Yoga has a lot of different benefits for chronic pain and chronic illness and can be worth trying out. If you’re hesitant, I totally get it, I was for the longest time as well.
Keep making the most of it!
Tag: yoga
My Favourite Self-Compassion Practices
We all struggle with self-compassion. I’ve written about it before on this blog, talked about it on the podcast, written guests posts on other blogs about it. I do self-compassion work all the time with my clients. And most importantly, I do self-compassion work all the time with myself. Self-compassion has been shown to lessen chronic pain, improve resilience, and keep us motivated – all of which are important when you have a chronic health condition. It can also help when experiencing trauma symptoms, anxiety, and depression. Being honest, while my pain is much, much less than it used to be, self-compassion has and continues to help me deal with it. More recently I’ve noticed the great effect it has for me during trauma triggers and anxiety. Self-compassion is also hard – at first – eventually it becomes a lot easier and more natural to do (though there is always effort to be put in). When I notice (using my mindfulness skills), I’m able to pause and ask myself what would be helpful now. More often than not I end up doing a self-compassion practice, which helps me regulate, centre, and continue on with my day.
There are tons of different self-compassion practices you can do. I do highly recommend the Mindful Self-Compassion Workbook by Kristin Neff and Christopher Germer. I bought it, used in on myself, and now use the exercises with my clients. Beyond the ones from the workbook, I have some other practices that I quite enjoy, use often, and really help. Without further ado, here are my 4 favourite self-compassion practices.
- Lovingkindness Meditation – this is actually a really old Buddhist practice that is used secularly now. It involves generating feelings of warmth and kindness towards ourselves and others (typically someone we care about, someone we feel neutral about, a difficult person, and everyone). We then repeat lovingkindness phrases, sending them first to ourselves, and then to each of the others. The reason I like this practice is because it is easier to send compassion to other people, and we still get to practice giving it to ourselves.
Typical lovingkindness phrases include:
May I be happy.
May I be safe.
My I be healthy.
May I be at peace.
But can include any phrases that resonate best with you.
Try it here. - Kind Hand – this is a practice I actually learned from a counselling textbook (ACT Made Simple) and find I use it a lot with myself because it’s such an easy gesture and quick way to offer myself compassion. (My clients tend to like it too). Basically you imagine your hand filling with the same kindness and care you offer others, and then place it on the part of your body you feel the most pain (emotional or physical) and let the kindness flow into it and then all around your body.
Try it here. - Heart Opening Yoga – this is working with the heart chakra, which helps with self-compassion and self-love. I’ve done this both as a vinyasa class and a yin class (I personally prefer the yin class, especially when I’m feeling anxious/activated because it’s more grounding). This usually includes a lot of chest openers, expansions and back bends to help us make room in the physical, emotional and spiritual bodies for compassion.
I personally recommend Yoga with Kassandra on YouTube for some great practices (I’ll be launching my own as soon as I finish my Yoga Teacher Training). - Compassionate letter writing or journalling – if you’re open to writing and/or like journalling, this can be a very effective practice. My former therapist had me do this once and I did find it helped (and of course, I’ve had my own clients do this as well). It can be quite difficult if you’re not used to giving yourself compassion, so I actually recommend trying any of the above 3 practices first. The formula for the letter is pretty simple:
-mindfully write what happened – being open, curious, and nonjudgmental about your experience, thoughts and feelings (who, what, when, where, maybe why).
-write some words connecting yourself to common humanity – we all experience pain, hurt, emotions, etc. and telling ourselves something like, “everyone feels this way sometimes” (etc) can help us remember that we are not alone.
-write something kind to yourself – imagine what you would say to a friend who was struggling. What kinds words would you offer? Just write those down, offering them to yourself.
Try it here.
Self-compassion is a powerful and useful practice. The more I integrate it into my life, the easier my life becomes. And of course I want the same for all of you, so that you can keep making the most of it!
My Experiences of Lifestyle Changes for Chronic Pain
I feel a little bit of unease writing this post because I don’t want to give the impression that I think it’s completely possible for everyone to do this. In fact, prior to my own personal experience, I thought this was highly unlikely if not nearly impossible even though I’ve read about others doing similar things (reducing ANA, reversing illness, stopping illness progression, etc.) through a lot of the same methods I’ve used. I only started with lifestyle changes in order to reduce symptoms and general distress so that I could do more values-based activities. All of what I did was with the guidance, help and advice of amazing holistic healthcare professionals – my naturopath, my psychotherapist, my physiotherapist(s), my chiropractor(s), and my massage therapist(s). My primary care/general practitioner/family doctor (however you want to say it) and my rheumatologist(s) supported my lifestyle changes but never advised me on them. They deal with medications, and frankly that’s fine. I also want to say, my intention has never been to go off any medications. I like an East-meets-West approach to healthcare. All that said, here’s what I did (in order of appearance):
- Stress Reduction – I learned a lot of coping skills to reduce my stress from my psychotherapist and have had regular acupuncture sessions with a naturopath for several years (minus 1 year where I didn’t have benefits).
