chronic pain and yoga

Blessed be the cracked, the weary, the sore. Yoga and pain.

12 years ago I was diagnosed with fibromyalgia.  This was not helpful. The diagnosis was this: you hurt, you have brain difficulty, there are questionable and various causes, it will always be this way.  My response: no shit, thanks much.

My pain - breaking, physical, unexplained - ran right alongside my depression - breaking, physical, consuming.  It was and is entirely possible that I do not have fibro, but my symptoms are caused by my major depression.  Or that I have fibro, for whatever reason, and this has played a role in my depression.  Throw in active alcoholism and I was just plain broken.  Why would I take up the diagnosis of chronic pain when I already lived with the chronic depression and the chemicals?  I didn't.  Other than to know in the back of my head that body, brain, pain are things I seem unable to explain to others.  That medicine has no very good answers.

And that from the earliest days of my yoga practice I began to feel better.collage  Not cured.  Not fixed.  But breathy and sweaty and tolerable.

Some days, though, I hurt profoundly.  I hurt like my muscles have been soaked in battery acid and my bones are ashy.  I hurt, today.

I want to write about pain, and yoga, but I'm not exactly sure how.  If you look for answers or help, you are hit with a daunting arrayof 'conquer the pain' and 'pain free' and 'beat the pain forever' palaver and self help books.  These set you on a cycle of hope and deeper despair when they don't work.  If you talk to doctors, you are overwhelmed with inadequate answers and the frightening realization that medicine doesn't know much and won't necessarily help you.  More despair.  I do not want to contribute to that cycle.

I don't want to say yoga will make the pain go away.  But it does help.  It can.

Three days ago, at the tail end of my teaching week, I came home exhausted and having a hard time thinking clearly.  I tried to list to myself the errands.  I tried to gather the laundry.  I began to cry.  It was too much, I was too tired, I could not do laundry.

Go ahead.  Say that's melodrama.

I eventually did do the laundry.  Not that day.  But I did it.  And walked around like a cripple, using chairs and walls and countertops to support me, hunched like a centenarian, placing my fingers and feet gingerly.  I started to berate myself.  Myself, yoga teacher.  Myself, woman who stands in front of the room and glides through sun salutations.  Myself, crying because the bed hurts.  Sound hurts.  Clothing hurts.

Whatever.  I limped through it.  I worked harder.  I recognized I wasn't eating very well, but shrugged it off because at least I was eating.  I woke up and wanted to sleep.   To sleep for days.  I 'conquered' tasks in two minute segments followed by half hour cringes.

Yesterday, I went to a family thing.  I hurt.  I held my niece, I laughed with cousins.  We joked about the spring that doesn't seem to come.  On the drive home, battling my tiny car over roads that were blown with icy snow, I hurt more and more.  I couldn't move my wrists well.  My shoulders burned.  And my spine felt like it was breaking, down along each vertebrae.  I stopped the car, stood as best I could and stretched, then drove again.  I stopped, I cried and cussed, then drove again.  I stopped, used both hands to heft myself out of the driver's seat, laboriously set both feet on the highway, held the car with both hands, and vomited because it hurt.  I don't know what hurt.  All.

I want to remove limbs.  I shake.  I want whiskey.  I want cigarettes.  This is stupid; I haven't had a drink in four years.  But I want it, just the same.

In the vernacular of chronic pain, this is a 'flare up'.


Somehow, though, it is okay.  It's too familiar.  I know it, by now.   And I knew, sitting crouched alongside a tiny blue car in the middle of a snow ice storm on a landscape blown to invisible, that I want to write about it for all those students who have told me about pain, too.  I want to say it hurts like blinding light, the body seems rot and spoil, but it is okay.

I made it home, I slept for fifteen hours in a sleep that was more exhausting than nurturing.  And then I read some little checklist for fibro flare ups.  A possible causes kind of thing.

  • cold or wet winter weather
  • too much or too little physical activity
  • stess
  • poor sleep

Which is as unhelpful as was that original diagnosis.  But, honestly, true.  There I was in the middle of an ice blizzard, after having taught seventeen classes a week for months on end.  I'd just navigated my way through a move, tax season, and a few familial stresses which were okay, but emotional none the less.  And I don't get any more than four or five hours of sleep on any given weekday.  Check, check, and check.

Still, I say it's okay.  This is life.  I want more of it.

