"Why does my back hurt?"
I get this question a lot from my clients. Simply put, there are a lot of reasons why and when it comes to the lower back and neck, science doesn’t have a clear answer. It’s difficult to pinpoint even with all of the diagnostic tools available to our medical people. My advice is to be your own best advocate. You have lived in your body and know it better than anyone.
There are many reasons why we experience pain. There can be a physical injury that results in acute pain, recurring pain after injury (like pushing too hard and too fast after an injury and having a setback), and chronic pain that lasts for longer than three months. There’s physical pain after medical illness, as a result of a disease process or after procedures like a surgery. There’s also sensations perceived as pain as a result of trauma/Trauma. So, what is trauma? What is Trauma?
We all perceive trauma in a variety of ways. What may be traumatic for one person may not be traumatic for another. Small “t” trauma can be “too much, too quick” or “too little for too long” that then overwhelms our nervous system. Big “T” trauma can be events like living though hurricanes, floods, pandemics, fires, war, white supremacy and genocide to name a few. Whether we experience trauma or Trauma, our nervous system reacts and responds. If the T/trauma is not processed through the body, it can get stored within the cells of the body and perceived as pain. I will reference The Body Keeps the Score by Bessel van der Kolk here for a more thorough explanation on this, but I will share my understanding of this. It is not that emotions get stored in the body. I hear that a lot in yoga when people say, “Stress gets stored in the hips.” Instead, the sensations cause our cellular makeup to shift and change and our brain can understand it as pain.
There are pain theories as well that shed light on the process in the brain that changes when chronic pain exists. One theory is related to pain neuroscience. According to pain neuroscience, pain can rewire the brain, altering our bodies sense of where pain is and what’s causing it. In this theory, chronic pain leads to a hyper-excitability of the nervous system. This is known as central sensitization which then causes an increased responsiveness of pain receptors. This causes an increased sensitivity to stimuli with a more broad pain response outside of the area of injury (credit shout out to www.physio-pedia.com). An older pain theory is the Gate Control Theory of Pain. In this theory, there are three different types of neural fibers that transmit painful signals to the spinal cord which then allows the signals to either go on to the brain to be perceived as types of pain, or the signals are blocked in the spinal cord. These nerve fibers transmit the sensations of burning, light touch, deep pressure, temperature, and hair movement.
How do you know where your pain is coming from? It requires self-inquiry, self-reflection, and a devotion to peeling back the layers within yourself to uncover the cause or causes of your pain. It requires and asks you to do the work in order to heal. There is not one pill that can take away all of your pain. There can be multiple reasons why you feel pain. For example, there can be physical ailments, and/or generational, sexual, or birth traumas that can all contribute to the physical felt sense known as pain.
I will suggest that if you have a newly felt pain or injury, see your medical provider. There can be medical issues that you can’t exercise or meditate your way through. There can be a mix of emotional issues manifesting as physical issues that need a support team and mental health professionals to help you process what and how you are feeling. Solving and healing your pain may need a multi-faceted, multi-disciplined approach. Recognize that pain is real and it is there to tell us something. It should not be ignored, but it can be managed. Advocate for yourself and reach out to get the help you need. This can include seeing your medical provider, talking to a mental health professional, seeing a physical therapist, working with a somatic body worker, seeking a support group, meeting up with friends, and/or going to a yoga class. There is not a one-size-fits-all approach to pain.