“Demystifying Chronic Pain, A Somatic Functional Perspective,” By David MacDougall.
How do we measure the cost of chronic muscle/joint pain? A recent article in the Journal of the American Medical Association indicates the cost of healthcare spending for back/neck pain is $87.6 billion a year. Studies indicate it is “the leading global cause of disability in 2015 in most countries.” Just stroll through your local pharmacy and note the amount of shelf space occupied by “pain killers,” and you can see that chronic pain is truly a cultural phenomenon. Since back, neck and other chronic musculoskeletal pain are so common, you may have personal experience with the cost and inconvenience/suffering they cause.
Low back pain is a prime example of the persistence of the medical enigma of chronic musculoskeletal pain. Much of the money spent treating back pain is allocated for diagnostic testing in an attempt to determine what is causing the pain. Yet despite the enhanced sensitivity of new imaging devices, typically no definite pathoanatomic site is found, and no theory of what causes regional back pain has stood up to scientific testing. The structural bias inherent in most of medical thinking obscures the fact that many regional musculoskeletal disorders do not respond to treatment as diseases because they are not diseases.
Medicine and Somatics each seek to determine the underlying causes of maladies such as back pain, but Somatics takes a broader perspective. The medical viewpoint is affirmed, but with Somatics the focus is not on “what” causes the illness as much as it is on “how” the physiological system has adapted to stress and trauma. Symptoms are seen as an indicator of strain due to dysfunction within the involved systems. Since muscles are the agents of function within the musculoskeletal system, it seems logical to focus our attention there. Indeed palpation of the hip and back muscles of back pain sufferers commonly reveals hypertonicity and soreness and softening of these tissues via manual therapy often brings temporary relief. But we must bear in mind that muscles contract only when activated via a signal from the motor nerve. If we wish to evoke a lasting change in muscle tension, the change must occur within the central nervous system that regulates nervous activation of muscle action.
Various methods may induce de-contraction of hypertonic muscles, but when the muscle contractions have been habituated and the condition has become chronic, an internal reorganization of the sensing and activation of muscle actions must occur before the changes evoked by therapy can persist. Those suffering must take an active role in developing more efficient self-regulation of muscle action.
The somatic exercises developed by Thomas Hanna, PhD are a proven time efficient, gentle means of enhancing voluntary control of movement and posture. The exercises are based in methods of somatic education developed by Hanna during 17 years practice of the Feldenkrais Method, and are informed by current theories of motor learning and biofeedback training. Helmut Milz, MD, former consultant to the World Health Organization, said, “these exercises could make a real difference for the vast number of people who suffer from musculoskeletal ailments.” Since enhancing the efficiency of bodily movement enhances vitality in all functions whether physical, emotional or mental, students find that as they lose the pains they have suffered with for years, other benefits occur as well. In the words of Thomas Hanna, “Somatic Exercises can change how we live our lives, how we believe that our minds and bodies interrelate, how powerful we think we are in controlling our lives, and how responsible we should be in taking care of our total being.”
Mark your calendar and register today for Dave’s Workshop on Saturday, Nov. 3rd, “Somatic Self-Care,” and learn an easy-to-practice set of somatic exercises that will enable you to reduce unwanted muscle tension and restore/maintain comfort and ease of movement with 10-15 minutes a day of pleasurable movements. Then, on Dec. 1st, Dave teaches us “A Somatic Approach to Better Breathing.”
David MacDougall, MA, LMT, is a certified Hanna Somatic Educator specializing in intelligent self-care for the reversal/prevention of muscle/joint pain. Contact Dave to register.
Dr. Lodico is trained in cognitive behavioral therapy, infusing it with mindfulness based practices to address chronic stress, anxiety and depression in clients. She uses a practical, problem solving approach to guide adults and families in resolving the constant challenges associated with thriving and parenting in today’s environment.
more fully is unfortunate because we are thereby forfeiting a powerful means of maintaining heart health.
know muscles have no will of their own, so we can see that the problem lies not in the muscles themselves, but is instead a consequence of deficient regulation and control. This functional deficit in the nervous system’s management of muscle function represents a lack of voluntary control that cannot be remedied by any amount of structural reengineering. Change must come from the inside out.
This month we welcome a new clinical psychologist to One Roof, Dr. Dana Lau. Her specialty is adolescent therapy, and she treats families and adults as well. Her practice includes DBT and mindfulness, so she is a great fit with all of us here. Her complete bio is on our