Self-compassion and back pain

Back pain is a big deal. An estimated 80% of the population will suffer from back pain at some point1, and in Australia, 1 in 6 people have chronic back pain.2
Self-compassion can help.

Six months ago, I couldn’t walk.

I was stuck in bed with acute lower back pain. Even standing in the kitchen to make tea was too painful. I’d somehow triggered an old condition of sciatica that gradually got worse and worse.

This condition had previously flared up from time to time, but nothing so dramatic for years. This time however, my approach was more accepting, less resistant. I “surrendered” into the experience.

“Well, if that’s what my body is saying right now, I better listen!”

It didn’t decrease the pain, but it sure felt softer, kinder and eased my tendency to tense up and brace against the discomfort.

As well as following medical advice, I tackled the emotional and mental side of back pain with self-compassion. Every day I practised Affectionate Breathing, Loving Kindness or Giving and Receiving Compassion, specifically for my back.

I religiously asked myself, “What do I need?” and asked friends, family and colleagues for more help. I felt so grateful to them, and this felt new and unusual to my proud, independent self. I gave that self some kindness and forgiveness.

Although I’m speaking about back pain here, as this was my personal experience, the evidence suggests that self-compassion can help with all kinds of chronic and acute pain.³

Mindfulness helped me discern between when I needed rest and when I was just avoiding exercise. I did gentle physio exercises every day. The inflammation died down with medication, and soon I returned to walking and swimming. I was listening to my body’s needs with more sensitivity than ever. Dancing slowly around my living room one night felt so good, answering a heartfelt wish and feeling the joy of moving again.

After a lovely, long Loving Kindness practice one day, I felt like exploring any unmet needs around my back pain. Something that “pinged” for me emotionally was sometimes feeling unsupported in life. So I called a counsellor and started exploring any life events that felt related. This was helpful; a great complement to practising self-compassion.

Five Tips for Working With Pain

  1. Give yourself a break! 
  • Acknowledging we are suffering and bringing loving awareness to the pain can help decrease our resistance to the pain.
  • Asking, “What do I need?” Maybe it’s rest, maybe movement.
  • Lowering your expectations of what you can do.
  • Adding rest and self-care breaks into the day.
  • Dropping work or activities that feel too exhausting. Say no, if you can!

2. Ask others for help 

  • We all feel pain, sometimes. Wouldn’t we help a friend with pain? Maybe this is your turn to ask for support and help
  • Self-Compassion Break for feelings of pride, inadequacy or independence.

3. Lean on formal practices for support 

4. Emotional needs 

  • Are there some emotional aspects of pain to explore, such as shame, anger, or feeling unsupported?

5. Self-kindness during the healing process 

  • Self-compassion for our impatience to heal, or for giving up the things we wish we could do

Mine isn’t a unique case. Research suggests that self-compassion training reduces pain severity and pain catastrophising as well as the anger, disappointment and frustration associated with pain. It also reduces self-blame, self-criticism and poor acceptance of one’s physical limitations.3, 4

In this interview (at 35:20), self-compassion expert Chris Germer discusses working with clients with back pain:

“One of the core aspects of chronic back pain is wishing not to have chronic back pain. It hurts and every fibre in our body says, ‘No!’ But the problem is, the more we do that, the more we activate the threat defence system and the body becomes tighter and we get more pain.”

“Self-compassion activates a different physiology — the mammalian care-giving system. We all know what this is like. If you have pain and someone puts their arm around you and really loves you, inside you have a feeling like, ‘Ahhhh!’ Your whole relationship to your back pain changes. There’s a relaxing, a letting go. This is called regulating emotion through affiliation; a sense of connection, a sense of care.”

“People with lower back pain are criticised for being in a bad mood, for not being able to do everything they used to do, so back pain becomes a social problem and becomes a shame issue. So there are so many levels of pain. What we do in self-compassion for back pain is learn to name all this stuff and know that back pain is not our fault, we know that we’re not alone and we begin to treat ourselves in the opposite way that the body treats us and others treat us. In other words, we begin to relax and give ourselves the messages we need to hear when we’re struggling.”

Five weeks after taking a self-compassionate approach, I could cut down the medication without feeling much pain. Self-compassion helped my impatience to heal, and it also highlighted any catastrophising: “What if I can’t balance properly? How can I continue to teach qi gong with no balance?!”

I feel so grateful for self-compassion practice and for supportive friends and family. Asking for help more often is something I’ll keep doing, whether in pain or not. It sure feels more supportive, more connecting and kinder. And it contributes to a more self-compassionate lifestyle and a healthier relationship with my body.

If you’ve used self-compassion to relieve the suffering experienced with pain, I’d love to hear from you! How did it help?

If you’re interested in learning more about Mindful Self-Compassion, we offercourses in Brisbane, and there are many other MSC courses running internationally.

 

Sources:

(1) In Project Briefs: Back Pain Patient Outcomes Assessment Team (BOAT). In MEDTEP Update, Vol. 1 Issue 1, Agency for Health Care Policy and Research, Rockville, MD.

(2) Impacts of chronic back problems (full publication; 15 Aug 2016) Australian Institute of Health and Welfare

(3) Pilot study of a compassion meditation intervention in chronic pain, Chapin, Darnall, Seppala, Doty, Hah and Mackey, 2016

(4) Self-Compassion in Patients With Persistent Musculoskeletal Pain: Relationship of Self-Compassion to Adjustment to Persistent Pain, Wren et al, 2012

 
Mindful Self-Compassion has been researched to help ease the emotional and mental stresses of physical pain, like pain catastrophising, self-criticism and depression, and to improve self-care and awareness of body sensations, so we’re more able to discern whether to push our bodies or not.
 
Some of those research articles are cited here
 
Content gratefully reproduced from my original blog post on the CMSC website.
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