Dealing with chronic pain and enjoying life againWorking with people in pain is a passion of mine, especially after my own experiences with injury, surgery, rehab, and chronic pain, so I wanted to share some of my experiences with the Egoscue method, which has made a profound difference in my life and in my ability to be active again. It’s really allowed me to get a handle on my pain, manage it effectively, and not be afraid to push the pain a little bit and get out there and do stuff.  And doing stuff is what helps most with my pain.

Dealing with Chronic Pain

The days I have my worst flares are days I’m not moving around much, that I’ve been in one position for too long, such as working at the computer. Even though I have a stand-up desk, the days I’m powering through school or work projects I don’t change my position up enough! (On a side nte, this is why I downloaded Workrave on my computer – it reminds me to get away from my screen for 30 seconds every 10 minutes or so and for a full 8 minutes every hour. I love it! And it’s fully customizable.)

Back to Egoscue: Movement is a huge part of pain management and this is where Egoscue is great; the gentle stretches and exercises are designed to help our bodies return to its functional design: one of aligned joints and balanced muscles. For a long time I thought that my pain was an indicator of tissue damage and that I shouldn’t move. I’ve since learned that pain is indicator of threat and the brain’s evaluation of a need for protection, an overexaggerated response, and that it us just a signal that something is out of whack.

My Pain Journey

For me, my pain was mostly a result of joints being out of alignment because of all the compensatory movements I engaged in during the year I was injured leading up to my surgery and the year of physical therapy following my surgery. Because I kept shifting my weight to relieve some of the pain, my lumbar spine (low back) was twisted on it’s axis and it lead to what is called SI joint dysfunction, which essentially means my hips are out of whack a lot of the time (they have minds of their own and don’t play well together).

This is usually seen in rotations in my t-spine (my upper back and shoulders are twisted relative to my hips) and my hips are rotated in opposite directions. Doing my e-cises helps me to realign everything and get my body in a better position, getting me out of pain and ready to be active.

The e-cises are easy to learn and are arranged in “menus”. So I have active menus, that feel like a workout,  pre-menus, that set me up for another activity like yoga or boarding,  post-menus for when I complete activities, and more restorative menus, that just keep me aligned and balanced. Does it take time? Yes. Does it take consistency? Absolutely. Do I have to commit to it (to myself) to do it everyday if I want to keep feeling good? Yes. But I’m worth it ;)

If I go a few days without doing a menu, I know it. Just as when I go for long periods of time in one position, I know it. When I’m in the most pain is when I know I need to get moving again – totally counter-intuitive to how I felt a few years ago. This is why I keep saying that movement is life!

Understanding Pain and Getting Moving
The key to overcoming pain is understanding it

And it helps to understand that pain is just a signal that something is out of whack, not that you’re causing damage, and that you can push or nudge that pain a bit more and get moving. And once you get moving, viola! – the pain will decrease and possibly even go away.

A great resource for learning more about what pain is is the Body in Mind research group. I interviewed the head of the research team, Lorimer Moseley, for a school project (he co-wrote the book Explain Pain, too) and will be sharing some more of how explaining pain can help manage pain symptoms in future posts.

To summarize here, the keys to overcoming pain are understanding pain, respecting pain but not fearing it, and moving and actively engaging in life.

The moving part is hard for a lot of people in pain because they fear moving will make the pain worse. That’s why pain education is important, once you understand that moving is what is causing the pain and that movement can actually help the pain get better, it is incredibly freeing. It allows us to get back to the activities we love doing and have missed. It allows us to engage more fully in our own lives.

A girlfriend of mine that has chronic low back pain has recently discovered this as well. If she goes a few days without exercising–PAIN. If she starts moving again–NO PAIN. The thing that’s great about Egoscue is that it looks at what is out of whack (which is different for everyone) to get you back in alignment, making it very specific to your body at the present moment. But there are also e-cises that are pretty universally and consistently beneficial, without a need for an assessment or an individualized menu. One of these is static back. Another is proper breathing (yes – breathing can be an exercise!). Static extension, floor twists, and cats and dogs are great, too.

Egoscue in Practice

For example, a menu could be 5 minutes of static back, 2-3 minutes of static extension, 1-2 minutes in a spinal floor twist (each way), and finishing up with 10 cats and dogs. Although it’s simple, simple doesn’t mean easy! And even though it’s simple, the results can be pretty fantastic.

Just becoming more familiar with some of the principles and basic movements and applying them to daily living can have profound effects for people in pain; I’m proof of how impactful it can be! (I’ve shared how Egoscue changed my life in another post, here, if you want to check it out!).

The Egoscue method addresses pain by looking at the whole picture, not the symptom, because where the pain is is not always, or even typically, the source of the pain. By looking at the alignment of the major joints; ankles, knees, hips, and shoulders, such that the knees and ankles are aligned with feet pointed forward, hips are firmly planted over symmetrical knees, shoulders sit directly over level hips, and the head is centered over level shoulders, any deviations that are found can be gently corrected through stretches and exercises.

