Ep 36: Advancements in Pain Science: Comparing Current Understanding vs. 2018

The study of pain has seen significant developments in recent years shifting our understanding of pain from a purely physical symptom to a complex multifaceted experience that involves the nervous system, psychological factors and social conditions.

As a yoga teacher, it's important to understand that asana, stretching, strengthening, and movement will not solve all pain related issues. There have been some instances where I've recommended restorative practices to students and that's helpful to assist in down-regulating the nervous system. However, restorative still does not address the entirety of bio-psycho-social aspects of pain and pain management.

In this episode, I'll explain and compare the differences in what we know now about pain management compared to just five years ago.

For reference: 

Cleveland Clinic Journal of Medicine:

https://www.ccjm.org/content/ccjom/90/4/245.full.pdf

Yoga for Injury Management: 8-week Mentorship
https://www.enhanced-body.com/yoga-for-injury-management

Transcript

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The study of pain has seen significant developments in recent years. shifting our understanding of pain from a purely physical symptom to a complex multifaceted experience that involves the nervous system, psychological factors and social context. As a yoga teacher, it's important to understand that Asana stretching, Strengthening and movement will not solve all pain related issues. There have been some instances where I've recommended restorative practices to students and that's helpful to assist in downregulating the nervous system. However restorative still Does not. address the entirety of bio-psycho-social aspects of pain and pain management. And this episode, I'll explain and compare the differences in what we knew just five years ago. And what we know now about paying. Welcome to the Essential Conversations for Yoga Teachers podcast with me. I'm Monica Bright, and I've been teaching yoga and running my yoga business for over a decade. This is the podcast for you if you're a yoga teacher, you're looking for support, you love to be in conversation, and you're a lifelong student. In this podcast, I'll share with you My life as a yoga teacher, the lessons I've learned, my process for building my business, and helpful ideas, tools, strategies, and systems I use and you can use so that your business thrives. We'll cover a diverse range of topics that will help you whether you're just starting out or you've got years under your belt and you want to dive deep and set yourself up for success. I'm so glad you're here. Listen, I don't take myself too seriously, so expect to hear some laughs along the way. Now, let's do this together. Welcome back to the podcast. I'm a Monica and I am so excited for this episode. Because we're diving into the subject of pain and pain science, which is more complex than we used to think just five years ago. And the study of pain has been super interesting. For me. And I just know that as the years passed, we're going to continue to learn so much more pain. Science has seen significant developments in recent years, shifting our understanding of pain from a purely physical symptom to a complex multifaceted experience that involves the nervous system, psychological factors and social context as a yoga. The teacher is important to understand that Asana. Stretching. Strengthening and movement will not solve all pain related issues. There've been some instances where I've recommended restorative practices to students and that's helpful. To assist in downregulating the nervous system. as well as helping students. Keep consistency in their yoga practice. However restorative still does not address the entirety. Of the bio-psycho-social aspects of pain and pain management. Our understanding of pain and injury has evolved a great deal over just the past five years. And in this episode, I'll explain and compare the differences in what we knew then and what we know now. The exciting part of all of this is that we're still learning so much from day to day. So imagine what we'll know in five more years. I don't know about you, but that's super exciting for me. Remember to give yourself grace. If you've taught something in the past that we know to be untrue now. No worries. I've certainly been there myself. Just continue to learn and grow and teach what you're learning. The best piece of advice I can give is to just remember that we're teaching from and informed place right now. And that's awesome. Push yourself to learn what current science reveals to us now and know that some of what you know now might and probably will change and that's okay. First I'll explain how we approached pain management in 2018 and how our knowledge has evolved since. And what this means for coping with and recovering from pain. It's only been five years, but in 2018 pain, science was beginning to move away from the traditional biomedical model, which linked pain directly to tissue damage. For example, if you were living with low back pain, we thought there must be some correlation with tissue damage. The dominant approach then is still focused heavily on structural and biomechanical explanations for pain. Key concepts like central sensitization. And the idea that pain could persist even after tissue healing were recognized, but these ideas were not as widely integrated into clinical practice as they are today as defined in the Cleveland clinic journal of medicine, central sensitization occurs when. The central nervous system undergoes structural functional. And chemical changes that make it more sensitive to pain and other sensory stimuli. I'll link the full article in the show notes below. So if you're interested in further reading, you'll have it right at your fingertips. Oftentimes back then managing pain happened through medication. Physical therapy and interventions like injections or surgery. While psychological approaches such as cognitive behavioral therapy. And mindfulness were beginning to gain traction. They were not yet central to pain management strategies. Okay. That's a super brief overview of the understanding of pain in 2018. Now let's compare what we've learned and now know, as compared to five years ago. So, what we now know is one pain as a multi dimensional experience. Today we understand pain as a bio-psycho-social phenomenon. This model emphasizes that pain is not only limited to physical injury, but also involves the brain's interpretation of signals, which is influenced by psychological factors like emotions. Thoughts and past experiences and social factors such as support networks and cultural beliefs. This shift is great because it means that treatment approaches now often integrate. Physical psychological and social interventions. While the bio-psycho-social model was