- Tied in with the above, regular meditation and eventually yoga practice. I continued to reduce and manage stress through these means. Mindfulness in general can really help with anxiety, depression, and has been shown to reduce pain in many, many people, across many, many studies. I currently meditate 20 minutes (minimum) per day and do yoga 4-5x/week (between 20 minutes to 1 hour each day).
- Exercise – my exercise routine began with some work with a personal trainer who worked with autoimmune disease in the past, and then going to the gym 3x/week. When the pandemic hit, I began working out at home with some basic body-weight strength training exercises. I currently alternate strength-training with exercises given to me by my physiotherapist and chiropractor. On top of that I walk around 10,000 steps per day. I find that it works best if I pace by splitting it up with breaks and doing the same amount of activity each day. My physiotherapist and I are working on building up my strength so I can do more and longer hiking (currently I can do up to 1.5 hours, once or twice/week).
- Stretching – I’m giving this it’s own category because it’s not ‘exercise’ and yoga, while can be a great stretch, is much more than that. I do several stretches daily that have been given to me by personal trainers, naturopaths, physiotherapists, chiropractors, and massage therapists. I stretch every part of my from my jaw to lats to wrists to legs to back to toes. I probably spend about 15 minutes just on stretches each day.
- Diet/nutrition – this is something I struggled with for a very long time. I was recommended paleo diets and AIP protocols and this and that and I struggled to stick to any of them. So I made my own protocol/diet by just paying attention to how I was feeling after eating different foods. Then I eliminated what doesn’t make me feel good. I describe my current diet as “gluten-free pesca-vegan” because I mainly eat fish/seafood and then a vegan diet (no dairy) and gluten-free. (I probably should cut down sugar more and reduce alcohol a bit more but I’m getting there). I’ve been on this “diet” since last November. What’s made it easier for me to stick with is actually that I’m cognitively flexible with it. What I mean is, if I’m out and there are no (or very limited) options for this way of eating, I just eat whatever. If I’m at someone’s house and they serve meat or gluten or whatever, I eat it. This happens at most once/week and often less than that.
This is just my experience. I’ve been able to go off of one medication entirely, one medication was reduce to “as needed” (granted I supplement CBD instead daily – 10mg), and my rheumatologist reduced one medication a few weeks ago from 2000mg/week to 1400mg/week. Despite my lower ANA I do still have some symptoms – a bit of inflammation, some pain, but overall it’s a lot better than it used to be.
Have any of you found a difference with lifestyle changes?
Keep making the most of it everyone!
Always seek help from qualified healthcare professionals before making any lifestyle changes.
How to Have a Better Attitude Toward Fitness (When You Have Chronic Pain)
We all know that the majority of the research says exercise = less pain. Honestly, I’m a supporter of this idea. Why? Because it has literally worked for me. I’ve managed to get off one medication, which happened when the only major lifestyle changes I had made were daily exercise (strength and cardio/waling) and daily meditation (plus yoga 2-3x/week). No more Lyrica for me! Now that doesn’t mean that I no longer have pain. It’s just more manageable. I notice that when I don’t exercise, my pain actually increases. Of course, this all seems totally backwards to our brains., mine included. When exercise was initially presented to me as an option for reducing pain, I was like “no way I’m going to do that! I’ll be in more pain.” Then I tried it and the rest is history.
The thing is, even if you believe that exercise will help (and I’m aware that some of you don’t believe it, and that’s okay)the problem becomes, how do we reframe our minds so that we can actually start to engage in some physical activity? There are a way different ways we can approach this (or use all of these ways, depending on what you need). The very first thing I do is connect with my values. Why is this important to me? What values will I be living by? For me, when it comes to exercise this is often aligning with values of health, self-care, and independence. They might be the same for you, or totally different. The second thing I do is to just looking at my thoughts. I ask myself, are these thoughts helpful or unhelpful? Are they taking me toward the life I want to live or away from it? Then it’s helpful to create some distance from them. This can be anything from naming the story I’m telling myself, to speaking the thought aloud with the phrase “I’m noticing I’m having the thought that…”, to placing the thought on a leaf in my mind and watching it float down a stream.