Egoscue works so well because it focuses on getting the entire body working as a unit and getting all of the joints lined up, rather than just honing in on the painful joint.

My Egoscue Experience

I remember my first session at Egoscue. I was searching for any kind of answer because I just wanted to not be in pain all the time. A year after my surgery I was still in a great deal of pain, despite being diligent in my physical therapy and doing all of my home exercises. I refused to take pain medications for a whole bunch of reasons (some reasonable, like I didn’t want to become dependent on them at the age of 34 as I am going to be dealing with pain issues for the rest of my life, and some unreasonable, like my fear of all things medicine that I acquired from my dad.)

My orthopedic surgeon recommended that I try the Egoscue Method instead of continuing with PT, something he recommends to all of his patients who present with persistent pain. I was at my wits end when I finally decided to go to a clinic, not having slept for 2 weeks because of the pain. After some postural assessments, standing and moving, my e-cises included me lying on my back with my legs at 90 degrees on a block (static back), pelvic tilts, standing on a stair on the balls of my feet with my heels hanging down (this helps reseat the pelvis and realign the major joints), and some t-spine mobility exercises. I wondered throughout the session how the heck these exercises were going to fix my SI joint pain, but I did it (I’m always game for trying new things!).

That night I slept like a baby. For the first time in two weeks I was comfortable enough to sleep because my pain was tolerable. I was amazed that such a simple approach, and one that didn’t even focus on where my pain was, was so effective. I was sold.

Dealing with Chronic Pain through movement - lunges with hands behind headInitially, my menus were pretty passive and a lot of it was ground-based to allow my body to get back into it a good position. Now that I’ve been doing Egoscue for a couple years, my body stays in that good position for a much longer period of time and I now have menus are more like workouts. I have a couple “reset”, quick menus, too. I have pre-menus before I do something more active, like yoga or boarding, and post-menus to make sure everything gets lined back up again. It’s simple. But simple doesn’t mean easy.

Movement, breathing, yoga, school, research: It all comes together

Part of my buy-in to the program was in some of the overlap with things I was already familiar with, too.  A lot of the e-cises in Egoscue are inspired by yoga postures. There is also a huge focus on breathing and I knew how crucial breathing was to performance and was beginning to learn its importance in proper whole-system function as well as pain relief. The idea of proper breathing and breathing with movement; things I had been focusing on for a while. It  just sort of brought everything together for me.

With the research I have done in pain education and understanding pain through my graduate program and my experience and training in Egoscue (I’m currently becoming certified in the method as a Postural Alignment Specialist 1), I hope to help other people suffering from chronic pain to manage their symptoms and reengage in life and the activities they love.

In the interim, I hope to share my experiences with all of you in the hopes that some of it will help.

If you have any specific questions, please use the contact form or the comments section and I will respond as quickly as I can!

As always, thanks for reading my posts!

References for my nerd friends :)

BodyInMind.org

Egoscue, P., & Gittines, R. (1998). Pain free. New York: Bantam Books.

 

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3 Responses to "Dealing with Chronic pain: Egoscue and Pain Education"

  1. Thanks for the post. I have heard of Egoscue for a long time and not looked into it more thoroughly. Do you know how it compares with other postural and movement approaches like The Restorative Exercise Institute or the Gokhale Method Institute?

    Keep up the good work!

    • Bob,

      Thanks for the comments! I am not as familiar with the Gokhale method or the Restorative Exercise Institute but of what I do know of them, there are a lot of similarities. All assess static and dynamic postures and have exercises to bring the body back into balance and alignment based on what is found.

      But I only have experience with Egoscue so can only speak to it’s effectiveness. It has quite literally changed my life! I am almost through the level one certification, I want to be a well-versed advocate for Egoscue for people who are in chronic pain.

      I am also looking to put together pain rehab protocols for people with persistent pain that addresses a broader scope of the biopsychosocial contributors to chronic pain, of which the approach of Egoscue will be a part.

    • Bob – I watched an intro webinar to the Gokhale method last night. It is actually quite different than Egoscue, it is much more focused on teaching daily postures for sitting and walking and they sell products to help you to attain proper posture while sitting (such as chairs and back pillows). They even teach how to walk.

      Egoscue is aimed at restoring the body to a neutral position to restore muscular balance and joint alignment through gentle exercises that slowly get your body back into alignment. The idea is that you don’t have to focus so much on your postures throughout the day because your body is back to it’s functional design. I personally prefer the Egoscue method approach, particularly for active people as once you get out of pain, the exercises get ramped up and are pretty active. They exercises also set you up to successfully engage in whatever activities you are going to engage in (golf, surfing, weightlifting, running, traveling on a plane – everything is on the table and nothing is off limits) and help you regain alignment once you’re done.

      I think Gokhale is really well-suited for people who are seated or sedentary for a lot of their day and could be a complementary approach to something a bit more active, like Egoscue (or restorative exercise, though I’m not familiar with that method).

      Just wanted to share that I looked into it a little further, hope that helps a bit!

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