Relax and enjoy this moment.
You’re on a white sand beach at just before dusk. There are few people on the sand with you and none of them are annoying you. In fact the one person on the sand next to you is that person, the one you always wanted to do this with. The tropical breeze whafts over a mixture of salt water and sun tan lotion. A perfectly mixed drink is in your hand- and the 2 other empties glasses are not too far off. You feel the gentle pull on your skin as the sun ever so gently reflects off your skin. There is a distant steel drum beating from far enough away that you can’t make it out all that well. That sound is mixed beautifully with a bird sound you are quite unfamiliar with. All this and your mind is clear. There are no children or grandchildren right now. There are no bills and everything is taken care of for the time being, You’ve made it and now you’re enjoying it.
This does not paint the picture of a person with chronic back pain. In fact, this person probably doesn’t have an ache to complain about. Truth is, they could absolutely be a back pain sufferer- however, the stress-free lifestyle you pictured probably would alleviate that pain… actually, now that you think about it- picturing this scenario reduced YOUR back pain! HOW’D THAT HAPPEN?!?
That was guided imagery, a stress reducing technique that allows us to relax a bit and let our body and brain calm down quite a bit.
Stress has a tremendous effect on the body. It increases our blood pressure, it tightens our muscles, it forces us to lose focus, and can reduce our communication skills to that of a caveman.
…But it’s not all bad- some stress is good and quite necessary for our survival. That is called Eustress (as opposed to Distress). It works on a bell curve as seen in this picture,
In this picture, we can see that with no stress, we do nothing and have issues of boredom and depression. As our stress levels increase, that muscle tightening mentioned earlier can help us perform better. In fact, before we lose focus, increased stress levels allows us to hyperfocus. Stress can raise us to levels way above where we usually are able to “perform” at (performance in this case could mean something as simple as going food shopping). Heightened stress levels allowed 21 year old Gold Medal gymnast, Simone Biles, win 6 for 6 gold at every gymnastic event at Worlds, the first American in history to achieve such a feat. Her stress levels had to be just so, so that she would get “in the zone” but stay “out of her head”. I bring up Superstar Biles because during her amazing performance, she had reported having a kidney stone… A KIDNEY STONE! Extremely painful debilitating kidney stones. Did that affect her gold winning routine? Nope- I doubt she even felt it.
Ok, so we accomplished that some stress is good, and well, I don’t have to do too much to tell you that too much stress can be bad.
How does that stress affect our back pain? The most common reason lends itself to our mindset…
I’ll play out another scenario for you now, but feel free to just read along this time as it won’t be nearly as pleasant
You’re walking down a dark and desolate alley in an area you aren’t too familiar with. You are looking for an address to meet a friend, but there are no numbers and even if there were, the lights are mostly burned out. You smell that unfortunately familiar smell of garbage that has baked in the sun, You hear an animal off in the distance who doesn’t sound too happy either. There is a sound of footsteps, a person, not an animal, but you don’t see anyone. You clutch your wallet/purse. AND THEN YOU FEEL SOMEONE PUT THEIR HAND ON YOUR SHOULDER!!!!!
Not so pleasant. I hope you weren’t too into that one. I did it for a reason though- put yourself in this scenario now.
You’re walking along your neighborhood on a nice cool autumn afternoon. You’re alone, but you always are on this particular walk. Maybe you’re going to the corner shop, maybe the post office, somewhere safe and familiar. You hear the usual hustle and bustle of your area and a neighbor is outside and waves to you. You have a big smile on your face when you feel someone put their hand on your shoulder…
Not so bad this time, why? Context is key. When you’re at a high stress level and wound up like a spring about to explode- your body prepares for the worst. You increase muscle tone in preparation for your fight or flight response. In the context of the medical world, tone refers to how taut a muscle is at rest as opposed to how ripped you look in a bathing suit. This high tone serves a primal purposes, but in most cases, we just tighten up our muscles and leave it like that all day every day. In the second scenario I just put in your mind’s eye, you were in a familiar comfortable environment and so when the hand touched your shoulder, you likely didn’t jump (or maybe you’re already too wound up). Another example of how our mind plays tricks with us is I placed a long piece of tape on the floor and asked you to walk heel to toe along it. You may fail, but you would at least try and get to the end. Same scenario, but instead of tape, we use a tightrope 100 feet in the air with no net. Different context, same activity.
Unfortunately, we live our lives at this higher than optimal stress levels due to so many issues we’re dealing with. All these issues increase stress and can increase pain. PAIN can increase stress and increase pain! Do you see how this progresses so quickly now?
Ok, writing this has actually started to cause my back to ache (seriously), so let’s talk about stress reduction for pain management.
Lifestyle medicine is a trending subspecialty in medicine and the evidence is undeniable how much our lifestyle directly affects our quality and years of life. Here is a great exercise that can help you reduce your stress levels right now…
We are trying to elicit a relaxation response with diaphragmatic breathing. The Benson-Henry Institute for Mind Body Medicine at Massachusetts General Hospital recommends doing the following when you are
Stuck in traffic
Put on “hold” during an important phone call
In your doctor’s waiting room
Someone says something which upsets you
Waiting for a phone call
Sitting in the dentist’s chair
Feeling overwhelmed by what you need to accomplish in the near future.
Standing in line
And of course, in pain
They suggest you “Put your hand just below your navel. Take a deep breath, bringing the air in through your nose and out through your mouth. You should feel your stomach rising about an inch as you breathe in, and falling about an inch as you breathe out. This is diaphragmatic breathing. If this is still difficult for you, lie on your back or on your stomach, where you will be more aware of your breathing pattern. Remember to relax your stomach muscles.“
They also recommend three different ways of using this diaphragmatic breathing, but my favorite is the following: Count very slowly to yourself from 10 down to zero, one number for each breath. With the first diaphragmatic breath, you say “10” to yourself, with the next breath, you say “nine”, etc. If you start feeling light-headed or dizzy, slow down the counting. When you get to “zero”, see how you are feeling. If you are feeling better, great! If not, try doing it again.”