Chronic Pain and how Somatics might help
Updated: Oct 18, 2022
I hate the word ‘chronic’. It sounds, well….. kinda chronic! In medical terms, chronic pain is considered to be pain lasting longer than 3 months, which is the longest expected healing time for most new injuries. However, some tissue healing, particularly if it is widespread or in more than one part, takes longer than average. Or there are some tissues, tendons for example, where the healing is normally slower because the tissues do not have a good blood supply…this is for good functional reasons ( it gives them greater strength).
But, in cases where the pain exceeds the expected tissue healing time, then we suspect that other factors are at play other than the injury itself. So, if you have persisting pain, the first port of call is your GP. There are lots of simple medical reasons why you may still be experiencing pain and these should be ruled out or treated . For example: Low back pain may be caused by kidney problems and all the exercises and physio in the world won’t fix this!
But let’s say, you have had all the blood tests, X-rays and investigations done, there were no major findings and you are still experiencing pain in muscles, joints or nerves, then you may well have that horrible term…chronic pain. But help is at hand.
All the recent pain research is allowing us to understand the very real mechanisms for this and allowing us to think of treatment options, and somatics is just one of those.
In many cases, your nervous system is now overly sensitive and causing you to have pain, even though your tissues have healed. And before you throw your eyes up to heaven, think about this: some people have really sensitive skin, others have really sensitive digestive systems. What if YOU just have a really sensitive nervous system??? And it’s causing you to have pain…..
Let’s go back to the skin thing: People with really sensitive skin can only wear very few creams or lotions or else they break out in rashes/inflammation. They can’t eat certain food or their skin ‘breaks out’. They may be really sensitive to hot or cold and most of them have skin eruptions when they are stressed….all those stress hormones running around their systems cause massive inflammatory reactions in their skin. They are not considered weird or abnormal, they just have sensitive skin.
Ditto with sensitive digestive systems: these people find that certain foods cause them to bloat or become constipated/cause diarrhoea. If things are very inflamed they make not be able to exercise without pain. Stress and the associated stress hormones are usually a big factor in exacerbating their symptoms. There used to be no credance given to people with these conditions, but that has changed and now stress management and diet and core tenets of managing their condition, along with medications.
So is it beyond the imagination to think that some people have very sensitive nervous systems and are more prone to getting chronic pain than others? Whereby an injury can aggravate the peripheral nerves more than in someone else? And that there should be no shame in that? Sometimes, it feels to me that people are blamed for STILL having pain….but I think it’s also fair to say that many people with chronic pain are stuck in the loop of looking for someone to find the fix for their damaged tissues, when ‘the fix’ has often to come from their own investigations and being open-minded enough to look at the pain science and accept some of it.
Here is what the pain science says:
- Pain is made worse with lack of sleep ( not easy, you say, when I’ve got pain…true)
- Pain is made worse by stress, again by the effects of cortisol on our peripheral nerves and brain ( by the way, in my book, stress includes fear, anxiety, perfectionism, high standards and the worst culprits are the people who don’t recognise their own stress….sorry, folks!)
- Pain is affected by your beliefs ( fears, anxieties, perfectionism, I can’t be weak, I must push through, anger that the accident wasn’t my fault, it’s not fair, guilt for feeling like this, anger at not being listened to). It’s ok and natural to feel these things and they shouldn’t be denied…. but dwelling in just one state of mind all of the time may not be helpful for your recovery. Worst of all is the belief that I have no control over my pain…how frightening that must feel.
- Previous trauma, both physical and emotional, sensitises your nervous system to pain.
- Pain is made worse by avoiding all activities that cause it and also by doing too much.
- Pain can be made worse by poor breathing patterns ( more of that in a later blog). Most people, who have long term pain have a very poor breath pattern: either holding their breath or breathing in a very shallow and fast way.
All of these, put your nervous system into a state of high-alert, also known as the stress response or ‘fight or flight’ mode. This makes you more prone to experiencing pain to a greater degree than others. Also I suspect, there may be genetic factors at play. It’s not your fault!!
Pain is reduced by taking your nervous system out of this high-alert state.
- Laughter and doing things you love ( even if they have to be adjusted for pain) create endorphins or ‘happy chemicals’ that soothe your nervous system….watch that funny movie!
- Understanding all the pain science and not feeling that recovery is beyond your control
- Not surprisingly, good sleep
- Good pain control (medication) when you get exacerbations or indeed pain injections are helpful for nervy pain.
- Learning your triggers for pain and finding ways to overcome them – in other words, you regaining some degree of control over things.
- Exercise is good for your nervous system, in the right doses. Staged activity where you learn your ‘tissue tolerance’: how much to push and then gradually increasing it is important.
- Finding ways to manage anxiety, fears and stress also reduces the stress hormones that are wreaking havoc with your system.
- Therapy ( talk therapy or non-verbal methods) to overcome previous past emotional trauma may be a factor in reducing sensitivity of the nervous system.
- Learning how to breathe correctly….( simple concept, but not so simple to do for some!). This is the basis of yoga, T’ai Chi and Qi Gong for a reason – it stimulates the soothing aspect of your nervous system. See my youtube video on how to breathe better here.
So how can Somatics help?
Well, firstly, what it DOESN’T do is deliberately stretch and move your painful part. This may happen, but it’s not the main aim. Somatics is not exercise, it is movement exploration.
It teaches you to explore movements in your body and learn how other distant parts may be tensing in response to moving . In other words, muscles are over-reacting to movement and sometimes to just the thought of movement. Somatics can help you to become aware of this so that you can change it.
Somatics teaches you how to overcome these tension responses to movement, allowing movement to become more relaxed. It teaches you how to un-tense.
It stimulates a relaxation state, soothing your nervous system ( also called a parasympathetic state)
All that concentration aimed at your body movements helps to still the mind, also reducing the stress response.
By learning which movements FEEL good and nice and non-threatening, somatics can teach your subconscious mind ( the one that feels a threat before YOU do) that some movements can be pain-free and pleasurable. It helps to re-wire the part of your brain that is putting your system in high-alert. Just like someone who has been in crutches for weeks still limps once they are off them, even when there is no pain, your subconscious may be trying to protect you from a threat that is no longer there. This makes you move differently. By working on distant areas first, you may then be able to progress to moving your sore area and controlling your tension response to that.
Here's a good one: Is it ages since you have 'felt like you'? By learning the movements that feel good, you might even get that feeling of being YOU again....nice thought, eh?
Somatic Therapy can be used to heal PTSD and other previous traumas. Be aware that my classes are not therapy, but may give you the experience to explore this more with a somatic therapist. Here is my take on it: just like smells can bring back a memory, so certain movements can also trigger a memory, particularly when your brain STOPPED those movements and prevented you from doing them. By re-learning those movements in a safe environment, you may be able to access your emotional responses to a memory and work with a therapist if needs be.
But let’s be honest, it’s not for everyone. You may find other ways to soothe your nervous system and your movement that work better for you. Email me for more information, or read my other blogs about Somatics.