when good outcomes happen after a period of suffering, it's evidence of healthy adaptive mechanisms that help us make the best of a bad situation. But occasionally the suffering appears to be a kind of magic ingredient that provokes an evolution (or a revolution) that wouldn’t have otherwise occurred.
Few people would ask to suffer, but studies show that when they look back on how suffering ultimately facilitated a great favorable change, most say they wouldn’t change anything.
Well, maybe one thing.
If only they could have trusted, they reflect, it could have been a different experience.
On top of the discomfort of suffering we often add an additional dimension of discomfort in the form of resistance (which is often triggered by fear). When the resistance stops – because we just can’t keep it up any longer, or through a conscious choice to trust and relinquish the resistance – this is when something else enters the equation. What do you call it? Grace? Clarity? Insight? And the suffering becomes a portal to a new way of being.
Today, when you encounter some suffering – maybe it will just be a little micro-suffering – what happens if you don’t resist it? What happens when you say, “I choose to trust” and dive into it?
I’d love to hear your thoughts on this (in the comments section below). Have you had experience where suffering facilitated something good? What was the pivotal point, when it turned from suffering into grace? Did that change your relationship with suffering? Do you trust more? Why or why not?
Love,
Peter
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In this month’s series on pain, I’ve detailed the interventions that I feel make the biggest difference in sustainable pain management without medication. I haven’t mentioned drugs because I feel their side effects make most of them inferior for chronic pain management. For short term use, I have no problem with aspirin or ibuprofen. Many of my our clients are as naturally-oriented as I am, and want to avoid pharmaceuticals at any cost, but if you get a headache once a year, don’t feel guilty about taking an aspirin for it! For longer term use, I encourage you to try the measures I’ve discussed and also to consider some natural analgesic and anti-inflammatory supplements, many of which are profiled in an article on joint pain I wrote a few years ago.
Now I will introduce a few final practices to help you avoid pain:
1. Pay attention to your posture. I’ve written a lot about posture, so here’s the deep and brief. The majority of our pain results from muscular strain, and a great deal of our muscular strain is postural strain. We may think about posture when we sit at a dinner table and perhaps when we lift a heavy box, but all day long we have opportunities to improve our posture and lessen the total strain our activities exert on our bodies.
Some of the key situations to pay attention to posture are: (A) Sitting on a chair or couch. (B) Holding a phone up to the ear. (C) Typing on a phone, tablet, or computer. (D) Driving. (E) Exercising (F) Sleeping.
In exercise, we call good posture “good form,” and without it, our workout isn’t as comprehensive, plus there’s a much higher risk of injury. When talking on the phone, we should be careful not to tilt the head to one side. When typing, keep the shoulders back, the chest open, and the spine straight. When driving, be aware that keeping your elbows up in order to grip the steering wheel means a prolonged strain of the back – take breaks, stretch, drink water, relax.
2. Get your sleep situation optimized. By bedtime, most people – even those with chronic pain – crawl into bed without having given a thought to the fact that they always wake up sore. This could simply be the result of 8 hours of immobility, but since we spend a third of our life in this place, it’s worthwhile to make it thoroughly rejuvenating to the body. Or at least, to ensure that it isn’t a detriment.
Unfortunately, many of the positions we put ourselves in create postural stress or put excessive pressure on sore spots. I’ve had patients make tremendous recoveries from severe pain just by changing their sleep configuration. Investigate mattresses and pillows of varying firmness. Get a body pillow, and/or multiple smaller pillows and experiment with positioning them so that all parts of you feel supported. Avoid positions that crimp muscles or joints (such as sleeping with an arm above your head or under your pillow). Almost everyone does best sleeping on their back, possibly with a small support under the arch of the neck and another under the arch of the lower back.
3. Treat your life like an all day workout. This is another subject I’ve covered extensively in the past, so I’ll bottom line it. All day long, we work certain muscles for longer than we ever dream of working them at the gym. And we habitually (though unintentionally) work the same muscles day after day and neglect the same muscles day after day. If we were approaching our day’s activities as a workout, we’d stretch before and after, we’d drink lots of water, we’d take breaks, we’d be well-rounded, etc. Try to bring the same level of consciousness to your everyday activities. Switch it up, take breaks, stretch, move around, engage your core, have good form, drink water and electrolytes, etc.
Holistic practices of conditioning, such as taijuquan (tai chi) and yoga are excellent in part because they help us to use the body and breath in a balanced way throughout our day. Of course, it’s up to you to not think of these as compartmentalized practices, but to endeavor to do yoga/tai chi all day long. Your life will change in ways that far exceed the alleviation of pain.
I hope you earnestly apply these recommendations and overcome your pain.
