Ashtanga Blog

Four common myths about physical pain

Thoughts on the origins and meaning of pain and how to move past it.

Tania Kemou practicing Yoga in Serifos, Greece

No one likes to suffer. We are all hardwired to run away from pain and move towards feelings of ease and happiness. Still, pain is an inherent part of life and can teach us so many things if only we listen instead of turning away. In this article I explore some common misconceptions about physical pain and try to shed some light on the mind-body connection as an integral part of health and healing.

1. Myth: All physical pain is due to injury or structural abnormality

It is common belief that whenever we experience pain somewhere in the body, we must be either injured or suffer from some physical ailment that needs to be addressed. The most common example is back pain. Most physicians, when consulted for back pain, would immediately ask for X-rays or MRI. They would then attribute the pain to some structural abnormality like herniated disk, osteoarthritis, disk degeneration and so on. The truth is those images would show some degree of degeneration in most people over the age of twenty. This is normal ageing and is not necessarily painful. Many people have herniated disks and have no idea about it and absolutely no pain. 

Between 1976 and 1980 two Israeli physicians, Dr. A. Magora and Dr. A. Schwarz published four medical articles in the Scandinavian Journal of Rehabilitation Medicine, in which they reported the results of studies they have done to determine whether certain spinal abnormalities caused back pain. They compared X-rays of two groups of people, one with and one without back pain. They found no statistical difference in the incidence of degenerative states of the spine between the two groups.

The American radiologist Dr. C. A. Splithoff published a study in the Journal of the American Medical Association in 1953, in which he compared the incidence of nine different spine abnormalities of the end of the spine in people with and without back pain. Again he didn’t find any statistical difference. 

Both studies suggest that structural abnormalities of the spine do not generally cause back pain.

Back pain can have many causes: too much sitting and therefore tight hips compressing the lower back, lack of physical activity, carrying too much weight the wrong way are some of them. Sometimes the causes are found in the mind rather than the body. Anxiety, anger and other repressed emotions can cause bodily pain as well as other physical ailments (more on this on point 4 below).

So no, not all pain is due to injury. And people in pain should certainly not be treated like invalids and candidates for surgery. The body has a tremendous capacity of healing itself, which is often not even given the chance to manifest because of misdiagnoses. For most cases, simple lifestyle changes are enough for the pain to lessen and even go away.

2. Myth: If we have pain we should refrain from physical activity and “rest it out”

This comes from a conviction deeply ingrained in our sedentary culture, that movement is risky and dangerous and immobilisation is the remedy to any kind of pain. I have been victim of this myself in the past, thinking and being told that I should not practice yoga if I have the minor pain or discomfort. The reality is that movement helps alleviate pain by increasing blood flow and “warming” the body. Movement is health and unless there is a serious condition like a broken limb, there is absolutely no reason to “rest it out”. 

Depending on where the pain is and how much it impacts the affected area you might need to revisit they way you usually move, move smarter and vary your routine. Immobilisation not only doesn’t help but might even make things worse by creating feelings of frustration and sadness because it is an imposed state.

Body and mind are connected and by doing something you love and enjoy you are sending signals to your body to release tension and get better.

3. Myth: If we have pain we must be doing something wrong in our yoga practice 

Throughout many years of practicing and teaching yoga I have noticed that most students are convinced that they can easily hurt themselves through practice. People obsess over alignment and their immediate reaction once pain manifests is that they must have done something wrong in the practice. I am not saying that it is impossible to hurt yourself through yoga. It can happen. But more often than not, the pain we experience during practice is not due to a “mistake”, wrong alignment or injury. 

Especially during the first few years of yoga practice, pain is often present because the body is being transformed through this new way of moving and breathing. It takes experience and skill to distinguish “transformational pain” from injury or “bad” pain.

It is a myth that yoga should never hurt. 

We come to the practice with our particular body type, history, lifestyle, all of which is embodied. It takes time to rebuild, create space, remove blockages and gain inner strength. It is challenging but deeply rewarding to accept occasional pain as a teacher rather than the enemy.

4. Myth: Physical pain is just “physical”

Many of the things I have learned about pain and its manifestations, I did by observing my body through a decade of daily yoga practice. There are specific parts of my body I often feel sore or painful. In the past I attributed this to an overzealous practice and a structural abnormality (scoliosis) I know I have. I have tried everything, taking rest, getting massages, acupuncture, chiropractor adjustments, even anti-inflammatory pills. All these things definitely helped in the short term but the pain would come again after a while. At some point I started observing the pain patterns and flare-ups and realised that the pain would come during or after a stressful event, or after periods of accumulated stress. Knowing that I am prone to anxiety helped me make the connection between my mind state and the tension I observed in my body. I realised there was nothing inherently wrong about my body and that helped me stop obsessing about the recurrent pain. I still get it from time to time but the intensity has lessened and so has my obsession over the pain.

Recently I came across the book “Healing back pain: The Mind-Body connection” by John E. Sarno, MD.I n this insightful book I recommend to everyone, Dr Sarno explains a very common but misunderstood phenomenon called TMS (Tension Myoneural Syndrome). 

TMS is a physical phenomenon caused by the mind’s tendency to repress negative emotions like anger and anxiety. To do so, the mind produces a physical reaction somewhere in the body to divert the attention from the painful emotions. The pain is caused by a temporary restriction of blood flow (and therefore oxygen) to the affected muscles, nerves or tendons/ligaments. Since those tissues are deprived from oxygen, tension develops and pain starts that can be either acute and debilitating or milder and chronic. 

Reading about TMS helped me put into perspective my experience with pain over the last few years. This very common syndrome often appears along with other psychosomatic ailments like peptic ulcers, colitis, tension headaches, migraines, asthma etc. This is yet another proof of the undeniable mind-body connection.

All the above considered, what should be the appropriate response to pain?

I think awareness of what pain is and why it manifests is very important. So is the knowledge that not all pain means there is a serious underlying condition. Trusting the body’s capacity to heal is empowering and liberating. 

Last but not least, when one considers pain and where it comes from, be it a patient or even more so a physician, the mind-body connection should be kept in sight. Emotional phenomena can stimulate physiologic ones.

The body is not a machine made from parts independent from each other.

It is time for modern medicine to quit trying to explain everything on the basis of physics and chemistry only. Instead, the patient should be considered as a whole, a physical being but also mental and spiritual. To move past pain and suffering we should all try to look deeper, free from prejudice and armed with compassion.