As an athletic therapist, I often work with individuals faced with managing painful conditions in the short and long term.
Many conditions or injuries do require surgery to repair underlying issues. That said, many pain-related symptoms do not require surgical intervention to alleviate.
Pain and other uncomfortable sensations occur for many reasons, often entirely unrelated to the localized area in which pain may be experienced. Pain is a sensation our body uses to get our attention and is one way our body tells us we are experiencing a threat or stressor. Interestingly, research now shows that our nervous system, the system largely responsible for the experience of pain, does not differentiate between a real or perceived threat. This means we can experience pain for more subjective reasons just as much as we can because of a direct trauma or structural issue.
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This is not to suggest we should ignore or avoid signals we receive from our body, including pain. Pain exists to get our attention, and until it receives acknowledgement and appropriate response, it will only increase in volume. Pain that does not change with time or context requires further investigation and should never be ignored.
Modalities I’ve found useful for clients experiencing pain include manual therapies such as massage, acupuncture, regular movement practices, breath practices and mindfulness-based practices.
Touch is extremely therapeutic to our very sensitive nervous systems. Humans have used touch as a form of healing for as long as we have existed. The tactile sensation of receiving touch in the form of massage or other manual therapies can make a big difference to how we perceive our environments, meaning the signals of pain can often be changed through this medium.
Likewise, movement can help to re-orient our nervous systems to a more resilient state and help us increase our threshold for life’s experiences. When we have a wider threshold for life, we tend to have less reason for our system to perceive threats. Our sensitivity to things that might cause pain responses becomes more attuned and less likely to react unnecessarily or out of context. Intentional movement of any kind — specifically, any kind that interests you and challenges you in meaningful ways — is one of the most consistently proven ways to help shift our internal states physically and emotionally.
For those dealing with pain, it can feel very uninteresting to pursue movement-related strategies. Whether it’s pain in a specific area of the body or a more generalized experience, it’s important to be aware that pain is not always indicative of something being physically wrong. Sometimes movement needs to be as simple as a short walk once or twice a day, or moving through a few stretches, even in areas that are not experiencing pain. Starting small and easy can often have a compounding effect.
For example, try intentionally slowing down movements you do anyway routinely in your day. This could include washing your hands or washing your hair. Slow this action down as much as possible and really pay attention to the sensations associated with this everyday movement. Slowing down movements like this also helps to calm the nervous system, which in turn lowers the volume on a pain response.
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Another go-to suggestion is to move each joint respectively in its pain-free range of motion, working your way up from the toes through the rest of the body. Slowly wiggle the toes, draw circles with the ankles in both directions, bend and straighten knees, move the legs side to side to move through the hips, from standing or sitting, reach toward the toes rolling forward through the spine and then roll up and reach toward the sky, shrug and release the shoulders, roll the wrists in circles, bend and straighten the elbows, and look in all directions with the head and neck. Repeat these two to three times per day.
Because sensations like pain are very interconnected to our neurological state, working with the breath can help shift our experience relatively quickly. Regulating the nervous system with the breath is one of my first recommendations for most of my clients. A simple practice of inhaling and exhaling for equal lengths of time for about two minutes a day or more is a great place to start. This practice has been shown in the long term to support healthy blood pressure, lower anxiety, support sleep, decrease chronic pain and improve digestion, among other things. I recommend aiming for four seconds on the inhale and four seconds on the exhale to start; however, starting with less time in and out is OK too.
When we can build a capacity and an awareness to acknowledge a sensation such as pain and sit with it — not unlike what we’d do for a friend experiencing pain — we often begin to change the discomfort associated with the pain itself. When pain gets our attention and we listen, we receive clues as to what the next appropriate action might be. When we can’t do that for ourselves, it’s important to seek guidance from professionals who can work with you to appropriately address the reasons why you are in pain.
