Pain is a good example of how mind and body are united

I'm intimately familiar with pain.

All of us are, of course, since everyone experiences pain -- aside from the unfortunate people who don't feel it at all, which isn't a good thing, because they usually suffer serious injuries or even death from not recognizing when something is dangerous, like a fire burning their skin.

Often pain becomes a more familiar companion the older we get. That's true of me. I was mostly pain free until early in 2020 when, at the age of 71, I developed sciatica in my right leg. 

Because this coincided with the beginning of the Covid pandemic in the United States, I wasn't able to get an MRI even though the pain was excruciating much of the time. I was determined to go for a lengthy walk around our rural neighborhood every day with our dog, since walking was supposed to be a good thing to do if someone had sciatica.

There were quite a few times when I'd cry for most of the walk, the pain was so severe. Ditto when I mowed our lawn with a walk-behind mower. I did it, but with a lot of tears. 

The sciatica pain eventually was markedly reduced, thanks to physical therapy and time. However, it's always been with me whenever I'm on my feet. I just have learned to tolerate or tune out the pain. For about the past six weeks the pain has been quite a bit worse, which led to me starting another round of physical therapy where I've gotten additional exercises to do several times a day.

My problem is that I'm not bad enough off to justify spinal surgery (the most frequent cause of sciatica is a bulging disk).

I might be able to get a MRI after I complete five physical therapy visits, but that depends on my insurance company. Cortisone injections in the spine are a possibility, though a MRI is needed to target their location.

So basically I've got sufficient pain to make it really annoying, yet not enough pain to justify a surgical or medical procedure. For the moment, I'm left with what I've been doing for the past four years: handling the pain as best I can with minimal outside help aside from physical therapy and pain patches at bedtime offered by SalonPas and BioFreeze.

Today I had a physical therapy appointment where I talked about the mental side of pain with Amanda, an experienced physical therapist who was familiar with the book I've been writing about recently, Ellen Langer's The Mindful Body.

Amanda agrees with Langer that every mental activity affects the body, and every bodily activity affects the mind. As an example of this, I told Amanda that even though my leg is hurting when I go to exercise at a gym three times a week, it doesn't bother me too much, because I'm focused on physical activity -- 30 minutes on an elliptical trainer, 20 minutes of lifting weights, 10-15 minutes of solitary Tai Chi.

However, twice a week, after the gym sessions I go to a Tai Chi class in downtown Salem at Pacific Martial Arts, where I've studied both hardstyle (karate) and softstyle (Tai Chi) practices for about 23 years.

Then I feel the pain in my leg considerably more. One reason seems to be that Tai Chi involves a lot of standing still along with slow movements that, when I have to put all my weight on my right/sciatica leg, is quite painful. 

A larger reason, though, is that I feel trapped in a way during the 90 minute class. Sure, I could go sit down and watch for a while if the pain was too intense, but I have never done this and don't want to do it, if at all possible. So there I am, me and my leg pain, with my mental focus much more on the pain, as contrasted with how I am at the gym, where I'm doing different things and control that doing.

Thus my experience is that while pain is undeniably physical, it also has a strong mental component. Meaning, the sort of attention I give to pain, along with my attitude toward pain, has an effect on how much pain I feel. 

(Pain is an interesting medical phenomenon, since it is entirely subjective, while usually having a physical aspect to it, one exception being "phantom limb" pain where someone feels pain from an arm or leg that has been amputated.)

I liked Langer's most recent book so much, I ordered one of her early books, Mindfulness, the 25th anniversary edition. I've only read a few pages, but saw in the index some mentions of pain. This quotation from William James, the noted psychologist of the late 1800s, mirrors what I've said above about how I experience pain.

The effect of context on pain has been known for a long time. In The Principles of Psychology, William James describes a Dr. Carpenter who suffered severe neuralgia:

He has frequently begun a lecture while suffering neuralgic pain so severe as to make him apprehend that he would find it impossible to proceed; yet no sooner has he by a determined effort fairly launched himself into the stream of thought, than he has found himself continuously borne along without the least distraction, until the end had come, and the attention had been released; then the pain has recurred with a force that has overmastered all resistance making him wonder how he could have ceased to feel it.

When one can take one's mind off pain, it seems to go away. Conversely, when the mind returns to pain, so does the body. If one can reinterpret a painful stimulus, it may cease to be painful.

Well, that'd be wonderful. I just haven't been able to do it.

However, as I said, I find myself able to lessen my sciatica pain by focusing on something other than my painful right leg. I recall that when I went on those super-painful dog walks around our neighborhood in 2020, tears welling up in my eyes, if I encountered someone else on the road, I was able to exchange some friendly greetings with them just fine. 

This shows the power of the mind. It can make painful things better, or pleasant things worse, depending on how we view those things and the meaning we ascribe to them.