known in 2018, it has since become more central to pain management with a stronger emphasis on the integration of mind, body approaches. Next is neuroplasticity and pain. Neuroplasticity is the brain's ability to reorganize itself by forming new neural connections. And it plays a crucial role in chronic or persistent pain. Pain can become a learned response with the brain reinforcing certain pain pathways. New research focuses on rewiring the brain in an effort to reduce these pain signals through techniques like graded exposure therapy and brain retraining exercises. The concept of neuroplasticity in pain was recognized in 2018, but not fully exploited in clinical practice. Now therapies specifically. Our targeting neuroplasticity and our more widely used. Number three, the immune system. So, what does the role of the immune system have to do with pain? Recent research has highlighted the role of the immune system in chronic or persistent pain, particularly how immune cells interact with the nervous system. To either promote or reduce pain. The immune system is deeply intertwined with the mechanisms of pain through its role in inflammation. Cytokine release. And the activation of immune cells in the nervous system. The immune system can both contribute to and modulating the experience of pain. Inflammatory processes, whether it's acute or persistent. And immune responses are now considered key players in chronic pain conditions. In 2018, the interaction between the immune system and chronic pain was less understood. But today treatments targeting inflammation and immune modulation are being explored more intensively. Next is pain, neuroscience, education, educating students or private clients about how pain works can significantly reduce pain and improve treatment outcomes. Having this education is especially helpful when you're working with injured students, so that you feel empowered to talk to people about the pain they're experiencing. I'll be completely honest here for a bit. My mother experienced chronic persistent and ongoing pain for many years of her life. And I am certain that trying to shift her beliefs about her pain would have been extremely difficult. Of course, it's important to remember that I'm talking about someone from a different generation who grew up with different beliefs and a bit of stubborn or strong willed, uh, personality. When it came to mindset shifts. Now don't get me wrong. I love my mother Tibbits, but I also knew her very well. I share this because it's important to remember that some people are more open to change than others. And you can have conversations with them. But keep that in the back of your Mind. I love to include this kind of information while I'm teaching a group class. As I've found that it's received a bit differently than a one-on-one conversation, but honestly it depends on the person for sure. Pain neuroscience education Helps students understand that pain doesn't always mean harm, which can help reduce the fear and anxiety. That we have around pain. And our two key factors that can in fact amplify pain. Well pain neuroscience education was beginning to gain popularity in 2018. It is now more widely adopted in both clinical and nonclinical settings. Now we have more technological innovations advances in technologies, such as functional MRI and other imaging techniques have helped to provide deeper insights into how pain is processed in the brain. These tools are being used to study chronic pain conditions more effectively and tailor specific treatments to individual patients. In 2018 imaging technology was used to study pain, but the specificity and application of these technologies have since advanced and allows for more personalized pain management strategies. Like I mentioned before. Let's discuss. Psychological approaches to pain management. Two of the most effective approaches are Mindfulness based stress reduction. And acceptance and commitment. Therapy. These interventions address the mental and emotional aspects of pain, helping people to change their relationship to pain. And manage it more effectively and reduce its impact on their lives. Leading to an improvement in quality of life. These are now recognized as key components in pain management. In comparison to 2018 while these two approaches were known, their integration into mainstream pain management has significantly increased with more and more evidence to support their effectiveness. Finally, I want to touch on social and environmental factors. There is a growing understanding that social support from family and friends, environmental factors, And even socioeconomic status can and does influence pain. Perception of pain and recovery, leading to more holistic treatment approaches that consider the patient's broader context and livelihood. In 2018, social and environmental factors were recognized and considered, but often secondary to physical and psychological factors. You may be asking yourself, how does this enhance my teaching or how can I incorporate this knowledge into my teaching or conversations with students? And these are fantastic questions to be asking.'cause it's not like you can, or you should just go start talking about pain, pain management. And pain recovery to students just right off the bat. A more mindful approach is always better. I remember when I was taking my 300 hour advanced teacher training in biomechanics. and we were learning and studying so many new concepts, including pain science. And. I knew that there was no way that I could just go back to teaching and begin to teach all of this information to students. The truth is that first I needed to integrate the information myself so that I was able to teach it. In a consumable and elementary manner so that students could understand and consider what I was teaching. I also slowly started having conversations with students about their ailments. What was bothering them? their diagnoses. What kinds of treatments they were going through and how they were managing those treatments? Like how were they feeling throughout those treatments? So, how do we integrate this knowledge? Like I always advise, take one concept, learn it and teach it to someone. It doesn't even have to be a student. Teach the concept to someone so that you realize how effective you are at communicating the information. And then once you start having those conversations, these conversations could even be with a friend who is dealing with pain. Or injuries, not necessarily a yoga student and just have the conversation back and forth and see what you garner from the conversation. See, what kind of questions you start to ask in that process? And you'll learn that the more conversations you have, the more effective, the more inquisitive. you get, And so it just becomes A process where you start to ask questions, get information, ask followup questions, maybe offer