My theory that doesn't mean anything, unless you're in it

I say yoga works.  It works through breath, movement, system wide, meditation based, give us a reason to go on ways. I don't have the degree or the credential to say why.  But I have this body.  I can make it fly, sometimes.  My theory is that yoga works in ways nothing else will, but it will change your ideas about who you are and what life is.

There is a growing body of research that shows yoga and meditation can help with chronic pain.  For a long while, these studies suggested they help with 'coping', that is, they do not lessen the symptoms at all but give us some modicum of tolerance for what hurts like hell.  Now, though, studies are beginning to show that symptoms themselves may be reduced.

Most studies suggest restorative and gentle yoga.  I believe in restorative and gentle yoga.  I believe there is a style and appropriate yoga for any body.  For me, however, a stronger, sweatier, more intense practice is downright crucial.  I need to go upside down.  I need to challenge the muscles, elongate the nerves.  When I don't for a day or two, 'symptoms' start popping up like ghosts.  I believe 'restorative and gentle' yoga are prescribed because most people don't have any experience with yoga.  If that's the case, it's a good place to start.

Yoga works with the breath.  Breath is immediatelyoxygen connected to the nervous system and the muscular-skeletal system.  Breathing as done in yoga speaks to our tissues and the formation of cells.  I'm not a scientist nor a doctor, but it seems to me those cells are fevered and over taxed and inflamed during pain; to breath as we do in yoga immediately turns on the parasympathetic nervous system, which facilitates healing, balance across our biochemical field, and the processes of healing, building, rejuvenation. Pain responds to the breath.

Nerves.  Oddly, pain doesn't happen in the brain but the experience of pain is considered to be mental, cognitive, brain based.  Let's skip the brain for a moment and go instead to the nerves.  The body scattered map as finely drawn as a universe.  Yoga stretches nerves (they stretch, just as muscle tissue does).  Yoga improves proprioceptive and reflex type things.  It is a way to recalibrate, soothe, and reconnect with reality - here and now demands on the body, sensation, awareness in space, texture and elongation and movement.  It improves communication between nerves and spine, nerves and brain, nerves and endocrine system, nerves and immune system, nerves and hormones.  If all of this is true, and 'pain' is a haywire backfire of those things, than yoga helps.

Inflammation.  Yogically speaking, any 'disease' or 'suffering' manifests somewhere in the body as inflammation.  Swelling, fever, indigestion.  Yogic practices alternately invert, compress, and massage us on a tissue and cellular level.  This processes the gunk of work outs, indigestion, stress hormones.  It directly stimulates improved circulation and lymphatic movement, promotes hormonal balance, begins to work through backlogs of old stress in the digestive and muscular and fascial networks.  Asthma, arthritis, anything rheumetoid is inflammation.  Studies have proven that yoga reduces inflammation.

Brain, but more than brain.  As a culture we roughly understand that depression, fear, wellbeing have something to do with neurotransmitters.  Serotonin, GABA, et al.  Some studies have shown that women have less serotonin then do men, and that fibro patients have serotonin deficiencies.  We tend to think of this stuff as brain based, and certainly they are.  But the stomach and digestive tract produce more serotonin than does the brain.  Our heart and psoas muscles seem to produce chemical reactions much like neural pathways.  And our fascial system, the base from which all chemical reactions across the body mind happen, conduits biochemical reactions in a way more nuanced and less understood than do the axons and dendrites of brain cells.  Again, yoga has been proven to balance mood, prbably balance chemicals, definitely to speak to the release of hormones.  So, if pain signals to the body have something to do with neurotransmitters and biochemical processes, then yoga helps.

Mind body. philosophy, gut experience.  There is something inarticulate about yoga.  At it's heart, it directly speaks to our human condition.  Somehow, it manages both to acknowledge and accept the limitations, sufferings, and pains we human beings face AND to give us a sense of freedom and resurrection.  Unlike self help books, miracle cures, and most religions, the philosophy and lived experience of yoga is an experience of grace under fire.  A strange blend of yes, it hurts to be human and to one day die, but living itself is precious.  There are thousands of books and memoirs about this.  Read those others.  I hurt to much to try to explain it just now, but I believe yoga has given me validation of my individual life and the experience of that individual life as rare and raw and beautiful.  It has given me the ability to face pain and love anyway.  Not to get over it, but to go through it.  And to feel, most days, as if I am dancing.