Be well,
Dr. Peter Borten
[post_title] => Unlocking Pain, Part Four – Body Mechanics
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In last week’s article, I introduced the Chinese Medicine concept that all forms of pain are caused by stagnation, and I explained that the standard of care for traumatic injuries – rest, ice, compression, and elevation – may actually inhibit the healing process. This week I’ll cover some interventions that do work to facilitate the resolution of pain – they’re things that everyone should know. All of them are ways of promoting movement to liberate stagnation.
1. Breathe. Our energy follows our breath. I discussed this in the context of stress and relaxation, where slowing the breath can calm agitation and crazy thinking. As it relates to pain, breathing fully and deeply encourages movement of life energy (Qi in Chinese medicine; prana in the yogic tradition) and blood. This helps to alleviate stagnation and ease pain.
Simply taking long, deep breaths, inhaling into the belly and making the exhale as long as you can, will calm your nervous system and reduce pain. You can usually get even better results by imagining the breath is moving through the painful area. If your elbow hurts, for instance, imagine you’re drawing air in through your elbow and then exhaling out your elbow, visualizing energy coursing through the region as you do so. If your pain is emotional, there will still be a part of the body where the emotion is most strongly felt, and this should be the focal point of your breathing. If you’re having a painful experience, keep breathing deeply and fully as you move through it.
2. Get a massage. Massage, at its most basic level, is the practice of mechanically breaking up stagnation and restoring proper flow. Regardless of the nature of your pain, massage will probably help. Plus, it feels good – how many medical interventions can you say that about?
While massage is an integral part of the healing practices of so many cultures, it is greatly undervalued in the United States. Maybe we have a hard time separating the idea of therapeutic touch from sexual touch. Maybe we just think things that feel good are indulgent and bad for us. But the reality is that the great majority of pain benefits from massage, which is a more impressive claim than can be made of nearly any conventional pain therapy. And human touch is a basic human need.
Although I believe there is no substitute for having someone else give you a massage, even self-massage can often be enormously beneficial. I have saved myself from severe pain countless times by rolling on a small, firm ball (a lacrosse ball is my favorite).
3. Drink water. It’s cheap and it’s easy. Dehydration makes almost any kind of pain worse, and some pain is entirely due to being dried out. So, first thing, make sure you’re drinking at least half the number of pounds you weigh as ounces of room temperature water each day. (That is, if you weigh 120 pounds, you should drink 60 ounces of water, a little at a time over the course of the day.)
Water is essential to the elasticity of our connective tissue and the fluidity of our joints. When I’m dehydrated, my neck and shoulders get tight and my head starts to hurt. I know that means I’ve forgotten about water.
Don’t undervalue the simple just because it’s simple. Just drink more water, get some massage, and breathe more deeply. Next week I’ll have more strategies for you.
Meanwhile, be well,
Dr. Peter Borten
[post_title] => Unlocking Pain, Part Two – Keep it Simple
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Early in my practice, people told me I should choose one area of medicine to specialize in, but I was resistant to it because of the lack of variety. Also, it seemed that the natural specialization for me would be pain since I have a knack for treating it, and that sounded, well, kind of boring.
But I gradually began focusing in that direction, and over the years my understanding of pain broadened. I became interested in the whole human experience of suffering, which was like finding a loophole because it’s a pretty vast spectrum.
Suffering is fascinating.
As much as humans hate suffering, we have a curiously complicated relationship with it. We watch movies and read books about it for entertainment. We ache when we see others suffer, but we kind of like the ache. We try it out intentionally (ghost peppers anyone?) and we’re compelled to learn the graphic details of a tragedy just so we can feel it more richly. Often we simultaneously generate it and resist it. And sometimes, we turn it into an incredible, life-changing blessing.
To an extent, it seems that when good outcomes happen after a period of suffering, it's evidence of healthy adaptive mechanisms that help us make the best of a bad situation. But occasionally the suffering appears to be a kind of magic ingredient that provokes an evolution (or a revolution) that wouldn’t have otherwise occurred.
Few people would ask to suffer, but studies show that when they look back on how suffering ultimately facilitated a great favorable change, most say they wouldn’t change anything.
Well, maybe one thing.
If only they could have trusted, they reflect, it could have been a different experience.
On top of the discomfort of suffering we often add an additional dimension of discomfort in the form of resistance (which is often triggered by fear). When the resistance stops – because we just can’t keep it up any longer, or through a conscious choice to trust and relinquish the resistance – this is when something else enters the equation. What do you call it? Grace? Clarity? Insight? And the suffering becomes a portal to a new way of being.
Today, when you encounter some suffering – maybe it will just be a little micro-suffering – what happens if you don’t resist it? What happens when you say, “I choose to trust” and dive into it?
I’d love to hear your thoughts on this (in the comments section below). Have you had experience where suffering facilitated something good? What was the pivotal point, when it turned from suffering into grace? Did that change your relationship with suffering? Do you trust more? Why or why not?
Love,
Peter
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