Are you super-aware of your pain?

It’s Backcare Awareness Week in the UK this week.  This got me to thinking about awareness…  How aware are we of our pain?  Can you be “too aware”?  I know that when I suffered lower back pain and sciatica on and off for three years, I was much more aware of it than I would have liked!

I think the people around me thought the same.  I was aware that my pain made others uncomfortable – they didn’t want to be aware of my suffering.  Perhaps because they were powerless to help, so it was easier for them if I just didn’t talk about it.  And yet, I was very aware of my lower back – even when it didn’t hurt; I’d be waiting for the next episode.  It could be so unpredictable.

But there’s lots of evidence (you know I love scientific research), that being overly aware can actually worsen the situation for you.  How many times have you felt yourself reach down cautiously into the dishwasher, perhaps leaning on the kitchen unit as you go down, back as straight as possible, knees doing all the bending?  Some people are labelled as being “hypervigilant“.  Hypervigilance is “an enhanced state of sensory sensitivity”.  This leads to increased anxiety and guarded movements with more muscle tension, both of which lead to – guess what – increased pain!

I know it’s hard not to be very aware and guarded; and I know that your pain may be much worse than mine was, but if you can accept that spending all day thinking about your pain is bad for you mentally and physically, what can you do about it?  Here’s what worked for me…

  1. Stay as physically active as possible.  Activity – especially aerobic activity (where your heart pumps harder and you’re out of breath) – produces natural opiates (painkillers) called endorphins.  These give you a natural high as well as dulling your pain.  Find something that you can do that raises your heart rate; for many people with sciatica or back pain that means getting in the water, perhaps walking up and down a pool rather than swimming.  Maybe you’re able to do a brisk walk, or cycle a bit, or use a cross trainer?  Find something.
  2. Enjoy yourself.  Make time to do things you enjoy.  If it’s too sore to do your favourite hobby, then find something else you can do despite your pain, e.g. watching funny movies.  You must spend time keeping your brain busy in a way that doesn’t focus on your pain.
  3. Gradually confront your fears.  Write down the activities that seem to make your pain worse.  How long can you do something for before it gets more sore, or how far can you bend before it hurts?  Write this down too.  Slowly increase this over days and weeks.  Seeing progress is really important and in doing this you’re re-programming your brain not to worry so much about that particular activity.
  4. Be mindful.  Try to catch yourself worrying about your pain, or waiting for the next pain, or “moaning” about it to friends/family.  Notice that this is what you’re doing and that this is actually contributing to your problem.  Take a moment to note this.  Then do something else.
  5. Forgive.  Forgive the impatience you see in others – it’s usually because they care about you, but are frustrated that they can’t help.  Forgive yourself too.  Whatever it was that got you into this mess, you didn’t do it on purpose.  Accept that you have a problem but that you’re working on getting better.
  6. Get positive support.  If you’re feeling overwhelmed and can’t see a way out, make sure to speak to your doctor or physical therapist.  I had quite a lot of osteopathic treatment that helped to get me through the darkest times.  I also learned a lot from other sufferers.
  7. Avoid negative people.  Support groups can be really bad for this – there are usually a few people who have had a terrible time (not their fault).  Unfortunately their bad experiences can colour your expectations, making you more hypervigilant – NOT what you need.

Again, I don’t want to underestimate the severity of your pain, but whether you have a mild pain or a terrible pain, my advice is summed up in the quote from one of my favourite movies of all time “The Shawshank Redemption”…

Get busy living or get busy dying.

If you’d like to talk to me about how I can support you, then please email me at

This week I’ve launched an online support program for lower back pain and sciatica sufferers.  Find out more here.

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