Let's make up a list of fifteen (that is arbitrary and random) things I know to be true: ie, tips and tricks, advice and how to, or just some tools you can cling to:

-When I teach students or answer questions about chronic pain (or, hey, weight loss or sore knees) I am often stuck: I cannot promise a danged thing.  I can't promise yoga will solve your infertility problems or that it will help you lose twenty pounds.  I can't promise the pain will go away or your knee will work.  But I usually do try to insist yoga will make it better.  This gets harder: most of us want a 'cure'.  We want three classes and then forever relief.  Yoga doesn't work that way.  Yoga will give you very specific things that will help.  But they are intended to be used.  If I do not practice for a few days in a row, the bad comes back.  If you want the yoga to work, you have to do the yoga.

- Consistency.  Don't go looking for a three hour yoga practice once a month, or fall into the yoga honeymoon of a season and then run away, or do the on again off again practice.  If you want to see what yoga is, do it every day.  It does not have to be much. It can be ten minutes.  But go for everyday.

-What kind of yoga.  Again, I believe there is a style of yoga for any and everyone.  Keep looking until you find a teacher who works for you, a style that works for you.  In group classes, DO NOT hesitate to make the practice your own and do wildly different styles than the rest of the room.  Most recommendations for chronic pain point to a gentle or restorative practice.  I can see the merit of this.  I know when I hurt like hell even gentle is near impossible.  However.  Those I know with chronic pain that has become manageable are people who manage it with Bikram yoga, running, Ashtanga yoga, or power yoga.  These are considered to be 'intense' or 'strong' forms of physical activities.  We can't do 100% all the time.  But we do push hard and do 'advanced' type things.  Don't assume that you can't do strong things - chances are you already do.  You've probably had children, or moved furniture at some point.  Having a diagnosis does not mean you can't do physical activity.  In my life, and those I know who have a grip on this pain thing, the intensity of a regular run or a hot yoga room is essential to our management.

-For some reason, movement helps.  Fascial studies are showing that a changing practice goes further than repetive, gym style movements.  Because 'trigger points' and fibro pain seems to have something to do with a pain 'remembered' though not actually really present in the moment, moving IN NEW WAYS and in different planes seems to ease and sooth and, for me, show me the parts of my body where pain is okay.  think of adding flowing movements, it doesn't have to be vinyasa but flowing from bridge to the floor, in addition to any repetitive (ie cycling, lifting, runner's movements).  Explore sensation, and find those that are good and interesting.  Try inversion, backbend, forward fold.  Do different things on different days.  Have favorites, but keep learning.  Relish the moments of 'hey, this is sweet'.

Food/supplement things that I've randomly found to work, and when I don't have, I will begin to slip:

-Avoid processed foods, refined flours and processed sugars.  Just do.  Do a little.  It gets easier.

-Eat more vegetables.  Three times more than you think.  Be aware that meat, dairy, wheat are all inflammatory and harder to digest.  Don't kick them, just balance them, and eat more green stuff.

-Figure out what 'inflammatory foods' and 'anti inflammatory foods' are.  Don't try to reinvent your kitchen.  Just try to add one of the soothers, notice if it's working, and add another.

-tumeric. you can find this in supplement form.  You can cook with it. I get the root at a little Vietnamese grocery and I put it in my juice.

-oral aloe vera.

-vitamins b and d.

-fish oil

-epsom salt baths.  lavender.  clove.  vertiver.

Blessed Be.

I do not like my pain.  I am too tired.  I want to teach, I want not to disappoint, I want to muscle through.

But, there is also a level on which my pains are acceptable.  They keep me honest.  They slow me down when I try to be too much to too many people, when I begin saying yes all the time.

And more than this, they have softened me to beauty and appreciation.  Yes, I hurt today.  But most days I'm playing with handstands, and able to teach others to play with handstands.  And I can cuss it all I want to, but it has given me a deep and abiding sympathy when I see the pain of others.  And the fact is, we all have pain, somewhere.  The fact is, we turn our lurching, mincing movements into dance.  We have to, or we get bitter and resentful and destructive.  Beethoven couldn't hear a thing when he composed his ode to joy.  The strongest people I know have survived things that would kill most animals.  And yet they hold children with a tenderness like the dawn creeping into the night sky.  They have bodies that hang together, against the odds.  They manage to get degrees, paint paintings, sing songs.

We are not perfect beings.  But we are good.

So I say blessed be the cracked, for they let the light in.  Blessed be the weary, for they are honest.  Blessed be the sore, for we are all sore, and we go on breathing anyway.