On November 26th, I presented at the Hillsdale Safe at Home Committee’s monthly Coffee Hour. This is text of my talk:
Good morning. Thank you for the introduction. And thank you all for coming. As you know my name is Franny Alexander. I am an RN and Yoga teacher, certified to teach chair yoga, yin yoga, and “Let Your Yoga Dance.” I am also qualified to teach restorative yoga and yoga for arthritis.
I entitled my talk Drink, Sleep, Love – Ways to Mitigate, Soothe, Treat, and Ease Chronic Pain. As we all know, there aren’t any instant fixes and one size does not fit all .
A few years ago I took a week-long program at the Kripalu Center for Yoga and Health, called Management of Chronic Pain for the Health Care Practitioner. Some of my talk will be based on the scientific, evidenced based studies documenting the many benefits of a wholistic approach to the management of chronic pain including yoga practices.
So we will begin by defining chronic pain… which could actually take up the whole class – maybe even a whole semester. So I will do my best to be brief, especially since I am not a scientist. We will talk about some ways to ease pain especially yoga practices. So OK – get ready- to practice standing on your heads. (ha ha)
First of all raise your hand if you never have had chronic pain…
Raise your hand if you do not have some form of arthritis…
Studies show that 1 in 4 American have chronic pain and 1 in 5 have some type of arthritis – so we are not alone.
Pain is described as an unpleasant sensation felt somewhere in the body. It is a sensory and emotional experience that can be acute or chronic and mild or severe. When it lasts for 3 months or more it is chronic pain.
We all have our pain stories -Right- I will tell you mine:
Briefly, about 20 years ago I went to the hospital’s “short stay” to have a routine procedure – D and C and somehow the doctor perforated my bowels, ovaries, fallopian tubes and my uterus – requiring extensive surgery – I woke up hours later surrounded by my family, including my sister from Florida. It was during that recovery period relying on my spiritual practices including yoga that I began to realize that there is a major difference between pain and the unpleasant feelings associated with pain (suffering)
So let me briefly tell you 2 stories which you may have heard to illustrate this – adapted from an old Cherokee fable and a Buddhist sutra.
Once upon a time, a grandmother was putting her granddaughter to bed. “Grandma tell me the story about the two wolves and the darts”. Ok, my child. “We all have two wolves living inside of us. One is calm, kind, resilient, and compassionate. She likes to help others. She is grateful. She enjoys walking in nature and being active. The other wolf likes to sit on the couch all day, complaining about this and that and judging others.” So grandmother, “Which wolf thrives?,” the child asks. The grandmother says “ The one you feed.”
Now Grandmother, what about the dart story? OK child (btw this story is really about two humans – one enlightened, one not – anyway)
Two wolves went for a walk. One was calmer than the other. She was a yoga teacher. Suddenly a hunter shot each one with a dart. The calmer wolf cries out in pain – then she tries to relax- takes a deep breath and settles down. The other wolf also cries out in pain but then she continues to become more agitated. “Why me,”she says and so on. She is hit with two darts – one is the dart of pain and the second dart, her perception of the pain, while the calm wolf was only hit by one dart . By this time, the child was fast asleep. I hope you guys are not!
All pain is real. But the story illustrates and research tells us that how you think about the pain can determine how it feels. We no longer believe in the mind-body duality. We interpret the pain in our brain. Our instinct is to believe the pain is where we feel it but when we have pain in a body part (no matter the cause of the pain) -the message is sent to the brain and a circuit is set up between the brain and the body. Think of it as “software” which is something we can choose to navigate and create new lines of communication and re-wire it with our thought. This “software” is actually many physiological and bio-chemical processes happening in our cells.
Thus the first wolf was hit with one dart – the pain but the second was hit with two darts, one was the pain and the second was his perception of the pain and it is this perception that can be modified.
In summary we know that pain is real, complex, but not immutable. The new scientific understanding of the the many physiological mechanism is fascinating to study and helpful. In fact understanding how pain works by your provider and yourself is the first step in managing it.
“Yet even so, best success for people in pain arises from their ability to view pain, people living in pain and pain care from many perspectives beyond biology and physiology “ ~Neil Pearson in Yoga and Science in Pain Care.
Two basic ways to ease chronic pain and boost your immune system are staying hydrated and getting enough sleep. I have handouts for you with some suggestions so I will just mention briefly:
https://peacemountainyoga.com/2018/03/14/drink-sleep-love/
WATER
We are 60 percent water. Water is needed to balance the functioning of every cell, tissue and organ in our body as well as provide nourishment for our joints, muscles and nerves. The feeling of thirst lags behind mild dehydration so when you are even slightly dehydrated you may notice some aches and pains, try reaching for a glass of water instead of an Advil. Perhaps the next time this happens, question -“Where is the best pharmacy around here?” It is right here in each of us actually – our bodies sometimes know more about what we need than the drug store.