At this point if I notice any sensations of anxiety or another emotion, I try to make some room for those. Maybe I send my breath into that area, or remember it’s normal to have anxiety, or drop an anchor which involves allowing my emotions to be there. By this point, I can usually do whatever activity it is I’ve decided I need to do (so in this case, exercise). While exercising there are a few more things I do so that I can improve my attitude. Firstly, I make sure my movement is mindful. I stay with the sensations of the movement, the smells in the air around me, what I can see and hear, all while exercising. This can be done on a walk or while doing strength training. You could also try yoga as a form of mindful movement that allows for stretching and exercise as added benefits. All my stretching in general is also done mindfully. I also make room for sensations while exercising. DO NOT exercise if it’s actually causing you extra physical pain. A little discomfort though is completely normal. I might do a quick body scan to check in with myself and make room for physical discomfort. I definitely use my noticing self to step back and just notice if it’s actually pain I’m feeling or if it is just discomfort that comes from exercise.
Lastly, I commit. I started out just going to the gym 3x/week. During the pandemic I built it up to strength training at home and going for walks to get fresh air and yoga a few times a week. The point is, you can start slow. And it’s probably better to if it’s a big change. You can also work with a physio/physical therapist, kinesiologist, occupational therapist, or personal trainer to help you get started (I worked with my physiotherapist, chiropractor and a personal trainer when I started). Here’s a podcast episode about exercise for chronic pain. So hopefully, this gives you some ideas on how to improve your attitude toward fitness with chronic pain. Until next week, keep making the most of it!
My Ultimate Pain Coping Skills Part 2: Relaxation
This is part 2 of my 4-part series on my favourite coping skills for chronic pain. These are all things that I use and find helpful. Additionally, they all have scientific evidence supporting them as being helpful. This week we’re going to talk about relaxation: how it can be beneficial and some ideas for incorporating relaxation into our daily lives.
Let’s start with what the research says is helpful about incorporating relaxation into our “treatment” for chronic pain. Relaxation enhances our ability to tolerate pain. But how does it do this? First, it increases our brain’s ability to respond to endorphins, which are our body’s natural pain relievers. Second, it reduces inflammation, which is often a cause of pain. Third, it allows our muscles to relax, and tense muscles tend to cause more painful sensations than relaxed muscles. Fourth, it reduces hypervigilance and desensitizes our central pain pathways, meaning that it helps to decrease our sensitivity to painful sensations. Fifth, it improves our mood and makes us less emotionally reactive to our pain, and since we know the mind-body connection is a thing, this makes sense. I also want to point out that the research states that mindfulness skills are more effective than relaxation skills. However, I think having both is important, and the research seems to support that as well.
So, let’s talk about a few different relaxation skills we can access, learn, and some other ones that I use that aren’t necessarily research based but are helpful for me.
- Progressive Muscle Relaxation: in this practice we tense each muscle group, one at a time, and then release the tension allowing for relaxation. I love this one and feel very relaxed afterwards. There’s been a lot of research on it, and it’s one we can do on our own as there are a ton of guided versions. Here’s a guided version I made from my YouTube channel.
- Guided imagery is another practice we can do on our own. I personally like “safe place” imagery, which I haven’t made for my YouTube channel yet but any guided imagery that uses peaceful, soothing or symbolically therapeutic mental images has evidence that it enhances relaxation from physical and emotional pain.
- Yoga is another practice that I normally associate with mindfulness, though I will admit that I find it relaxing as well. Yoga emphasizes a number of processes including acceptance, attention, mediation and relaxation, which is likely why many people find it effective. Here’s an interview I did with MS Warrior and Yoga Instructor, Clarissa, on the podcast.
- Hypnosis in an intervention that I haven’t tried, however there is growing research that it shows promise as being helpful for chronic pain. It alters our perception and cognitive patterns that occur in chronic pain syndromes through the use of relaxation. Here’s an interview I did with physical therapist, Sam, who uses hypnosis with his patients.
- Biofeedback is another intervention I haven’t tried but has a lot of research support it’s use and was discussed at the World Pain Summit I attended last fall. It increases our physical awareness and induces relaxation through the use of markers of the stress response. I definitely think it’s worth looking into.
- Pick any activity you find relaxing! Okay so this doesn’t have specific scientific evidence but if it induces relaxation then it can’t be bad. For me, that is taking a bubble bath (or epsom salt bath) and reading a book. I find it incredibly relaxing and definitely helpful for me.
