Using Your Head to Heal Back Pain

The mind and its connection to illness and healing can’t exactly be explained by science. But Judi Bar can tell you that she experienced firsthand the power of the mind working against, and then with, her body.

A ballerina from childhood, as an adult she danced professionally into her forties. Strong and physically fit, she appeared to be a model of good health. Until one morning, in her mid-forties, she woke up and could barely move without wrenching back pain. Her back was in serious spasm. “It seemed to come out of the blue, and it was the beginning of a five-year process of chronic pain that overtook my life,” says Bar, who now works as a yoga therapist on the executive team of the Lifestyle 180 Program of the Center for Integrative Medicine at the Cleveland Clinic.

An MRI showed that she had spinal stenosis, arthritis and degenerative back disease. Doctors told Bar that she had the back of an 80-year-old. Her years of dancing definitely could have contributed to her condition, as could her stressful lifestyle.

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“Since there were so many pieces of the puzzle, and not one distinct injury like a fall, it was likely the combination of many things,” says Bar. And while she had dull backaches for years, she’d never had pain like this before — a deep spasm around her entire back that didn’t allow her to move without unbearable pain.

The doctors told her that her spine had just likely reached a breaking point, which, while not common, can happen. A neurosurgeon told her that she needed multiple surgeries and that eventually she would probably not be able to walk. “It felt hopeless. I became a victim of the pain and felt like I had no options,” she recalls.

Untangling the Pain Spiral
It’s easy to let pain victimize us. At times it’s relentless — it beats us up and exhausts us. Not only do we not have the energy to keep moving, it hurts to move. Inactivity leads to more pain, which leads to more inactivity and depression and hopelessness.

Bar recognized that she was trapped in this pain spiral and needed to first heal herself. She went back to the neurosurgeon and said that she’d give herself a year on her own to try to heal. To do that, she knew instinctively that the first thing she had to do was get past the label of being weak and sick — a person with a “bad back.” “So often, we don’t think we can get past the label, but you have to in order to heal,” she says.

She also began practicing yoga again with her former instructor, and she searched around for another spine specialist who supported complimentary care and could monitor her progress. Bar then took a close look at her life — which was hectic and stressful — to see how she could reduce her stress and help herself more. She changed her diet (including eliminating processed foods and adding more whole grains, fruits and vegetables), reduced her workload, started meditating and began consciously breathing.

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At first, though, movement was excruciating; there was so much pain, she could barely bend over or walk. “After a few weeks, I started to break through the pain edge and feel slightly better,” she says. But it was a long process. It would be five full years before she could really say that her pain was mostly gone.

Through all of it, she had to be patient with herself and really listen to the cues from her body so she didn’t push herself too far, too fast and re-aggravate her condition. Now, at 58, when Bar has pain, she knows how to deal with it. But as far as she’s concerned: “I’m good as new,” she says.

No doubt, Bar’s story is extraordinary. But she doesn’t see it as a miracle: She sees it as the result of hard work and making a conscious effort to change. And while her story may not be typical of everyone, it is a great example of how connected mind and body are, and how making lifestyle changes and incorporating stress reduction techniques can help conquer physical ailments and pain. Here, three ways to break out of the downward pain spiral:

1.  Awareness
Awareness is one of our best tools in healing our bodies. When we’re in pain, we often have two contradictory instincts: We either (1) try to distract ourselves from the pain or try not to even acknowledge it, or (2) we obsess about it and let it completely consume us. There is a third route: simple awareness without judgment or agenda.

Several times throughout the day, take a few minutes to sit or lie quietly and pay attention to your breathing and how your body feels. Then start to notice what makes the pain worse, as well as what helps it, Bar says. Does being around certain people or being in certain situations make the pain more acute? Does the pain always seem to happen at a certain time of day — and if so, what are you doing when it happens? Collect information about your body and your pain.

2. Relaxation
Shutting off our stress response is a first step toward relaxing both our bodies and our minds. It’s especially helpful for back pain sufferers, and it takes only a few minutes. Lie on your back (on a surface that’s comfortable) with your knees bent over a pillow and your hands on your belly. Inhale for six counts and let your belly fully inflate, then exhale for six counts and let it deplete. Try 10 breaths that way. Diaphragmatic breathing, or belly breathing, relaxes your nervous system and stops the flow of cortisol and adrenaline — which helps to slow down the inflammatory response. Even if you’re not having an episode, this is a great exercise to do as a daily de-stressor.

3. Gentle movement
If you’re in a great deal of pain and/or you’ve been inactive for some time, jumping right into intense exercise is not a good idea (and probably not even physically possible). The name of the game is gentle and slow. Your breathing and your awareness (how does this move make me feel?) are your guides to movement: They’ll dictate what, and how much, you can do. “The key with back pain and movement is consistency. Pick a few movements and try to do them every day, for at least 10 minutes,” says Bar.

Bar recommends doing these gentle movements, borrowed from yoga, every day if you can.

• Seated shoulder/neck rolls. Sit up straight near the edge of a sturdy chair (preferably not one on wheels) with your feet flat on the ground. Roll your shoulders forward and backward. Turn your head to one side, and trace the notch in your collarbone with your chin as roll your head down and around to the other side.
• Seated torso circles. In the same position, try to make small circles with your torso (circle in both directions).
• Pelvic rocks. Same position: Rock your pelvis forward as you round your back slightly (like a cat); then straighten up as you rock your pelvis back slightly, pressing your shoulders down and dropping your head slightly back.
• Seated forward bend. This is an inversion, so take it slow and avoid dropping your head all the way down if you have high blood pressure. Same position in the chair, but walk your feet apart. Keep your knees bent as you slowly drop your torso down to the floor, trying to touch your hands to the floor.
• Modified down dog. Stand by your kitchen counter (or a surface about the same height) with your forearms on the countertop. Keep them there as you walk a few feet back, dropping your torso parallel (or close to parallel) so that your back is flat (or close to flat) and you feel a stretch in your shoulders and a release in your back. (You can also try this with a wall, but there’s not as much support.)

A more formal yoga practice can teach you the basics of meditation, breathing and stretching. Even better, seek out someone who’s been trained in therapeutic yoga and has the certification E500 RYT, which means he/she is Yoga Alliance certified. No matter which type of exercise you choose, the key is sticking with it and giving it time to work. “Moving might make you feel worse at first, but then it will make you feel better,” says Bar.

—by Judi Ketteler