SLEEP
Wow OMG- We could also talk about this for days so once again, I have prepared a handout for you and I have more information on my website. So very briefly, a healthy amount of sleep supports our immune system and helps regulate physical and mental functioning. So it follows that lack of sleep messes up the above. People with chronic pain and arthritis may have difficulty sleeping or wake up at night with discomfort. So this puts you in double jeopardy because the pain robs you of a night’s rest, so you experience fatigue during the day which makes you more susceptible to discomfort during the day. The Mayo Clinic suggests many ways to improve your sleep without relying on sleeping pills and here they are in your hand out.
LOVE
OK finally, let’s talk about Love. So I am not talking about romantic love right now. There are many forms of love in a spiritual practice and these practices bring more ease into your life. Very briefly there is “Metta” which means loving-kindness – it is a practice where you wish yourself “metta” first and then wish it upon others. Feeling compassion for others as well as genuine joy for another’s good fortune will also bring you peace and comfort. Practicing gratitude for yourself, your family, your environment, and Nature I feel is the highest form of love.
“You yourself as much as anybody in the entire universe, deserves your love and affection”~Buddha
Finally we are going to talk about self love practices and please keep this in mind always:
SELF LOVE IS NOT SELFISH LOVE
Some ways to practice self love:
-slow down -do 10 per cent less. eliminate non essentials
-unplug from devices
“Almost everything will work again if you unplug it, including you.”~Ann Lamont
-walk in Nature, keep a journal, get a massage (or two), watch sitcoms, volunteer, go out the movies and eat pop corn, get a puppy (or not), sing loudly in your car, take a cat nap, dance in the moonlight. The list can go on and on………..see my handout here:
https://peacemountainyoga.com/wp-content/uploads/2018/03/Love-handout-LG-v2.pdf
Life is what happens when you are busy making other plans~John Lennon.
YOGA
So finally, let’s talk about yoga. I truly believe that yoga is a self care practice that nourishes the body, heart, and spirit, and calms the mind. In other words it is a “broad spectrum antibiotic!”
Here are a few definitions although there are many more:
Yoga is the awakened union of the Breath, Body, and Mind ~Frank Jude Bocci
Yoga is the journey of the self, through the self to the self ~Bhagavad Gita
The highest spiritual practice is self observation without judgement” ~Swami Kripalu
“Yoga is a meditation on sensation and breath” ~Rudy Pierce
Of course yoga is “not about touching your toes, it is about what you learn on the way down” ~Judith Lasater
Keep this in mind: “We do not use the body to get into the pose, we use the pose to get into the body” ~Bernie Clark
So in fact yoga is an ancient science and philosophy developed in the east about 5,000 years ago . The word “yoga” means joining or “yoking” of the body and the mind. It is a journey to connect with your true nature, your authentic self and ultimately self transcendence.
Hatha yoga is the most popular yoga practiced in the west.
The esoteric meaning of hatha is “ha”which signifies the sun and “tha” which signifies the moon. Thus it is the yoga that unifies the power of the sun and the moon-male and female energies within all of us. This creates balance in our system.
Hatha yoga utilizes postures (asana), breath work, (pranayama), relaxation and meditative awareness.
The benefits of Hatha Yoga are many. Briefly the asana work on all levels and systems of the body creating strength, flexibility and ease of movement. A yoga practice can ease pain and reduce stress. (see details of benefits below)
Meditation:
https://peacemountainyoga.com/2018/02/01/guide-to-sitting-meditation/
Meditation (many definitions and many types of practices) is a practice of focusing your attention to achieve a sense of calm, awareness, and heightened energy. It is the space between your thoughts. Mindfulness is a form of meditation where you just notice thoughts, feelings and surroundings in the present moment without judgement or reaction. Today we will practice metta or loving kindness meditation. See link for details.
https://peacemountainyoga.com/2018/02/15/opening-your-heart-metta-meditation/
Briefly we will repeat a phrase about ourselves (a blessing to ourselves.) We will send this blessing to our loved ones or a particular person in need of our love and TLC. Finally we will send this blessing out to the world, perhaps visualizing victims of war or natural disasters. Here we go:
Close your eyes. Deepen your breath
Open up your heart and chest
Shoulders relaxed
Lift and lengthen your spine
Say to yourself after me 3 times:
May I be filled with loving-kindness
May I be well
May I be safe
May I be happy and free
Then repeat 3 times- May he or she or they be………
Then repeat 3 times- May they all ……..
Pranayama -a collection of breathing exercises developed by the ancient yogis for purification, mental focus, rejuvenation and healing. Prana means life force energy and yama translate into control or mastery of. A pranayama practice helps to still the mind and direct the flow of energy in the body.
Savasana – a relaxation practice done at the end of a yoga class that allows the body and mind to rest, unwind, and integrate the benefits of the previous yoga class.
In conclusion, yoga that incorporates the above becomes a journey inward resulting in self-understanding. It is a path leading to compassionate self-awareness, a strong, flexible body and a liberated spirit. It is a transformation that can lead to a more peaceful, mindful, grounded, and joyful approach to life.
Some Evidenced-based studies: This is how a yoga practice can ease chronic pain.
