Forever Painless

End Chronic Pain and Reclaim Your Life in 30 Minutes a Day

Miranda Esmonde-White

• Publisher: Harper Wave
• Year: 2016
• Print ISBN: 9780062448668
• eBook ISBN: 9780062448682
• Topic: Biological Sciences
• Subtopic: Alternative & Complementary Medicine
• Index: Biological Sciences

End chronic pain—for good—with this practical guide from the PBS personality behind Classical Stretch and author of the New York Times bestseller Aging Backwards.

Chronic pain is the most common cause of long-term disability in the United States. Twenty percent of American adults accept back spasms, throbbing joints, arthritis aches, and other physical pain as an inevitable consequence of aging, illness, or injury. But the human body is not meant to endure chronic pain. Miranda Esmonde-White has spent decades helping professional athletes, ballet dancers, and Olympians overcome potentially career-ending injuries and guiding MS patients and cancer survivors toward pain-free mobility. Now, in Forever Painless, she shows everyone how to heal their aching bodies and live pain free.

The root of nearly all pain is movement—or lack thereof. We need to move our bodies to refresh, nourish, and revitalize our cells. Without physical activity, our cells become stagnant and decay, accelerating the aging process and causing pain. People who suffer chronic pain often become sedentary, afraid that movement and activity will make things worse, when just the opposite is true: movement is essential to healing. In Forever Painless, Miranda provides detailed instructions for gentle exercise designed to ease discomfort in the feet and ankles, knees, hips, back, and neck—allowing anyone to live happier, healthier, and pain-free no matter their age.

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Part One

When the Pain Doesn’t Go Away

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CHAPTER 1

Our Modern Epidemic of Pain

Pain is part of the human condition. During our lifetimes, we all experience a few episodes of acute physical pain. Not many of us will escape the kind of pain we feel after stubbing a toe, spraining an ankle, or stepping barefoot on a piece of glass. But fortunately, for most people, acute pain tends to be as short-lived as it is severe.

This type of pain is normal; it’s healthy pain. Healthy pain is an indicator that something is wrong or is doing damage to our body. Healthy pain is part of an essential warning system—without feeling the sharp pain that accompanies a broken limb, for example, we would carry on using it until we caused even greater damage. So in situations of injury, pain functions as a protective alarm, warning us that our house is on fire and we must take action to save it. Once the fire is out—once the broken bone has healed or the torn muscle repaired—the pain should recede.

This acute pain is completely different from the type of pain that comprises four of the top 10 reasons why Americans consult doctors and other health-care providers: chronic pain. Often, chronic pain is the fire alarm that won’t shut off. This enduring, unrelieved pain is a major global health-care problem, a disease in its own right. For sometimes mysterious reasons, this pain may start gently but, over time, become stronger and stronger. We might visit several different doctors in our search for the cause of the pain, but the truth is, many times the root cause is easily overlooked. It may be something as simple as sitting hunched in front of a computer all day. Or that bicycle accident we had a decade ago. Or something else—we often just don’t know.

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PAIN AND DEPRESSION: A TWO-WAY STREET

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Pain and depression tend to go together, for both biological and psychological reasons. When you’re in pain, you understandably tend to feel more depressed; when you are depressed, your body actually has a heightened sensitivity to pain. The factors involved are complex and often misunderstood. For example, imbalances in certain neurotransmitters, such as serotonin and norepinephrine, are linked to both depression and pain—a fact that can lead some to believe “it’s all in the head.”¹ But both conditions are also characterized by systemic inflammation, a risk factor for heart disease, diabetes, and many autoimmune conditions. And research has proved that the worse our painful physical symptoms are, the more severe any related depression tends to be.²

We need to take this connection extremely seriously. In a recent review in the journal Current Psychiatry Reports, Scottish researchers found that up to 50 percent of chronic pain patients also suffered from depression related to the pain, and 17 percent suffered so badly that some days they wanted to die.³ A Canadian study found that people living with pain had double the risk of suicide, compared with people without chronic pain.⁴

These statistics are tragic to me. People need help, right now.

The program in this book can help you recover both mentally and physically; exercise is a proven remedy for both pain and depression. But please be gentle with yourself and realize that sometimes exercise is not enough. Be sure to talk about your physical and emotional health with your doctor; getting the help you need for either pain or depression will automatically help both.

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None of the standard medical approaches are designed to permanently relieve non-disease-related chronic pain. It seems to persist even with visits to massage therapists, physical therapists, osteopaths, chiropractors, and other specialists. These passive treatments feel good and provide temporary relief—but the pain usually returns within hours.

According to the National Institutes of Health, chronic pain is the most common cause of long-term disability in the United States. Chronic pain is a life-altering, life-limiting daily state for one in five U.S. adults. The American Chronic Pain Association lists lower back problems, arthritis, repetitive stress injuries, headaches, and fibromyalgia as some of the most common sources of pain.