As a therapist, I’m always surprised how many of my clients don’t have a lot of relaxation skills, which makes me wonder how many people actually actively use relaxation skills in general. So, I hope this gives you some helpful options, and I encourage you to try to make some time each day to actively do something relaxing. Keep making the most of it!
References:
Mind-body therapies Use in chronic pain management
Mindfulness-Based Meditation Versus Progressive Relaxation Meditation: Impact on Chronic Pain in Older Female Patients With Diabetic Neuropathy
Hypnotic Approaches for Chronic Pain Management
The Meaning of Yoga and How it Can Help Chronic Pain
For those of you who are against yoga, because some random person said to you once, “But have you tried yoga?” when you were telling them about your pain or illness, just stay with me for a second. No one likes unsolicited advice, but I’m guessing that if you’re here, reading this blog post or looking at this blog at all, it’s not really considered unsolicited. There is actually a lot of evidence that yoga can be helpful for pain, and I have personally found a huge difference after beginning to practice restorative yoga at the beginning of the pandemic (circa April 2020 is when I began).
Let’s start off by reviewing some of the research as to what yoga can help with and if it actually is beneficial. Guess what? The research is overwhelming a yes, yoga is helpful for chronic pain. There are tons of studies on it but I just picked three for the purpose of this post. Tal, Unrah & Dick (2011) found that pain patients in their study were able to “reframe what it is to live with chronic pain.” What does that mean? Well, not all of there patients actually decreased in the pain itself, but most found that the pain bothered them less. In other words, it was less interfering in their daily lives. Skip ahead to 2019 where Uebelacker et al. found in their study that pain patients who did yoga saw their moods improve, decrease in their anxiety levels and decrease in their pain levels. That same year, Schmid et al. (2019), found that pain patients who engaged in yoga had better occupational performance (they could return to work, do well at work), were more engaged in their regular daily activities, and had less depressive episodes.
This research is all well and dandy but the original intent of my post was to look at the meaning of the word “yoga” and how that in itself shows how it can be helpful to us chronic pain warriors. Yoga is derived from the Sanskrit word “yuj” which means to unite (or unity). This describes unity between the individual with the universe, person with nature, and importantly, mind with body. This is likely why we see things like mood improvements and decreases in anxiety in people who practice yoga, which is mindful movement. A yogi is someone who is self-realized and self-realization leads to freedom. Linking back to the research, freedom to work, freedom to engage in activities, and freedom from pain being “bothersome.” Finally it’s important to note that health (both physical and mental) is a natural result of practicing yoga, for all of the above reasons. Do you have to practice yoga? No. But I also don’t see the harm in trying (assuming you have consulted with your healthcare team).
I hope this brings some insight. Keep making the most of it!
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Video: Daily Yoga – Supported Fish
I find yoga to be helpful for chronic pain and my mental health. This is another one of the yoga poses I really like for my upper back. Please speak to your healthcare team about any changes to your exercise routine. This content is for educational purposes only.
How resilient have you been feeling lately? Anything less than an 8/10, then check out this podcast episode on how to cultivate resilience.
Keep making the most of it!
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Video: Daily Yoga – Sphinx Pose
This week we’re exploring one of my favourite yoga poses. I find it to be a great stretch for my back as well as my chest as it acts as a back bend and chest opener. Make sure to check with your healthcare team before doing any new exercise routines. The information in the video is based solely on my experiences. Stretches can be great for pain that is muscular – check out this podcast interview with Dr. Yass about muscular pain. As always, keep making the most of it!
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Video: Daily Yoga – Chest Openers
Chest openers are among my favourite yoga poses because I am always tight in my chest, really noticing it under the shoulders, near my armpits. And I always feel good during this stretch. Stretching is super important when managing chronic pain, and something most of us don’t do enough of, which is another reason I’ve incorporated yin yoga into my daily routine. Please consult with your healthcare team before starting any new exercise routines. I am not a professional yoga teacher, just giving your some education on what has worked well for me! Yoga is also a great way to contact the preent moment, which is the topic of this week’s podcast episode, avaiable here.
Alright everyone, for now, take care and keep making the most of it!