These benefits listed are from John Hopkins School of Medicine:
YOGA
- Yoga improves strength, flexibility, and balance
- Yoga helps with back pain relief
- Yoga can ease arthritis symptoms -it can reduce pain and stiffness in joints, increase range of motion and flexibility
- Yoga benefits heart health-regular yoga practice can reduce levels of stress, and body-wide inflammation, decrease BP and help control weight
- Yoga relaxes you to help you sleep better
- Yoga gives you more energy and can brighten your mood
- Yoga helps you manage stress. According to the NIH, evidence shows that yoga supports stress management, mental health, mindfulness, healthy eating, weight loss and quality of sleep
- Yoga can connect you with a supportive community
- Yoga promotes better self care
- Yoga is used in the treatment of cancer patients to decrease depression, insomnia, fatigue, and increase anxiety control
MEDITATION (also see above)
- Boost memory
- Improves mental health
- Improves sleep
- Increased attention
- Decreases pain
- Lowers blood pressure
- Fosters compassion
PRANAYAMA (also see above)
- Improves lung function
- Improves cognition
- Mental clarity
- Fosters cardio vascular health
- Improves mindfulness
- Reduces cravings
SAVASANA
Activates the parasympathetic nervous system- does some of the above as well as releasing muscle tension, improves sleep quality for sure ,regulates BP and emotional stability
Some Science behind the above -yoga can change your biochemistry-hence the physical and mental benefits.
BDNF – (Brain-derived neurotropic factor – Protein to keep your brain neurons healthy and maintains neuroplasticity and yoga can increase this protein and this helps to relieve chronic pain and decrease depression
GABA – (Gamma-aminobutyric acid) – An increase in this acid after yoga or meditation produces calmness, decreasing stress- it is like pressing a relax button.
Serotonin Surge – Yoga can increase serotonin levels (low levels can contribute to depression)
Adrenaline and Cortisol – Yoga can decrease these stress hormones.
Dopamine Regulation – Yoga helps to maintain balance because when it is out of whack it can be linked to unhealthy behavior such as addiction
(this is from The Science of Yoga by Ann Swanson) She claims that even a small practice can lead to big changes- the positive momentum can begin )
FAVORITE QUOTES
Knowing yourself is the beginning of all wisdom ~ Aristotle
Every living being is a stream of love ~` Swami Kripalu
There are probably things in your life from which you can unburden yourself ~Richard
Be kind – everyone you know is fighting an uphill battle
The only path wide enough for us all is love ~Kamand Kojouri
We can take a nothing day and suddenly make it more worthwhile ~Mary Tyler Moore
The heart knows a thousand ways to speak ~Rumi
There is a voice that doesn’t use words listen ~Rumi
Happiness lies not in figuring out what is missing, but finding out what is present ~Tara Brach
Turn inward to face yourself
The only power our thoughts have is the power we give them ~Joseph Goldstein
Leave the familiar for awhile let your senses and body stretch out. Change rooms in your mind for a day ~Hafiz
Don’t close the barn door, just because the horse has left ~a yoga student
The only way out is through ~Robert Frost
You have no need to travel anywhere
Journey within yourself
Enter a mine of rubies
And bath in the splendor of your own light ~ Rumi
The quieter you become the more you hear
HELPFUL RESOURCES FOR PAIN RELIEF
- Mindfulness Meditation for Pain Relief – CD or audible by Jon Kabat-Zinn
- Yoga Therapy for Arthritis by Dr. Steffany Moonaz
- Relax into Healing – Pain: Softening the Sensation with Nancy Hopps -CD and booklet
- Why we Sleep -Unlocking the Power of Sleep and Dreams
- Yoga for Pain Relief-A new Approach to an ancient Practice by Lee Albert, NMT
- You are Not your Pain by Vidyamala Burch and Danny Penman (includes a CD)
- The Healing Power of the Breath by Richard P. Brown, MD and Patricia L. Gerbarg, MD (includes a CD)
- Meals that Heal Inflammation by Julie Daniluk, R.H.N.
- Relax into Healing – Pain: Softening the Sensation with Nancy Hopps -CD and booklet
- Restorative Yoga-A step by step guide to complete relaxation with Sudha Carolyn Lundeen-DVD
- Yoga Nidra- Divine Sleep Yoga Nidra-Healing by Jennifer Reis on YouTube or her CDs
- Relax into Yoga for Seniors- A six week program for strength, balance, flexibility and pain relief by Kimberly Carson and Carol Krucoff
- Yoga for Healthy Aging -A guide to life long well being by Baxter Bell, MD and Nina Zolotow
- Insight Timer is my favorite APP – it actually has thousands of tracks on guided relaxation, healing, gratitude practices, meditation, calming music, yoga, spiritual guidelines in various disciplines etc for example: Pain Relief Meditation with Dr. Kim Lye
For more information -see the video, Tame the Beast by Professor Lorimer Moseley,PhD -rethinking persistent pain on youtube but also on his podcasts – Introduction Why Pain Matters- and other episodes about how pain works and latest developments in treatments and how people recover based on extensive research with robust clinical trials.
He feels that the physician should have a clear knowledge of how pain works in order to work with patients.