mental health

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Mind over Matter… and low back pain?

“If you don’t mind, it doesn’t matter…”

This quote may seem too simple for those with chronic pain.

However, it appears there is a good deal of truth to it. Researchers in neuropsychology fields are mapping out the complex pathways of chronic pain transmission in the brain and body. It appears that how we “feel” about our pain can keep the intensity higher for as long as we are afraid or depressed about our pain.

If we learn to mentally “leave it alone,” the brain learns to file the pain in a different cabinet. One at the back of the “office” of its neural pathways.

However, if we keep tagging the pain as “important” by fretting over it or dwelling on it, the brain keeps the pain highlighted and files it on the middle of our desk. Where we can see it all the time.

There are many tricks to learning to de-prioritize our chronic pain. At the bottom of this article are a brief list of mental exercises we can use to help us cope. My preferred approach is the use of physical exercise.

Before engaging in any physical exercise, check with your health professional to make sure you know what is causing your low back pain and that it is safe for you to move.

Benefits of exercise in regards to chronic pain:

1. Increased muscle tone = decreased ability to convey pain signals

We’ve long ago proven that when muscles and tendons are regularly exercised, their pain threshold goes through the roof. Think of exercise as a natural pain killer.

2. Increased core strength lightens the load on discs and joints

As we beef up our core, we are tuning up our lumbar spines and pelvic joints. We are literally lubricating the joints and cleaning up the soft tissue. Also, core strength is like tightening the strings on a tennis racket. It makes the low back work better and takes pressure off the joints.

3. Movement = confidence

As we learn to safely exercise an area that is typically in pain, we learn to move in pain free ways. Interestingly, much of the problem with chronic pain is that it convinces the sufferer not to move. Which weakens muscles that then convey more pain and also put more pressure on hurting joints.

It is a negative feedback cycle that perpetuates the pain condition. The body can learn to move in the pain free areas and this helps the brain place the low back pain on a lower priority level.

This, in turn, decreases the pain felt by the individual.

Get diagnosed, then start with a simple exercise routing for the core. Have an appropriate healthcare practitioner prescribe a routine that is right for you.

And just to ad some zip to your fight on chronic pain, add the following mental exercises to your routine:

The following strategies are from the online magazine www.spine-health.com:

Altered focus.
Very powerful. This technique involves focusing your attention on any specific non-painful part of the body (hand, foot, etc.) and altering sensation in that part of the body. For example, imagine your hand warming up. This will take the mind away from focusing on the source of your pain.

Mental anesthesia.
Also very powerful. This technique is done by imagining an injection of numbing anesthetic (like the Novocain a dentist uses) into your area of pain. Similarly, you may then wish to imagine a soothing and cooling ice pack being placed onto the area of pain.

Mental analgesia.
Building on the mental anesthesia concept, this technique involves imagining an injection of a strong pain killer, such as morphine, into the painful area. Along the same lines, you can focus on imagining your brain producing massive amounts of endorphins, your body’s natural pain relieving hormones, and having them flood into to the painful parts of your body.

Use your mind to produce altered sensations, such as heat, cold, anesthetic, in a non-painful hand, and then place the hand on the painful area. Envision transferring this pleasant, altered sensation into the painful area.

Pain movement.
Mentally move your pain from one area of your body to another, anywhere you think the pain will be easier for you to handle. If you can’t take another minute of your leg pain, for example, mentally move the pain up from your leg and into your low back. If you want, then more your pain out of your body and into the air.

Some of these techniques are probably best learned with the help of a professional, and it usually takes practice for these techniques to become effective in helping alleviate chronic pain. It is often advisable to work on pain coping strategies for about 30 minutes 3 times a week. With practice, you will find that your powers over the pain will increase, and it will take less mental energy to achieve more pain relief.


Exercise and Mental Health

For years, a growing trend in psychology has been to link mental health to physical health. This should come as no surprise as the central nervous system is an organ woven tightly into your physical body. The primary engine of health is the musculoskeletal system. Vital organs will display better health in a vigorously exercised specimen than in an individual that simply eats well but is sedentary. Likewise, active individuals report less anxiety and depression than sedentary folk.

A new link is being discovered between physical activity and dementia. It seems that senior aged individuals who learn new physical skills have a lower rate of dementia as they advance in years. The brain’s wiring is predominantly motor oriented. It either brings information back from muscles and joints or is sending them there. So an elderly person that is walking, cycling and learning to lawn bowl or play crocket is engaging more of their brain than a similar aged individual that is sedentary and does lots of reading, crossword puzzles and sudoku.

Although there is nothing wrong with mental stimulation, purely sedentary lifestyles engage less brain matter no matter how much socializing or reading one does. Use it or lose it. And the “use it” must involve motor activity.

In fact, doctors are beginning to encourage elderly patients to try and ween themselves off canes and even walkers. Although this suggestion is not for everyone, the underlying principle is that fear of a future fall is shrinking the elderly person’s physical activity spectrum. In turn, their nervous system is being slowly shut down, making it more likely that they fall in the future or become dependent on a medi-scooter or wheelchair. Not to mention it will bring the onset of cognitive decline because less and less brain matter is being stimulated.

Stroke patients that could previously only crawl have re-learned to walk by the sheer determination to keep trying. The parts of their brain that had previously been programmed to control locomotion had been killed by the stroke. Yet by repeatedly trying to move their arms and legs, they gradually retrained other portions of the brain to take over the task of over-seeing the walking mechanisms. Post-traumatic stress disorders, depression and traumatic brain injuries are beginning to be primarily rehabilitated in physical therapy settings. Teaching patients to balance while tracking a moving object with their eyes is a motor skill. Yet it helps the brain to re-set its emotional mechanisms and re-focus its hormonal pattern.

In short, the key to many ills of the central nervous system is a physically active and demanding lifestyle.

People who have dementia in their families or who are themselves recovering from stress disorders, depression or brain injuries, should follow five basic rules of lifestyle modification:

  1. eat well and clean and drink plenty of water
  2. nap during day and go to bed at a regular (and somewhat early) hour each night
  3. socialize often
  4. read and challenge yourself mentally (turn off the gadgets and television)
  5. exercise 4 to 5 times each week, incorporating new skills every once in awhile (kick boxing class, roller blading, kayaking, etc)

Brains are meant to sense the world around us and react to it. Our organs and minds will follow the body’s lead. Keep it strong and active and your mind will be as such!

Best of luck!

Dr. Parenteau

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