Within the Limits of Pain

The other day I was at Staples printing up some new student cards.  A woman standing next to me noticed that I was doing something for a yoga center.  She told me that she loved yoga and was curious if I worked there and what kind of yoga do they have.

After learning I was the director and that we have a therapeutic orientation, she asked me if I could recommend some poses to help a situation with her lower back.

“I have this thing in my lower back.”

“A thing? You mean pain?”

“No. Not really pain.”

“OK. Well, do you feel this thing consistently or just during certain activities?”

“I feel it all the time.  Last night it was really bad.”

“Really bad? That sounds like pain.”

Upon further inquiry, I learned that she waits tables four days a week and is on her feet for 12+ hours on those days. When she’s not at work, she is attending power vinyasa yoga classes and running avidly.

She seemed confused that I was asking about her life. She just wanted to know some poses that would stretch out her back. The problem is that, in many instances, more stretching or strengthening does not make pain go away. Especially if we’re not admitting to the pain we have until it reaches a critical mass that can no longer be avoided.

Recent statistics show the number of adults with chronic low back pain is on the rise. Doctors recommend three courses of action: (1) Lifestyle change, (2) Medication or (3) Surgery. When diagnostic testing reveals no definitive cause, treatment is based largely on the patient accurately describing the intensity of pain on a scale from 1 to 10.

If the pain is deemed manageable enough to not warrant surgery than doctors will commonly prescribe medication to manage symptoms and recommend, “staying active within the limits of your pain and avoiding activities that worsen pain.”

The dilemma that many of us face is that we are not always so good at making an honest assessment of how we feel. Is my pain a 2 or 3 or an 8 or 9? Staying within the limits of pain is kind of hard if we don’t know what the limits are. Not to mention, a lot of us have livelihoods that place unreasonable demands on our bodies.

Even when our jobs don’t require us to be on our feet 12+ hours a day, we still often maintain crazy schedules. We run ourselves ragged all day every day and then when we have pain we think something is wrong.

In therapeutic yoga, the course of practice is determined by taking into account not just the level of pain but the context in which the pain is taking place, sometimes referred to as the “multi-dimensionality” of the person. Meaning that we are not just the muscles and bones and proteins that the x-rays and blood tests show.

We are human beings with jobs, relationships, apartments and emotions. All of these many facets of our experience are playing into what is happening in our bodies and how we feel. When pain is chronic and enigmatic, a re-evaluation of habitual activities and priorities is often the key to turning it around.

Frankly, my new friend at Staples was not all that interested in hearing about her “multi-dimensionality.” I got the distinct feeling that she wasn’t going to be stopping into the center anytime soon. I can understand why. She didn’t feel that her pain warranted making any changes to what she was doing.

The important point is that utilizing yoga practice to alleviate pain requires an honest assessment of ourselves and the discipline to not just do more but, sometimes, to do less.

Yoga poses do not fix pain. Practicing yoga poses is potentially a vehicle for cultivating the awareness to know the limits of our pain.  In so doing, we develop the facility to heal.

J. Brown is a yoga teacher, writer and founder of Abhyasa Yoga Center in Brooklyn, NY.  His writing has been featured in Yoga Therapy in Practice, Yoga Therapy Today and the International Journal of Yoga Therapy.  Visit his website at yogijbrown.com