Brace Yourself!
Let’s talk flare-ups for a second. Those who have dealt with chronic pain flare-ups will have no problem imagining the following scenario:
Imagine yourself on a regular morning, you are on your way to your car, maybe it’s a normal workday and you’re about to embark on your daily commute, or maybe it’s the weekend, and you are on your way to a family gathering. You didn’t even get into the car yet and there it is “£!>@F*!!’’ a shooting pain in your lower back. Or maybe it is the start of a migraine for you? Or maybe you are dealing with excruciating pain all over your body, starting in a familiar place and then moving around, becoming worse every second.
1 in 5 adults suffer from chronic symptoms, and whichever your flavour of chronic pain, it just always shows up when we least need it, doesn’t it? Either as a shooting stabbing surprise or a slow creeping sensation and you know exactly where it will go. Agony station! Yep, here we go again…
When that happens, what is the first thing we do? We brace ourselves for what’s about to come, right? We tense up, involuntarily but automatically, our thoughts remind us about how bad it was last time, and we anticipate the worst. This often leaves us no choice but to call in sick or cancel our plans and on top of everything feel guilty for having to do so, AGAIN.
The Pain-Fear Cycle
What really happens in our body when we brace ourselves and resist the pain? Our brain receives confirmation from us, through our reaction and behaviour that we are indeed in danger, and thus sends even more pain to warn us. Because in reality that is truly what pain is: a warning signal from our brain. Our fear of the pain turns the pain dial up, like a volume button for pain, as Dr. Rachel Zoffness so beautifully explains in her book The Pain Management Workbook.¹ The more we fear, brace, resist the more we tell our brain it is right to send these danger signals, and here the pain cycle takes us from bad to worse.
The next step is usually to start avoiding certain activities or movements altogether, because we flagged them as dangerous. As a result, we are creating a neural pathway in our brain, a pain pathway, and this pain pathway gets engraved deeper and deeper over time the more proof it collects about the perceived danger. We are basically ‘practicing pain’, just like when we practice playing a musical instrument, and the more we practice, the easier it becomes for our brain to ‘launch the default response’, because it becomes more and more familiar.
What started out as a warning signal, becomes a debilitating cycle that only worsens overtime if we do not break the cycle.
[Note: I am not talking about the pain from a broken bone, or any other form of acute pain. This refers to chronic pain, or reoccurring symptoms, that seem to come out of nowhere and are usually not detectible on scans].
The Risk of Numbing
What usually happens in these cases is that we find ways to numb and take medication to “stop the pain”. This is understandable, especially when it is the only thing we have access to, it is the default prescription to chronic symptoms. The trouble here is that medication often does nothing but mask the symptoms, it doesn’t actually make it go away. Not only that, in the case of chronic pain, long-term medication usage might even be making the pain worse.
Research has shown that medication does not desensitise a brain to pain in the long-term. In fact, the opposite happens, that over time what opioids do is to sensitise the brain to pain.
“At high doses, opioid painkillers actually seem to amplify pain by changing signalling in the central nervous system, making the body generally more sensitive to painful stimuli”,² writes Kelly Servick in Science, describing the phenomenon called opioid-induced hyperalgesia (OIH).
The same is confirmed by Harvard Medical School, in an article by Shafik Boyaji (MD) & David Boyce (MD):
“Researchers have looked at many patients who were taking opioids for long periods of time and compared their pain tolerance or pain sensitivity to that of patients who were not taking opioids. Researchers also compared patients’ pain sensitivity before and after starting opioid therapy. In both cases they found that administration of opioids paradoxically increased sensitivity to pain and made pre-existing pain worse, and higher doses of opioids were associated with higher sensitivity to pain.”³
Conclusion: the standard ‘solution’ (meds) for chronic pain sufferers is not a solution at all, and even with all the research pointing towards this fact, it is still the go-to approach in the medical world, keeping people on this downwards spiral.
Somatic Tracking
Now let’s talk about what can help counters all of this pain inducing, pain increasing, painfulness. One technique has proven to help turn down the pain dial is somatic tracking. How does it work?
During somatic tracking, what you do is to let the pain come over you and instead of bracing yourself and tensing up, just to sit with it. It might not be easy, especially in the beginning, nor is it a quick fix, but it is super powerful, and overtime actually works.
Why? Because when you do this, you are basically telling your brain that whatever this sensation is, it is SAFE. Sending your brain messages of safety, will decrease the brain’s perception of pain and will turn down the pain dial. You are basically collecting new proof and it teaches your brain to “reinterpret signals from your body through a lens of safety, thus deactivating the pain” explain Alan Gorden and Alon Ziv.⁴
During this exercise you work on the fear. By reducing the fear response when you experience a flare-up, you start sending new messages to your nervous system that you are in fact safe. Over time, these messages of safety will overwrite the messages of danger, and this will make the symptoms decrease as well. On top of that, somatic tracking is a form of introspection and helps us to reconnect with ourselves. By allowing the sensation to be, and getting curious rather than pushing it away, we can go within. When we go within and start listening to our body, rather than trying to silence it or distract ourselves, this can
Conclusion
You may have been told medication is the only thing you can do for the pain but know that it does nothing but mask the symptoms, it is simply no long-term solution for chronic symptoms.
One technique that has proven to work is somatic tracking. By sitting with your pain, allowing it instead of resisting it, and becoming a curious observer of your bodily sensations, you can help overcome the fear of the pain. Fear is what sends the brain danger signals and these turn up the pain volume. You want to send you brain and nervous system messages of safety, to overwrite the pain pathways that have become ingrained overtime.
So, I encourage you, try it out. Sit with your pain and tune in to your body rather than tune out or numb. It will take some practice, but it can help you significantly reduce your symptoms overtime. If you need help doing so, you can search for a somatic tracking audio, to guide you through the process. I created one that I share with my clients, which you can find here.⁵
Let me know how it goes for you, and feel free to reach out in case you have any questions or comments at info@risefromchronicpain.com
Have a lovely day!
Sources
- The Pain Management Workbook: Powerful CBT and Mindfulness Skills to Take Control of Pain and Reclaim Your Life, by Rachel Zoffness, New Harbinger Publications, 2020
- https://www.science.org/content/article/why-painkillers-sometimes-make-pain-worse
- https://www.health.harvard.edu/blog/more-opioids-more-pain-fueling-the-fire-2019070817024
- https://www.curablehealth.com/podcast/what-is-somatic-tracking
- Somatic tracking audio by Rise from Chronic Pain: https://www.youtube.com/watch?v=0031wR2cWHI
Main – Photo by Kourosh Qaffari
