08 Aug When You Can’t Stop for Pain
I have talked in previous blogs about taking care of yourself when you have pain by taking regular movement and rest breaks. However, we don’t always have this choice. And sometimes a situation has developed where doing something for only a short duration triggers the pain. You still have to get on and finish. What do you do then? Grit your teeth and bear the pain to get the task finished?
How can we modify the way we do things to make them less pain provoking?
A helpful thing to understand about pain is that is your nervous system ‘talking to you’. When you are feeling pain out of proportion to the work involved e.g. when just an hour or two of sitting, or lifting a few light weights is painful, this is often* because your nervous system is sensitised, and is overreacting to normal signals from the tissues.
The advantage of knowing this is that we can help the nervous system to gradually calm down with quite small changes. Just doing things in subtly different ways can give some relief from pain quickly, and that in turn can help the nervous system be less on ‘high alert’ (more on this next month)
We often have habits in the way we do things, particularly the daily routine things that are practised a lot and therefore have strong ‘pathways’ in the nervous system.
Think about cleaning your teeth: you probably do it in the same way, everyday, twice a day. I expect you don’t think at all about how you are doing it. There will be lots of habit embedded in that task – the way you stand, the way you grip the handle, how much force you use, how you bend over to spit, etc.
If cleaning your teeth caused you pain, changing how you do it would be challenge, because you do it largely unconsciously. (Cleaning your teeth is not a big pain provoker generally because its only for a couple of minutes, and its not highly stressful, but it’s a good example of a daily task that we do unconsciously. And some people have pain doing even these everyday things. So bear with me….)
Here are some ideas for getting past your habits.
using your non-dominant hand
I.e. using your left hand if you are right handed. Not only does this give your right side a rest, you will not have such strong habits in what you do, so you are less likely to press harder than you need to for instance. It can be tricky relearning a skill with the other hand, so you might just want to change over for a few moments at a time to begin with. But if you are learning something new, why not try with the non-dominant hand from the start?
Pick one aspect of the task to change
For instance you could concentrate on using the minimum effort with the arm, how much you lift the elbow and contract the arm muscles. This might seem like a small change, but it can make quite a difference to how something feels, making it less effortful and less pain provoking. It can be difficult to notice how much effort we are making doing tasks, but just starting to bring this into our awareness and literally’ toning it down’ can help us to be less ‘switched on’ and tense, which is really helpful for calming pain.
This can make things more comfortable in itself, and/or can serve as prompt to do the whole task differently. So, say when cleaning your teeth you normally hunch over the sink. Make one change: you will stand upright, and bend at the hips to get down to the sink. If the teeth cleaning provoked back pain, this might help a lot in itself. If it was the arms that hurt, standing differently would be out of your usual habit and would prompt you to be more mindful of the whole task e.g. to pay attention to how hard you are gripping the brush, and thinking about how you cleaning your teeth, rather than furiously brushing while worrying about a meeting you have later.
Changing from a manual to electric toothbrush would make the experience very different for a while. It may eliminate straight away some unhelpful habits, like brushing too vigorously (putting in more effort than you need for a task). Because it’s different, you will notice teeth cleaning for a while, so it would be a great time to introduce new habits e.g. doing it as a mindful activity rather than a stressy rushed time, or using it as a time to ‘think up’ (standing more upright but with minimal effort), rather than be collapsed or tense. This is so much easier to do when there is already novelty and your brain is paying more attention to the task.
Ok, teeth brushing is trivial activity, but could you think of ways of changing something that is pain provoking for you?
This is where changing your chair or desk set up can be effective in itself, by putting you in a slightly different position, so it changes the input to your nervous system. This can be helpful, sometimes permanently, but often the benefits wane because there is still the fixed position + stress combination ( see here)
However, if you use a slight change to your set up, eg a wrist support, or a different chair, as a prompt to awareness of your tension habits and how often you take breaks, you can use the change to establish a new way of looking after yourself.
Similarly changing the set up of your bike might help you to be more comfortable, but if you use that novel feeling of the new set up as a reminder to not be tense, or grip the handles too tightly you will get even more benefit long term. As the bike set up becomes more familiar hopefully some of the new habits will carry on.
Some of these changes may be useful permanently, but some may only need to be temporary. If you have a movement or position that causes you pain you may not have to avoid it forever! See next months article about calming the nervous system for reasons why.
In Alexander Technique we use all these kinds of modifications of movement, positioning and the way of thinking about what we are doing. This helps you keep active and doing what you need to do, and what you enjoy. These ideas help us while we learn other aspects of the technique, such as how to notice how much effort and tension we are using, and reduce it to the minimum, which can take a little time and some hands on input. The idea isn’t to be prescriptive e.g. ‘you must bend with your hips to avoid back pain’, but if bending at the hips helps your back pain and makes movement easier, let’s learn how to make that a habit. Then when your back pain is calmer because it isn’t being provoked all the time, we can relearn rounding the back in a lengthened expansive way that doesn’t cause pain.
Getting out of a ‘stuck’ habitual way of doing things can kickstart recovery from pain.
How could you make small changes to what you do to avoid provoking your pain?
How could you establish them as habits?
*this article is not a substitute for medical advice. If you have concerns, especially about new or increasing pain please consult your G.P
Would you like some help changing how you do things so you can keep going without the pain?
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