I mentioned in the last post that maintaining a sense of humor was crucial during those early years when I really understood that pain was going to be a part of my life. Also important, as noted, were a few key concepts that I had to incorporate into this new understanding: first, that each person’s experience of pain is unique and personal to the individual, and second, that accepting and embracing pain as an ally would be more effective than denying and fighting with it. I figured out numerous other things too, mostly through trial and error. This blog post details some of the most beneficial strategies I began to implement in my life. I have carried them on and they remain an important part of my coping repertoire today.
Recalling back to my first blog about chronic pain, “Distinguishing between Pain, Chronic Pain and Disabilitly”, I listed several “alternative remedies” for dealing with pain — that is, alternative to drug therapy. These were: Acupuncture, Massage, Meditation, Spinal Manipulation, Biofeedback, Exercise, Physical Therapy, and Cognitive Behavioral Therapy. As noted, a pain psychiatrist provided important lessons that would fall into the category of Cognitive Behavioral Therapy (essentially, finding ways to cope with pain’s discomfort and limiting the extent to which it interferes with life). Here is a run down of some of the other strategies, and how they have worked for me.
Strategy 1 — The importance of Mindfulness and Mindfulness Meditation.
Much has been written about mindfulness, so I will only touch briefly on it here. Basically, mindfulness means maintaining a moment-by-moment awareness of thoughts, feelings, bodily sensations, and one’s surrounding environment. It also involves acceptance, which essentially entails paying attention to thoughts and feelings without judging them. Two books that the psychiatrist recommended especially helped me during the early years of chronic pain, “Wherever You Go, There You Are” and “Full Catastrophe Living”, both by Jon Kabat-Zinn. Reading these books really helped me understand not only what mindfulness is, but also how techniques of mindfulness and meditation could alleviate stress and chronic pain. I wholeheartedly recommend these books for anyone trying to get a grip on chronic pain, and also for those trying to support someone experiencing chronic pain. I read and re-read both books in those early years and later on as well, feeling relieved that finally I had something concrete to grasp that helped me to really solidify the concepts I was exploring. The benefits of some form of meditation to help deal with pain are well documented. As with so many other things, meditation is personal and what works for one person may or may not work for another. The inspirational takeaway from my forays into mindfulness and meditation I want to share with my readers is this: Explore mindfulness or whatever seems to ring true for you. The important thing is to find a way to BE WHO AND WHERE YOU ARE, IN TIME AND SPACE RIGHT NOW — learning to accept all aspects of this moment.
Strategy 2 — Professional Massage Therapy.
I started getting regular massages not long after my first back surgery, based on the recommendation of my marathon training coach. While still training for the marathon (the one I never ran), he commented that I was tense, uptight, and seemed to have a very difficult time relaxing. I couldn’t argue with that assessment; all of those things were true before the marathon attempt, and equally as true in the months following. I will always remember my first massage, with a massage therapist (not coincidentally!) in the same building where I now practice. She literally had to teach me how to breathe on the massage table, and even how to begin to relax into the massage process. Thus began my commitment to receiving massage, a long standing, necessary, and beneficial life practice that continues to this day. Initially I focused simply on learning to relax and breathe; over time, my relationship with massage has encompassed a wide range of purposes and goals. Very certainly, I could not have healed so successfully — physically and psychologically — from all the surgeries, recoveries, and setbacks without the help of massage. Nor could I have become the optimistic massage practitioner I am today without the skilled support of numerous massage therapists who have helped and taught me over the years.
Strategy 3 — Self-Massage.
Closely related to the benefits I received from professional massage are those I learned through self-massage. Early in the pain years, I laid down frequently because that was the most comfortable position I could find. While prone, I explored how things fit together, gently working sore regions to ascertain my body’s pain configurations. Not surprisingly, I figured out that massaging painful areas helped. Yet I also noticed that following the pain to it’s muscular or ligamentous attachment site sometimes brought even more substantial and lasting pain relief. This was long before my formal massage training, so I really didn’t know what I was doing. But I was curious and courageous in my explorations with self-massage, and I got quite good at helping to relieve my own pain. On long distance car trips I could usually be found rubbing my gluteal muscles and sacroiliac ligament attachments (where the sacrum attaches to the pelvis), one hand moving on my backside for hours on end (or two hands if I was the passenger!) This initially generated some questions and joking around, but eventually it got to the point where my kids (and even their friends) didn’t bother to comment on my unusual travel habits. I still smile wondering what exactly they may have been thinking! Regardless, I felt tremendously empowered by my ability to effectively surmount the challenges of travel while simultaneously reducing my pain. Learning to understand and soothe my body through self-massage became a truly useful pain management tool.
Strategy 4 — Acupuncture.
As the granddaughter, daughter, sister, and ex-wife of traditionally trained MD’s, I was raised with Western Medicine in my blood. So acupuncture was a stretch for me in the early days. Initially resistant to the idea, I finally tried it out of desperation and multiple recommendations. In order to get good benefit from acupuncture, I had to open my mind to the concept, and put aside my Western Medicine bias. Over the years, I have found acupuncture to be a reliably helpful method of pain management, one I have returned to periodically and one which I will continue to explore in the future.
Strategy 5 — Physical Therapy.
I cannot overemphasize the benefits of Physical Therapy in my chronic pain journey. I first undertook PT following my first back surgery in 1999, and have been in and out of it countless times since then. The overall benefit of PT for recovery from surgeries and injuries has been enormous. One of the most useful concepts I recall from one of my first Physical Therapists was that I could become my own “abdominal corset”. This idea, and the physical skills it connoted, pre-dated my involvement with Pilates, which has also been a great tool and uses similar ideology. I could and still do grasp the concept of the corset, and I continue to use that visualization every day to keep my abdominals tight and protect my back during daily activities. Similar to acupuncture and massage, reaping the full rewards of PT in any given session requires patience, acceptance of where I am at the time in my body, and a commitment to the process. Over the years I have found that the effectiveness of all these three treatment options is only as great as my willingness to slow down and accept that nothing happens overnight. Through experience, I now know that my body will participate in the process of healing if I give it half a chance. As my Orthopedic Physician Father used to always say…”The body just wants to heal. Let it take it’s course.”
Strategy 6 — Regular Exercise.
This topic alone merits an entire blog, if not an entire book! My commitment to movement is absolute. During every period of my life — despite ongoing injuries, surgeries, and a plethora of challenges with pain — I have found ways to move my body on a regular basis. I cannot fully express how important this has been for me; it may be THE most important thing in my now-rather-large tool chest. Countless studies have shown that regular exercise, even simply some type of daily movement, has huge benefits for a person’s state of mind AND body. I remember my dad always talking about getting things moving just as soon as possible after any and all surgeries. He lived out this advice during his own periods of recovery, so it’s no surprise that as I write this with my foot and ankle sequestered in my post-op boot, my toes are a-wiggling! While exercise has been, for the most part, highly beneficial (and an irreplaceable element of my life), it also has been the most difficult thing to mediate and monitor. I’ve had to learn to let go of expectations and frustrations associated with it — over and over again. I love exercising, and pain has often interfered with fulfilling this deep desire. My chronic pain journey would be incomplete without a look into this complicated dynamic. In the next blog post, I will explore how I channeled my exercise passion into forming a non-profit organization in the early chronic pain days, which also fed my strong desire to make a difference in the world.