some support and so on and so on. As I mentioned before, the advancements in pain science have led to the development of more comprehensive, personalized, and more effective approaches to pain management through holistic pain management treatment plans, which now often include a combination of physical therapy, psychological support education, and at times medication, the holistic approach addressed. Dresses, the physical, emotional, and social dimensions of pain. If you want to learn more, talk to your students about their treatment plans, the more you talk to them about what they're doing, how they're responding to treatment and how it's affecting their daily lives, the more you'll learn. I look forward to the chances that I get to talk to students about what's going on in their bodies and how they're coping, because it just adds layers to my understanding. Next is empowering patients continued consistent and better education about pain allows for students to become more. Empowered to manage their conditions. I want to stress consistent communication here. I am aware that yoga teachers, doctors, physical therapists and other medical experts are at varying levels of understanding pain. I'm not going to lie. Students have shared with me advice and exercises that their PTs are giving them. And I know for sure. That's not going to help. Even medical experts are resistant to change. And because they spent so many years in schools, sometimes they take longer to see a different view on how to manage pain. If on a personal level, they're resistant to holistic healing, then that belief might just be a part of their practice. This is why it's important for people who are experiencing chronic or persistent pain to get second, third, even a fourth diagnosis and weigh all of the information and be more empowered to ask more questions, better questions and deeper questions so that they're in more of a partnership with their medical advisors. When you're well-versed on pain, science and management. You can help students feel more empowered when talking to their doctors and therapist as well? At the very least. Helping students understand that pain does not always equate to tissue damage reduces fear. Which can help lessen pain intensity. Next focus on prevention and early intervention. Helping students Bouve well, Ditch the crazy unattainable and often injury inducing yoga poses, and instead teach sustainable yoga practices makes you a more responsible teacher. Yep. I said it. And I'm sticking to it. also teach students to become more mindful and aware of their bodies. What feels different today? How do you feel when you move like this? How do you respond after a challenging pose or transition or sequence? These are the questions you can incorporate into your teaching and queuing that helps students connect to their bodies. Therefore his students begin to feel differently. They catch that right away, because they've learned to be so abundantly aware of their own bodies, unfortunately, but realistically, you can't completely prevent the occurrence of injury or pain. But you can empower students to notice if something feels different. And that's the key here. And then finally your dedication to honing your skills, creating more mindful and intentional sequences and understanding what works and what doesn't will help you create deeper connections with your students who trust you, whether they're injured or not. When students believe that you're able to play a part in solving. Or even just supporting them through their navigation of pain. Or they believe that you will find research. Look out for more information to help them. It increases their trust in you. And this separates you from other yoga teachers, lesbian, honest in the sea of yoga teachers. We have to find the areas of teaching that we love. So that we're teaching from our most authentic places. So if you're really interested in anatomy, injuries, pain science, or are you Veda? Chakras or yoga philosophy, study those subjects and have an understanding of human bodies because in the end you're still. Teaching movement. Since 2018 pain science and understanding how to approach. Recovery from pain has evolved dramatically moving from a primarily biomedical model to a more integrated bio-psycho-social approach. Now we recognize pain as a complex multi-dimensional experience. And this understanding has transformed how the treatment and management of pain leads to more effective. Personalized and holistic strategies. No doubt research will continue to it bands and the future of pain management looks promising as it encompasses our whole bodies. Our relationships and our life experiences. I love talking about anatomy, pain, injuries, and pain science. And I want all teachers of movement to understand how a working knowledge of it affects your teaching. I don't think we talk about the importance of anatomy enough. And have this conversation feels uncomfortable. I totally understand. But this is exactly where change happens. Pick up an anatomy book, turn to a page and learn something. Watch a video series. Talk to your students about their bodies, really watch them move and notice what you see and find trusted teachers and accounts on social media that will teach you. Just keep taking the steps to be more informed. I hope that this episode sparks some deeper thought around why the knowledge of pain and understanding it. And recovery is so important as a movement. teacher. I've added a link in the show notes for you to send me a quick text a message about your thoughts on this episode or any other. I will know your phone number. It's a cool addition to the platform I use that allows for this new and really easy way for you to communicate with me. Once you click on it, it will take you to your messages. Don't delete the code. That's how your message will get to me. And I would love to know your thoughts on this topic. I love diving into these conversations because there are so many important discussions to be had in the teaching world. You know that my goal is for you to love the yoga teaching life. And allow it to be fulfilling and rewarding. And sometimes it takes a work and a few conversations to get there. If you love this episode, let me know, subscribe to the podcast. So you're always in the note when a new episode drops. And share it with another yoga teacher who you think would love to be in on these conversations. Thank you for helping to spread the word And if you've been taking notes in your journal, as he listened to these episodes, I'm so glad. And I'd love to hear about it. Finally, don't forget to join my newsletter. That's just for yoga teachers. I've got some exciting teachings coming soon And I'll want to tell you all about them. The link is in the show notes below, and I would love for you to join it so we can always stay connected. All right. That's it for now. Bye.