Holistic Pain relief Versus Reductionist and my Epiphany this year

Hi there fellow holism believer,

When it comes to managing pain (and other things), there are generally two approaches people can take. A reductionist approach or a holistic approach. While both can offer relief. They differ significantly in their methods and the results they produce in the long term. A reductionist approach, often employed in conventional Western medicine. Focuses on eliminating symptoms through the use of painkillers or temporary solutions. On the other hand, a holistic approach aims to address the root cause of pain. It considers the body as an integrated system. This can lead to more sustainable results and a greater sense of well-being.

What is a Reductionist Approach?

A reductionist approach to pain management tends to isolate and treat the symptoms. Rather than the underlying issue. Painkillers, anti-inflammatory drugs, and even some physical therapies might provide temporary relief. But they often act as "band-aids," masking the pain without addressing the root cause. For example, if someone has back pain, a common response would be to prescribe muscle relaxants. Or nonsteroidal anti-inflammatory drugs (NSAIDs) to decrease discomfort. While these interventions can offer short-term relief. They do not address what may have caused the back pain in the first place. Whether it be poor posture, muscle imbalances, or a lack of spinal stability.

The problem with this approach is that it can lead to a cycle of dependency. Because the pain is only temporarily alleviated. People often find themselves reaching for another dose of medication. Whenever the pain returns. A Holistic Approach: Getting to the Root Cause

A holistic approach, on the other hand, looks beyond the symptom. It aims to uncover and address the underlying cause of pain. This involves a thorough assessment of lifestyle. Movement patterns, emotional health, and even sleep quality. The goal is to treat the person as a whole. Understanding that pain is not just a physical sensation. But also a complex experience influenced by many factors.

The Role of Yoga in Holistic Pain Management

Yoga, when used as part of a holistic approach. Can be effective in managing and even alleviating chronic pain. There is an increasing body of research supporting the use of yoga for pain management. Specific techniques, such as diaphragmatic breathing. Targeted yoga postures, can activate the parasympathetic nervous system,. which is the body’s rest-and-digest response. This helps reduce stress, lower inflammation, and decrease the body's perception of pain. Creating a sense of control and acceptance.
Fostering relaxation and enhancing overall well-being (Vallath, 2010).

Step #1 Pain Trigger Identification

One prominent expert in this field is Dr. Stuart McGill. A world renowned academic and author of Back Mechanic (among other books). In this book, Dr. McGill emphasises the importance of identifying pain triggers. Then avoiding those movements or postures that exacerbate pain. He explains that understanding these triggers is the first step in a long-term pain management plan. As continually provoking pain through certain movements can hinder the healing process. For example, if someone’s pain is triggered by sitting in a slouched position. They need to address how they sit to prevent further irritation.

Beyond just avoiding pain triggers. Dr. McGill also highlights the importance of strengthening the spine. Through 3  non-negotiable abdominal exercises.  These exercises help build endurance and stability in the core. Which in turn protects the spine and reduces the likelihood of re-injury.
As-well as avoiding certain activities first thing in the morning. Due to scientific evidence of overnight creep.
Understanding what movements, postures. Or habits exacerbate the pain is crucial. 

Step #2 Reflect on the Potential Causes

My Personal Experience: Pain Management for Lower Back Pain 

For example, my lower back pain is exacerbated when my spine loses its neutral position.

Figuring out what could have caused this issue. I have a few theories and I believe it's a combination of the following:
Old horse riding injuries have caught up with me;
Endometriosis and Adenymiosis which can caused chronic pain in the lower back. I was formerly diagnosed with this in 2022.
Too much sitting:
I don't think my abdominals ever gained the strength back after an emergency C-section in 2019 (( I could have put more effort into this;
I did the wrong exercises to strengthen my core. Not all pilates exercises are suitable of everyone. C-Curve abdominals exacerbate my back instead of strengthening my abdominals;
Trauma in my fascia. Most people who have been diagnosed with post-traumatic stress disorder suffer from chronic pain. The trauma affect the fascia. More and more studies are coming out to prove this. Since the fire of January 2024, my lower back pain has become increasingly worse. This is a topic within itself. So it deserves its own email and blog once I've done more research and experimented with my own body.

