A Somatic Perspective on Chronic Pain & Yoga

In 2015, nearly 20 million people in the United States were practicing yoga and contributing to an industry that was worth 10 billion a year, according to a study conducted on behalf of a magazine called, Yoga Journal. With so many yoga teachers there is a risk that some are not knowledgeable about the pitfalls of the practice and how to keep their students from hurting themselves.

To manage chronic back pain Cathryn Jakobson Ramin spent years and a small fortune on treatments looking for solutions. In her book, Crooked, she startles you with intensive reporting on all aspects of spine medicine, which is expensive and often ineffective. Published in 2017, it is a timely and evidence-based resource for chronic back pain sufferers. After reading Crooked, her interviews and research may just shatter assumptions you have about surgery, chiropractic methods, physical therapy, and painkillers. In the book she instructs us how to avoid some of what she calls therapeutic dead ends; and how to save money and much frustration as she outwits the back-pain industry. Like me, Ramin practiced yoga to relieve chronic back pain and concluded that restorative yoga does wonders for relaxation. Although, she found in her extensive research that yoga will not typically make a patient with a weak back any stronger. She agrees however that gentle and restorative yoga is a good place to start your healing process and begin to bring awareness to your internal sensations.

Just a brief bit about chronic pain from my book Complementary Alternative Medicine Relieving and Preventing Chronic Pain:

Most will agree that chronic pain is pain that lasts longer than 3 to 6 months. The prevalence of chronic neck/back pain is quite sobering, and when you add in its complexity; it is no wonder that people just give up and attempt to live with the pain as I did until it stops you in your tracks. Statistics tell us that drugs and surgery only work roughly 50% of the time in addressing chronic musculoskeletal pain. Overprescribing drugs has resulted in widespread addiction, and it’s becoming more and more difficult to obtain pain medication for those in serious need. This difficulty leads to overwhelming negative emotions and emotions can conjure pain, and it becomes a vicious cycle.

Ramin writes about the chronic back pain patients who were often weak and inexperienced and what happened to them in a yoga class that overlooked the lumbar and cervical regions of the spine. They may have improperly folded forward – even in simple poses – that presented a significant risk. Some were also doing headstands before their shoulders were strong enough to provide necessary support.

Sciatica is a common ailment you hear about in yoga classes and it’s been associated with diseases of old age. Having co-owned a yoga studio for 20 years I have witnessed people of all ages with this excruciatingly painful condition that occurs when the lower back increasingly arches and pinches one or both of the sciatic nerves. This condition is the perfect transition to my favorite way to relieve and prevent chronic muscular pain, Somatics. Thomas Hanna, the pioneer of Somatics Education explains that patients in excruciating sciatic pain are often terrified of the surgery that is sometimes prescribed after physical therapy fails to provide relief. He found that the so-called ruptured discs mostly turned out to be the intervertebral disk bulging from the viselike pressure of involuntary contraction in the lower back muscles. Properly retrained through Somatic exercise and genuine awareness they released their contraction; and the patients were eventually pain free.

Eventually, Ramin resorted to back surgery and afterward she was shocked and anguished when she found she was still in pain. Then the wise words of a physical therapist, Deane Juhan moved her thinking: “our habits, our jobs, our social situations, our general dispositions” – encourage us to “prefer certain fixed positions” and cling to them until we consider the possibility to move in different ways. It was only after practicing the mind/body movements of the Feldenkrais Method (Somatic Movement) for about two months that Ramin was finally out of pain. You may just rediscover, as she and I did: “A free, effortless sense of movement we had in the first few years of life – and undo many of the aches and pains that plague us as adults who have literally become too set in our ways.” I have had one passive session with a Feldenkrais practitioner. I was gently manipulated on a massage table for about 40 minutes and was truly amazed how loose, relaxed, and sort of sloppy my body felt afterward walking around the room. Unfortunately, passive manipulation does not train your nervous system how to stay in that relaxed body state. You need to learn and incorporate the movements into your daily life. Just your reading this article is a step in the right direction; brains love solutions and so why not get started?

I learned, just like Ramin, not to put my Somatic Tools away in my toolbox when completed and just wait for another day. They have become my way of moving through life. Before I sit down to write I decide what I will do if I find myself uncomfortable.

Looking for freedom in my body has become a ritual that shapes my form and produces energy that becomes a healthier way of living.

For example, I shift myself forward on my chair, making sure both feet are planted securely on the floor and my knees are directly over my heels in a straight line. With both feet remaining in place I begin to shift one knee further out in front of the other just an inch or two and bring it back while I shift the other knee slightly forward. This swiveling back and forth on my pelvis gets me in touch with my center of gravity. I settle into the chair a bit more relaxed before I continue working.

Along with Somatics and Yoga, Ramin included the practice of Qigong in her chapter titled: The Posture Mavens. Ramin concluded that Qigong classes proved to be helpful for recovering from back pain. She wrote, “Beyond improving pain, the exercises have shown to enhance cognitive abilities; and improve balance, gait, and posture.”

Over the months and years that Ramin worked while she was writing her book, her once poor posture and gait slowly changed. She only slumped when she was exhausted. As she gained body control she felt different. She describes herself as “no longer a brain on a stick.” She knew she had really turned the corner when a tall gentlemen at a school event offered this compliment: “You have lovely posture, and that is very unusual in a woman of your height.” Ramin also tells us that she feels much better and stronger at age sixty than she felt at age fifty.

Somatic exercises have become a part of my morning practice. I offer a class at Willow Glen Yoga every Friday morning at 9AM called SomaQi.

Somatics works at the root of our chronic pain…our habitual ways of moving.

~ Mary Ellen Hannon