The price tag of chronic pain is staggering. In the United States, the cost of chronic pain in adults, including health-care expenses and lost productivity, has been estimated at $560 billion to $630 billion annually. (That’s billion with a b!) Then there is the incalculable toll on individuals and families. A survey of almost fifty thousand Europeans found that 27 percent of chronic pain sufferers said their pain made maintaining their relationships with family and friends very difficult, if not impossible.⁵ Chronic pain sufferers experience deficits in all kinds of cognitive functioning, including perception, thinking, reasoning, and memory. According to the European Journal of Pain, 61 percent of those with chronic pain are less able or simply unable to work outside the home because of their pain.⁶ One Canadian study found that arthritis pain shortened sufferers’ working lives by an average of four years.⁷

Sadly, due to their inability to diagnose or treat so-called mechanical pain (or non-specific musculoskeletal pain), many doctors believe that some degree of pain is normal and that we should be prepared to tolerate it. And millions of people do just that, year after year. Too often people turn to doctors who have little training in pain management and who tend to freely prescribe drugs, including opioids, in response to complaints of pain. Even if you put aside the serious risk of overdose and death, opioids can also increase the risk of accidents, disrupt your periods (if you’re a woman), lower your sex drive (whether you’re a woman or a man), trigger sleep apnea, cause constipation, and contribute to heart and lung problems. Many doctors simply aren’t educated about the risks. In fact, a recent Canadian study found that veterinarians receive five times more training in pain management than medical doctors do.⁸ And a European survey of patients suffering moderate to severe chronic pain found that one in four patients said their doctor never asked about pain or, if pain was discussed, the doctor did not know how to treat it.

I am not a doctor—but I am a firm believer that the topic of pain should be a routine part of our health checkups, and that we should expect our doctors to be able to offer solutions beyond medication. Living pain-free should be a human right. The preamble to the World Health Organization’s constitution—which was adopted in 1948 and has remained unchanged ever since—defines health as “a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity.”⁹ I agree wholeheartedly with this view—it’s the only way that pain is going to get the respect, attention, medical research, and treatment options it deserves. Unfortunately, many research dollars dedicated to investigating pain are focused on pharmaceuticals, not long-term relief. But we don’t have to wait for the medical establishment to catch up—we already have plenty of evidence that our bodies hold the keys to a pain-free life.

Our Body’s Built-In Pain Relief

Traditional approaches to anatomy and health have taught us that the human body is the sum total of many independent systems:

The brain and nerves function as our nervous system.

Muscles, bones, and soft tissues comprise our musculoskeletal system.

The glands and organs that regulate our hormones make up our endocrine system.

The heart and blood vessels, which pump blood and oxygen to every cell in the body, form the cardiovascular system.

The organ systems, combined, are the engines of life.

Every moment of our lives depends on the complex interaction of these systems. And for a long time, the connective-tissue system—the bands and sheets of fascia under the skin that attach, enclose, and separate our muscles and organs—were seen as the supporting structure for the other systems, which did the real work of keeping us alive and healthy. But the more we learn about the integral role that fascia plays in our overall health, the more we’re starting to see that the best way to keep all of these systems functioning properly is to keep connective tissue healthy, strong, and flexible. The closest thing that we have to a universal cure-all is regular exercise with correct form.

Every bite of food we eat and every thought we think creates a ripple effect within the body. We know that if we eat refined carbohydrates, for example, our pancreas will release more insulin to help our cells absorb the sudden increase in blood sugar. On the flip side, we also know that if we take a moment to pause amid a stressful day to take a few deep breaths, our circulatory system will carry extra-oxygenated blood up to the brain and to all of our muscles, helping us feel calmer, sharper, and more energized.

In much the same way, each time we twist or turn, bend or lift, the stretching triggers changes in our connective tissue, and different messages start careening throughout our body. Doctors used to believe that many of these messages were carried exclusively by the nervous system, but new theories suggest that connective tissue also plays a critical role in this messaging network. Because not only does our connective tissue support our musculoskeletal system, it also provides the actual building blocks of our organs. Researchers now believe that this tissue could function as its own “meta-system” within the body, constantly connecting with various regions and coordinating the messages and activities of each bodily system.

Most of us have never given much thought to our fascia. We may have a vague idea that fascia fills in the gaps in our body, but new research suggests that this connective tissue is not passive at all. Recent studies by Dr. Helene M. Langevin, director of the Osher Center for Integrative Medicine (jointly based at Brigham and Women’s Hospital and Harvard Medical School) and a professor of neurological sciences at the University of Vermont, have found that connective tissue not only lengthens and changes in response to pressure from the outside—such as stretching or the insertion of acupuncture needles—but also lengthens and reorganizes itself from within. Dr. Langevin’s studies have shown that when needles are inserted into the collagen of the fascia during acupuncture, connective tissue “grabs” the needle and twists around it. Then, a few moments later, fascial cells located a few centimeters away from the needle extend and fundamentally change their composition in response.

Let’s take a moment to let that sink in: not only is this tissue being moved by an outside force—it is also moving and stretching and changing itself from within.¹⁰ Amazing, right? The idea of self-stretching tissue suddenly makes our fascia seem a lot more active and dynamic—and essential to our health—than we once assumed.

While it’s incredible that connective tissue has the ability to react to movement, the only way to trigger this self-healing reaction is just that: with movement. The more we learn about Essentrics, the clearer it becomes that this type of exercise is exactly what our connective tissue needs to facilitate internal changes. And perhaps most exciting of all is the idea that these changes may actually be a self-healing mechanism that the scientific community has been trying to pinpoint for centuries.

Sound far-fetched? Consider some other self-healing mechanisms in the human body that we take for granted:

If we cut ourselves, the wound will eventually close and the skin will grow back.

If we break a bone, it will fuse it...

Table of contents

• Dedication
• Contents
• Foreword
• Introduction
• Part One: When the Pain Doesn’t Go Away
• Part Two: The Forever Painless Program
• Conclusion
• Acknowledgments
• Appendix: Complementary and Alternative Treatments for Pain Relief
• Notes
• Index
• About the Author
• Also by Miranda Esmonde-White
• Copyright
• About the Publisher