This happened about ten years ago. Upper back pain that CTs, MRIs, PTs shed not a shred of light upon. One PT duck taped my back to try and prevent me from moving in the manner that caused the most pain. This was, unsurprisingly, ineffective. The musculature in my upper back would progressively seize up at night. The longer I was immobile, the tighter it became. The tightness could take my breath in certain positions. Once I was up and remobilizing with specific movements (1) it improved drastically but the pain still lingered until it was time to sleep again. Then the vice would start tightening.
I don’t know what brought me to the realization that the pain was both psycho-emotional and spiritual. I think it coincided with the time I was questioning my purpose in the world and starting to see that for me anyway, certainly, life was so much more than climbing the corporate ladder. And in the heavy backdrop, my mom had been diagnosed with ovarian cancer. The one who always told me how short life is. At work, my entire product line had been recalled by the FDA. And last but not least, I was living in St. Louis with an MBA course load far from family and close friends. It was a place I knew shortly after arriving that I would leave the first opportunity I got. At that point, I had been living in STL for three years.
A disregard for what lies beneath the obvious, in this case, the potential psycho-emotional and spiritual components of pain are potentially why there are so many cases of what is termed non-specific back pain (2). Yet, back pain is one of the most common medical problems affecting 8 out of 10 people at some point in their lives. Of course, there are other causes that may include:
- Non-specific – caused by over-use, an injury or deformity – sprains (over-stretching/tear of ligament), strains (tendon or muscle tears) tight hamstrings, sciatica, alignment disorders, osteoarthritis, sacroiliac dysfunction (3)
- Neurological (specific): nerve root compression caused by herniated disks, stenosis, piriformis syndrome (3)
- Underlying conditions such as infections, tumors, kidney stones, arthritis, osteoporosis
In my case, when it started happening again a few months ago, I knew from past experience that it was a barometer of how things were going (or not going as was my perspective) in my life. Neal Pearson, PT, says: “We feel pain when our brain decides that something dangerous is happening.” The danger my nervous system was registering was not a bear chasing me down, it was fear. Fear of failure, what’s next, why is this happening, the usual questions that batter one’s self-esteem and ability to stay open among other things. Instead, I was shutting down, shutting down to possibilities. Pearson also says: “When the pain is more intense the system is trying to get you to change behavior” and that the most effective way to manage pain, chronic or acute, is by intervention at the level of the body and the mind. Further, there comes a point where ignoring it is not a good idea. This is where an integrated yoga practice can be so powerful. Yes, walking and other physical activity is helpful because it mobilizes my structure and to some degree my mental state given the endorphin boost but I need more support to calm my mind, buoy my spirit and nourish my heart. A carefully structured yoga practice with the right components can do this. This is the art and science of the approach that I take as a Yoga Therapist for myself and my clients.
I also needed a multi-pronged approach. I saw a holistically oriented chiropractor, a Chinese medicine practitioner, and endeavored to be more mindful of my mind. Essentially, what I was telling myself. It wasn’t good. In Michael Singer’s wonderful book, The Untethered Soul, he suggests imagining the mind as your roommate. Not too long after sitting on the couch with your “roommate,” you’ll want to get as far away as possible! Your roommate tells you things over and over and over, (s)he jumps from subject to subject, telling you things that aren’t very positive and things that fly in the face of reality. Ah, and here’s where so much of our suffering comes from: our inability to see things as they truly are. That in itself merits many books.
In the tradition of Yoga and other systems of mind/body medicine, imbalance is said to exist at the more subtle levels of our being (4) before they manifest in our structure, or annamaya kosha. Another case for what lurks beneath the surface of that iceberg. It is not my intention to negate other causes of back pain as listed above but rather, to encourage a more holistic approach to your pain, no matter where it has decided to manifest.
As for what I ultimately did, stay tuned for next month’s blog. Meanwhile, be curious about what your pain might be trying to tell you.
Warm Holiday Wishes,
THIS IS NOT A SUBSTITUTE FOR A MEDICAL EVALUATION
(1) It’s sometimes difficult to start moving but in many cases, this is what’s needed to relieve pain. Please see a doctor immediately if you experience burning sensations, tingling, numbness, or incontinence.
(2) Effectiveness of treatments for acute and sub-acute mechanical non-specific low back pain: protocol for a systematic review and network meta-analysis , Gianola et al., Systematic Reviews, 2019, 8:196
(3) www.clevelandclinic.org Chronic Back Pain
(4) There are five koshas, or sheaths, the other four being: pranamaya – the energetic/animating force; manomaya – the mind; vijnanamaya – the intellect/wisdom; and anandamaya kosha – the soul, bliss, or heart center
Image Credit: Inside Science