Step #3 Treat the Pain with a Holistic Approach.

Now that you have more of an idea on the pain triggers and potential causes. You will have more of an idea on what to do to alleviate this pain. Other than medication. These are my techniques

1. Lifestyle Adjustments
   In my situation, avoiding the Pain triggers meant reducing time spent sitting and lying. When sitting and lying I use lumbar support to ensure my spine is in a neutral position. I.e it's not flattened, the curves remain in a natural position. I use the lumbar supports designed my Stuart McgIll. These products are adjustable as to how thick the support is. So once you feel relief you stop inflating it. Which recognises skeletal variation. Our spinal curvature varies.  Being careful with what I do first thing in the morning due to overnight creep. I do more walking. Dr McGill recommends this. As motion is the lotion of life!

   Also optimising sleep, nutrition, and stress management strategies. Poor nutrition can have a detrimental effect on fascia. Due to systemic inflammation.  While an anti-inflammatory diet can help reduce systemic inflammation. That might be contributing to pain. Poor sleep can increas

2. Myo-fascial Release Techniques to Hydrate my Fascia
   Using tools like Yoga Tune Up balls. Not just where the pain is but other areas. Recognising the continuity of the fascia which causes referred pain. This releases adhesions and tension in the myo-fascia.  In and around my lower back. This part of the body is rich in nerve endings. Healthy fascia has less nociceptors (nerve endings that send pain information to the brain) as a result. So, MFR can be effective in both reducing muscle tightness. And modulating the nervous system's perception of pain (as above). The act of rolling out and targeting trigger points helps reduce pain sensitivity. Increases circulation, and restores range of motion. Contributing to a long-term decrease in pain.

3. My EpiohanyI also started focusing on releasing my diaphragm and psoas. As I had an epiphany in 2024 as my lower back pain worsened despite to lots of major surgery! This was my body's reaction to surviving a second fire.
   The diaphragm and psoas contract after a traumatic event.  This was yet another trigger in my life after multiple other traumatic events. As a result, sympathetic nervous system dominance occurs. Which prevents efficient breathing patterns. You cannot breathe properly with a tight diaphragm. It's arguably the most important muscle in your body. As it is primary respiratory muscle. 
   Not only does tight psoas tighten the diaphragm, but it also can cause lower back pain. Because one of its origin being in the lumbar spine.  Releasing the posts is crucial for my lower back pain. Hence, this approach goes beyond just addressing physical pain. It incorporates mental, emotional, and environmental factors. Understanding that pain is rarely a standalone experience. 

4. Spinal Stability Exercises. Incorporating specific spinal strengthening exercises as outlined by Dr. Stuart McGill is part of my regular routine. The McGill Big Three exercises are excellent for building core stability. 

   I also incorporate specific yoga  practices that are backed by science. Such as sandbag breathing to weight train my diaphragm. 

While a reductionist approach may offer quick relief. A holistic approach addresses pain at its root. Offering sustainable and long-lasting results. By considering the body as an interconnected system. We can develop strategies that not only eliminate pain. But also enhance overall health and well-being. For those living with chronic pain, this multi-layered approach can be life-changing. Helping to reduce dependence on medications. Empowering individuals to take charge of their health.

This is the true benefit of a holistic approach. Treating the whole person, not just the symptom.

Click here for more on the PSOAS

Click here for more on Dr Stuart McGill's big 3

References

1. McGill, S. (2015). Back Mechanic: The Step-by-Step McGill Method to Fix Back Pain. Backfitpro Inc.

2. Vallath, N. (2010). Perspectives on yoga inputs in the management of chronic pain. Indian Journal of Palliative Care https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2936076/  retrieved on 8 August 2024.