Motion Forword - December 2023 - No 6
Welcome to Motion Forword - Words of a Therapist! Issue 6!
Motion Forword is about discussing the combined benefits of movement with a positive mental attitude. Using my personal/professional experiences, evidence-based research and some of your own experiences.
Bringing some hope, positivity, happiness and maybe usefulness to those, perhaps like yourself, that needs a pick me up.
A change up in the order this month… starting with…
My back pain story
I turned 34 this month and I’ve had back pain for more than half of that.
My earliest memory of pain was when I was about 13 years old.
We were doing piggyback racing. I somehow slipped, my piggy fell on my foot and sprained my ankle. I was on crutches for a while, my ankle recovered and it doesn’t really cause me any issues anymore*.
* Besides a lack of movement there from poor rehab (bad young naive Nathan!)
But I have had lower back pain for perhaps longer than that… I just can’t remember. The earliest memory of this was when I was 16-17 years old doing throw-ins playing football. I’d arch my back to produce a pretty decent throw-in. Rory Delap would have been impressed. But it would hurt my back.
By the time I was 22 I remember being told I had ‘very hypertrophic lumbar erector spinae muscles’ when I was in my first year of Osteopathic school by a final 4th year student who thought he had it all figured out.
And I did. I’ve always been a strong and relatively fit person, so my back was reasonably developed!
But focusing on treating just the physical part of my problem, as we were taught at Uni, didn’t get rid of my problem.
Like 8 million others in the UK I would describe myself as a persistent pain sufferer. My pain has never really completely gone and has even negatively affected my ability to play hockey, drive and do my work.
14 years on, I have learnt a lot about pain, specifically chronic/persistent pain, and how to treat it. It’s complex and multifaceted but it helps make sense of questions like:
Why does my pain come on randomly? Even when I’m not doing anything physical?
Why can I do quite physically demanding things fine but benign things like walking or sitting hurt?
Why does it feel worse if I am tired, stressed or upset?
Why does driving sometimes hurt so much?
Why can something help one day but not the next?
Why can something hurt one day but not the next?
Why do I get so many different diagnoses from different specialists/ doctors?
Why do painkillers not really help or help at all?
Over the last 3 years or so,... I have learnt (and am still learning) how to manage and treat my pain better. Understanding my triggers (physical, mental, emotional, social) better and how to negate them or proactively predict and counter them.
These days in my work, my own experience of back pain allows me to empathise that much better with you… my patients.
Understanding your worries and concerns whilst giving you some hope. Understanding how awful and frustrating it feels when your body can’t do what you want it to do. Understanding the need for answers but struggling to find one...
Something about me -
If you’ve been reading my previous Motion Forword rambles you’ll know I’m a pretty active person…
Hockey, gym, dancing, salsa, skiing, running and the newest addition, Acroyoga!
In my past, I’ve also dabbled in table tennis, football, break dancing, athletics, crossfit, badminton, tennis, swimming and rock climbing/bouldering.
Only rarely has my back pain stopped me from doing these things.
For example, perhaps a year and a half ago when I had a long drive to Kent then back the following day to Bournemouth (3hr+ drive) to play hockey. After 15 minutes on the pitch my back seized up. I crawled off the pitch. I had to concede and listen to my body, as frustrating as it was.
I learnt some lessons from this experience:
My back doesn’t like long drives immediately followed by activity, especially hockey. There needs to be some grace period.
Drinking the night before and not hydrating enough didn’t help.
There is a strong connection between my physical health (specifically my back pain) and my emotional/psychological health.
Rehabbing my back effectively required me to take a step back from things I enjoyed which was upsetting and frustrating but necessary.
Points 1, 2 and 4 probably aren’t a huge surprise to you as you read this. Easy to comprehend and aligns with most people’, and even ‘experts’, understanding.
Point 3 might be a surprise to read but it is becoming increasingly apparent in the research that emotions (even past emotional trauma) can shape our experiences and predispose us to pain.
In my example above, at the time I was holding onto guilt, sadness and a lot of uncertainty. If those feelings weren’t there maybe I would have been able to play OK. Because, let's face it, I have definitely driven for long periods prior to hockey before!
I am not ashamed to say I was having counseling at the time to help me process these feelings. In addition, taking my own advice, taking a step back from hockey to focus on my rehab and recovery.
These days,... I’m not perfect! In fact, as I write this, I am going through a pretty terrible stint of back pain. Just not as dramatic as Nick Miller from New Girl:
As s**t as it feels, I trust my body to heal itself in time with a little help from me doing the right things.
In my experience, there is no ‘end’ to looking after yourself. And chronic/persistent pain requires us to constantly take care of ourselves. But with the new knowledge that is out there, we are starting to understand how to better treat and manage these types of problems.
Which leads onto my ‘Something for you’...
Something for you - Curable App
The Curable App is something I have come across quite recently that is designed to help people better understand and manage their persistent pain* with the most up-to-date research.
*You should note that persistent/chronic pain behaves very differently to acute injuries/pain. This type of education is best if you have suffered with pain for more than 3 months.
It takes an educational approach to dealing with persistent pain. The ‘unlocking your brain’s own medicine cabinet’ is quite a nice way to think about it. We have our own endogenous (internal) opioid* and endorphin producing pathways in our brains which can act as a natural painkiller!
* Drugs like codeine, tramadol and morphine work because they act on our own internal opioid receptors.
I have been given access to the app to try for myself…
I am quite impressed thus far. There are a lot of resources that discuss the multifaceted behaviour of pain, how even personality traits can influence how you experience pain and more. You can use it on desktop or on an app, both equally user friendly and straightforward.
In addition, it takes you through some exercises/workshops to help. Including meditation, mindful writing, education and brain training and it tailors these exercises based on how you use the app. So if you don’t like mindful writing, no problem, focus on other aspects instead.
‘Reframing what your pain means’ is a theme in the app so it may take some time to get your head around what the hell it is trying to do for you! But a lot of what it says and does aligns with my own understanding and beliefs around pain. So if my word is anything to go by… stick at it.
What is exciting is that I can offer you 6 weeks free access to this! If you’d like, please feel free to ask me for a pass and I can email it straight to you. Consider it an early Christmas present! (They do ask for card details when you sign up with no upfront payment, but you can cancel at 6 weeks if it isn’t for you).
Thanks for reading.
Merry Christmas 🎅🎄☃️🎁 & a Happy New Year! 🎆🍾🥂🥳
Until next month…
Motion Forword ⏩⏩
Nathan