We get many people coming to our student acupuncture clinic with chronic pain. Some are looking for a solution that avoids surgery, or reduces the need for painkillers; others have tried everything and acupuncture is their final, desperate recourse! (Charming!)
Chronic pain is a strange phenomenon. In many cases of musculoskeletal injury, the actual tissue has long repaired itself, but still the pain lingers, as though the brain is stuck in a habitual and unhelpful loop. There is no longer any need for pain signals to tell us to protect the area, yet still the nervous system persists.
Not only can our nervous response to pain be baffling, but so can our psycho-emotional response. People tend to mentally separate pain out from themselves. They take ownership of it (“My bad leg…”). They even, as with one patient we had recently, actually personify their pain and give it agency: “My bad back doesn’t like it when I move like this.”
Is this healthy? On one level, it is an instinctive coping mechanism. Like anything else for which we feel aversion, we naturally want to push it away, remove it from our experience. So this mental trick of objectifying pain is our mind’s way of reducing it. The trouble is, it just doesn’t work. In fact, by solidifying it as a definable “thing”, we’re probably making it worse. We’re probably embedding it deeper, entrenching it into our daily experience. This mental response could even be the very thing that is blocking our ability to heal.
I discovered a wonderful little book recently, called “Pain is Really Strange”, by Steve Haines, and illustrated by Sophie Standing. Laid out in comic strip format, it makes for a short but entertaining and enlightening read. The main thrust of it is that pain is not the simple, mechanical response to injury or dangerous stimuli that most of us imagine it to be. It’s much more complicated than that. And thoroughly subjective, too.
Haines gives various examples: there is one person who felt agony at the merest touch of a feather, and another individual who ran a race with a broken leg. Surgeries to remove nerve endings around painful cancers only result in the pain returning later, and more severely. I’ll refrain from summarising the whole text, but it suffices to say that pain is… er… well, it’s really, really strange.
But it is an entirely malleable phenomenon, and chronic pain can be reduced – even cured. Even understanding our pain better can help to reduce our experience of it.
Acupuncture can certainly work, too. In Chinese Medicine, pain is viewed as a stagnation of Qi and Blood. By needling appropriately, we can instruct the central nervous system to move energy in the relevant channel and shift the area of stagnation. Unblock the dammed river and get things flowing again.
In fact, in many cases, working to retrain the brain is a far better strategy than painkillers or surgery. Haines suggests a few techniques, including the visualisation of joyful and free movement, and also changing our linguistic relationship with pain.
Often, the problem is compounded by the language and metaphors we use. We talk about “combatting” pain, and view it as our enemy – something outside of ourselves. Perhaps this dissociative relationship is only further embedding our experience of pain? Perhaps it would be far better to feel and accept the sensations we experience, and refrain from labelling it as “pain”, or even something “bad”, at all?
This is easier said than done, of course, and I certainly don’t mean to belittle people’s experience of chronic pain, but there is much evidence in mindfulness research that the meditative technique of refraining from overlaying judgements on our direct experience is in fact an extremely healthy approach. As a way of dealing with chronic pain, which seems to be as much a habit of the mind as anything else, this attitude of detachment and acceptance, this method of direct perception without subsequent labelling, could be a crucial part of the healing process.
Then, of course, there’s the obvious response to a state of stagnancy… move! Literally, physically move. Move the body, move the blood, move the lymph, move the Qi. Move in small ways. Move in new ways. We all intuitively know that if we sit still for prolonged periods, our bodies get clunky; we get aches and twinges, we lose our flexibility and our connection to our physical selves. Muscles shorten. Joints stiffen. I have definitely seen a huge increase in suppleness and fluidity of movement since I started practising yoga, Qigong, Taijiquan, and Baguazhang. Better posture. Better connectedness. More relaxation. Less stiffness. Less pain.
By viscerally connecting, immersing, your mind into your body, yoking your breath, and switching off your headphones, you can reach unimagined levels of inner awareness.
Which brings me to the solution to pain that Haines seems to emphasise most: we should seek to increase our skills at proprioception and interoception. In simple words, we should learn to look inside. By increasing our awareness of our own bodies, we can reduce our experience of pain. The parallels here to Daoist meditation techniques are uncanny and undeniable. Neidan (internal alchemy) methods incorporate looking at and listening to the internal body with a great deal of sensitivity and detail, employing contrasting methods of both stillness and movement. Neidan teaches us to explore our thoughts and our breath, and to fully inhabit the physical body, by feeling the internal organs, paying attention to inner spaces and structures, feeling sensations, and becoming aware of inner processes, all with a mindset of calm, detached curiosity…
… It would appear that modern pain research may have just “discovered” the benefits of Daoist meditation and Qigong in the same way progenitors of western dry needling techniques “discovered” the efficacy of acupuncture!
Oh well, we may be a few thousand years behind the Chinese, but we get there in the end…!
Haines’ book is excellent, and I highly recommend it, but it is particularly interesting when viewed through the lens of traditional Chinese health practices. It turns out that our best recourses to reducing pain are a combination of Daoist meditation and mindful movement, such as Qigong, yoga, or martial arts. Or dance. Or swimming. Or running. Or walking. Anything, really, as long as it is done with our fullest attention and awareness.
What’s more, establishing a meditation and mindful movement practice won’t just help you to deal with pain; it will help you to relax and let go of all sorts of anxieties, ruminative thinking patterns, stuck and attritional emotions, self-doubt and negative thoughts, lack of confidence and motivation, emotional trauma, unhealthy cognitive loops, habitual responses, unconscious and automatic behaviours… the list goes on!
Haines reassures us that pain is plastic, and we can change it in a similar way to learning to write with our weak hand. It requires small steps, gentle persistence, and a creative approach to retraining our own minds. Pain is a subjective phenomenon, and as such it is within our capacity to change it. We all know experientially that if we tell ourselves something is going to hurt, then it probably will.
The Azure Dragon 