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6 Ways I’m Managing a Weather-Caused Flare (+ 5 More Ways I Could)
Long title, I know. But nonetheless I thought I’d share some of my tips with you, plus a few other evidence-based ones I found online as I’m trying to get through this. I’m writing this exactly one week before it will be published so fingers crossed that it’s over by the time you’re reading it, but if not, then I’ll just have to accept it as it is. My flare is likely caused by a few things. First, I recently moved and moving is stressful (even a relatively easy move like I had) and stress can cause a flare. Second, I moved from a dry climate in the interior of British Columbia to the wet, lower mainland of BC. I always notice my symptoms, especially pain gets worse when it rains… but then I knowingly moved to a rainy climate (*face palm*). All jokes aside, my symptoms are increased pain, increased fatigue, really bad jaw pain, my left foot is super veiny and sore (my calf is fine though so unlikely anything super serious). How the heck can I manage all of this?
- Acceptance. Yes, I know some of you are rolling your eyes or saying that this is ridiculous or unlikely to work. But I find it does. I accept that my pain is here, while knowing that the intensity changes hour by hour, sometimes even minute by minute, and I know that when my flare is over I’ll go back to baseline. Acceptance is helpful. I’ve been doing body scans and other mindfulness activities to help with the acceptance, but honestly just acknowledging my experience without getting wrapped up in it is helpful. Check out this acceptance practice.
- Exercise, Movement and Stretching. If you read this blog regularly you know that I like to exercise. And I still pace myself by trying to stay consistent with what I do. I definitely increase my stretching during flares. Particularly I focus on the areas that seem to hurt or need it the most. For example, my jaw is the worst today as I write this, and I’ve made sure to do jaw stretches throughout the day. For more on jaw pain specifically, check out this podcast episode with Dr. Shirazi.
- Warm Baths. I LOVE my baths. I literally take a bath 4-5x a week in the winter months. And with the rain, I’m definitely needing them. They help relax my muscles, keep me warm, and are very relaxing. Trust me when I say I could never (and would never) live in an apartment without a bathtub. Knowing what is vital to your self-care is essential to dealing with a flare. Check out this podcast episode on it.
- Dressing Warmly and in Layers. Vancouver, if you’ve never been, is a city where everyone dresses in layers. It will likely rain at some point during the day, though you never know exactly when. It could also start off cool and warm up, or vice versa. So I’ve been making sure to put on 3 layers when I go out, and have a pair of mittens on me. I need to remember a hat and/or an umbrella, but I’m working on it!
- Hydration. I tend to drink a lot of water. Admittedly more when I’m working. Staying on top of my water intake is so important to managing my flares and really my health! I’m trying to drink 5 full glasses of water a day minimum. I basically keep a glass of water next to me all day and every time it’s empty, I refill it. Listen to my podcast conversation with Beau Berman about gut health and how important drinking water is to him.
- Omega-3’s and Vitamin D. I typically try to get these from the foods I eat. Lots of fish mostly (rich in both), as well as mushrooms, spinach, avocado and tofu and really a variety of others foods are rich in vitamin D. These are really important for reducing inflammation naturally and honestly are just really good for you! Also, Vitamin D is a way to combat with the “winter blues” (which I often get) and the more severe, Seasonal Affective Disorder.
So those are the 6 things that I am doing, but what are the 5 things that I’m not but probably should be?
- Acupuncture. This is actually an evidence-based and recommended treatment for chronic pain. I’ve had it in the past and I’m hoping to start back up with bi-monthly sessions next month. Listen to the podcast episode on recommended treatments for chronic pain for more info.
- Massage. I miss getting massages. It’s been nearly a year since I had one, and this is also a service I used to get bi-monthly. I’ll likely also start these back up soon as well. Clearly I need to. The benefits of massage can be heard in the podcast episode with Danielle Potvin.
- NSAIDs. I’m not a fan of these drugs to be honest. They can cause stomach problems when on them long term. I’ve drastically cut back on them and only take them to supplement the more natural medications I take (i.e., CBD). If you’re aware of the risks and find them helpful then this can be a helpful solution.
- Natural supplements. The only natural supplement I currently take is magnesium bis-glycinate which is a muscle relaxant (and I mainly use it when I’m menstruating). Other recommended supplements are fish oil, ginger (which I sometimes have in food and/or tea), turmeric (which I sometimes have in tea), and gingko. These are definitely worth checking out to use in addition to some of the other suggestions.
- Limit Stress. Oh I can’t wait until I’m passed the stress of the move and starting up new counselling practices. The truth is there is always some kind of stress in our lives and it really comes down to how we manage stress. I typically do a good job with mindfulness, meditation, yoga, and relaxation practices. So this might just be a reminder to do a bit more of that. And also, if you are able to avoid stress then that’s a good plan (I do not plan on moving again for quite some time!).
So that’s it! 11 ways in total to manage a flare. Keep making the most of it everyone!
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Chronically Living 