Comments

[Appreciative Reader]

Sciatica, I’d heard of the thing, but didn’t know what it is. That’s really …grim, having to deal with unrelenting pain, that’s always with you (except when, as you say, you momentarily distract yourself)!

People talk of exceptional endurance and courage when fighting a war, for instance; but the fact is that most people actually end up facing up such a situation, in more or less degree, thanks simply to age. And I suppose it takes no less of courage and endurance to keep …enduring it, just because it doesn’t involve something dramatic, like guns and enemy fire.

__________

Placebos one knows about, obviously, but that part of it I hadn’t heard about, and I wonder what the mechanism of that might be. I mean where you talk of being aware that it’s only a placebo, and yet despite that it works. Very curious, the ways of the mind.

[Connie]

Just FYI.. I had horrible sciatic pain for a year and finally got ‘cupping’ treatment which relieved the pain in three treatments.

[Ron E.]

I can empathize with Brian’s condition as I had sciatica pain for a few years. I guess everyone’s pain is different but mine always occurred after sitting too long and particularly during long, 5-6 hours of driving. It’s was so painful, searing down the back of the thigh right down to the foot. Both my daughter and walking friend had to have operations to remove a ‘spur’ from a spinal disk which was affecting nerve pathways.

I’ve no doubt of the affect of physical pain to one’s mental state. Apparently, it also works the other way in that one’s mental state can affect pain in the body. I recall the case of a soldier who was running under fire and he kept falling over. He eventually realized his foot had been blown off. It seems that under the battle conditions he was in, his brain didn’t recognise the missing foot – it was too busy keeping him alive.

[Appreciative Reader]

Not to make light of a someone's dire situation, but that thing about the soldier getting his foot blown off, Ron, and noticing only a good while later, that's kind of like something out of a cartoon, no? Like run off a cliff, look around, suddenly realize you're actually hanging there in mid-air, and only then, after noticing it, and after first letting out a loud yell, only then start the straight fall down.

Absolutely, even leaving out all of the hocus pocus that's often tied up with subjects like this, but it's a fascinating, the things our mind is capable of doing.

...Actually, talking about this, that makes me think of hypnosis. Brian, I guess you're aware of the thing, and no doubt your doctor/s would direct you to it if there's anything to it and if it might be applicable to your particular case: but hypnosis is supposed to sometimes help with pain management. Both kinds, the Doctor Strange swinging a pendulum and squinting into your eyes type, as well as the self-hypnosis type. If you haven't already looked into it, then it might not hurt to explore that option. (Always taking care not to get mired in the woo surrounding all of this. And always assuming there's anything to it, which also is not really a given. Not as if I'm vouching for hypnosis, just throwing this out there, in case it might be of use to you, is all.)

At one time I'd been very interested in hypnosis. Actively attended some sessions, courses, and actually still have some certificates to show for it. But the really fun part of those courses I'd attended were the hands-on sessions. The instructor would first hypnotize one or two of us, then show us how it is done, then guide us through the process, and have us hypnotize one another. ...Oddly enough, apparently I was the odd one out, in that I wasn't a good subject, in that not once did I get hypnotized, despite the instructor putting in a good bit of time specially and specifically for me, and nor when we participants were trying it out on one another (in presence of and as guided by the instructor). And this despite my trying my very best to co-operate, and in fact feeling a bit ...uncomfortable, inadequate, because while everyone seemed to moving their arms and saying stuff, as far as me, absolutely nothing!

On the other hand, I was apparently an excellent subject in terms of being able to hypnotize others. In those group sessions, the guy (or gal) I was partnered with would immediately start doing whatever I "ordered" them to, and hell, I always thought they were just play-acting, kidding around. But when I'd wink at them, or ask them sotto voce, no response. And afterwards, when I'd ask them in detail, they'd all claim they had zero memory of it; and yet, here they were, doing exactly as I was "ordering" them to. It was very very weird.

Sorry, that's probably a great deal of detail that doesn't lead anywhere in and of itself; but my point was, Brian, you might look up hypnosis as an aid to manage your pain. It apparently helps people sometimes, very dramatically at times. But of course, always with the pinch of salt at the ready, goes without saying, given how surrounded with woo this hypnosis business is, and given that for all I know it might be 100% woo beginning to end, with nothing to it at all, that's quite possible to. ...Still, it might be a thing to consider and explore, maybe, always in consultation with your doctor/s obviously, and always remaining vigilant not to be taken in by woo.

[William J]

Hi Brian https://www.psychologytoday.com/us/blog/out-the-darkness/201711/sham-surgery

[777]

Hi Brian
Your pain can easily be forgotten by listening to one of my
432Hz Videos on X.COM/ankhaton
I explained there how body cells recover

Success

77
15 minutes p/day