Julia Coetzee had just graduated from university, landed a promising job with a leading bank, and moved to Johannesburg with her new husband, when she began to feel a deep and debilitating ache that permeated every muscle, tendon, and ligament. “It should have been the happiest time in my life,” says Coetzee, now 33. “Instead, I couldn’t even get out of bed.” Two doctors later, she was diagnosed with lupus, irritable bowel syndrome, and fibromyalgia – three conditions that share the common thread of pain.
Coetzee is one of millions of South Africans (one in four) who suffer from chronic pain as a result of injury, neurological or joint disorders, auto-immune diseases, or other conditions. We typically think of pain as a direct, immediate, and finite response to a specific stimulus. You hit your thumb with a hammer, for instance, and it hurts. Chronic pain – as defined by The Centre for Pain Management at Groote Schuur Hospital as any pain that has been present for over six months and does not respond to conventional therapy – is more complex and, experts believe, may be a disorder of the central nervous system.
Ironically, although pain is the most common reason people seek medical treatment, doctors often feel ill-equipped to deal with it. “Medical doctors are trained to prevent loss of life,” says Jacob Teitelbaum, author of Pain Free 1-2-3! (McGraw-Hill), “they’re not always focussed on quality of life.” Over-the-counter drugs are by no means a magic bullet. Unlike acute pain, chronic pain is a disease and does not respond to bedrest, painkillers and injections.
But there are alternatives. Pain is increasingly being treated by non-traditional techniques, and relief is no longer out of reach. Just ask Coetzee, “The pain may be mandatory, but the misery is optional,” she says.
CULTIVATE A SENSE OF CONTROL
An integrative approach is what helped Irene Timmins, 38, of East London. Seven years ago, she slipped while standing on a playground slide with her one-year-old daughter. She injured her lower back, damaging her sacroiliac joint (the connection between the spine and the pelvis) and causing chronic inflammation in her tailbone. She couldn’t stand without help, and sitting was excruciating.
Despite the best efforts of a team of anaesthesiologists, psychiatrists, and orthopaedic surgeons at a major hospital, Timmins’ condition deteriorated. Steroid medication had no effect on her pain and she gained eight kilograms, worsening her despair. At times, she was bedridden and nearly suicidal. “After a year and a half, the doctors said they couldn’t help, and discharged me,” she says. “In retrospect, it was a blessing in disguise.”
Forced to find an alternative treatment, Timmins consulted a neurologist who was also trained as a physiotherapist, chiropractor, and acupuncturist. “Over time, his treatments and my hard work reduced the inflammation and began to provide substantial relief,” she says. But the biggest change was in her attitude. She believes focusing on the positive was instrumental in improving her mental and physical health. “Before the accident,” she explains, “I was more mobile, but I was living life with my eyes closed. Now I try to look at the good in people, be more joyful, and fully embrace every day.”
Such a shift isn’t easy. Faced with unending discomfort, many formerly active people are forced to give up things they previously enjoyed. The loss causes many chronic pain sufferers to feel powerless and hate their bodies, thus taking action is key to managing chronic pain.
MAKE A MIND-BODY CONNECTION
Focusing on a single moment rather than contemplating a life of agony is critical to overcoming pain and the accompanying anxiety, say experts. Low-impact exercise, yoga, meditation, guided imagery, and tai chi can help. Although exercise might seem incomprehensible when your pain is at its worst, taking up a gentle activity such as swimming or walking can help reduce the musculoskeletal tension behind many aches and may also prompt the body to produce endorphins – chemicals that block pain signals in the brain and help alleviate depression. But taking that first step can be difficult, admits Lori Newell, author of The Book of Exercise and Yoga for Those with Arthritis, Fibromyalgia, and Related Conditions (Sacred Space Health Centre). “People in pain are often afraid of movement; I try to help them relax,” she says.
Yoga is at the core of a programme that Robert de Wet, 45, a financial planner, has followed since he first began suffering excruciating back pain at the age of 31. “I’d never experienced anything like it,” he recalls. “And it didn’t seem to be linked to anything I’d done.” For the next few years, de Wet had regular flare-ups that some-
“I’ve cultivated a sense of self-acceptance. I’m stronger, clearer and better able to take care of myself. I’m able to focus on other things…”
But that changed when he began practicing the Cobra pose (Bhujangasana) on a regular basis. “Now, I joke that if the house was burning down, I’d still do my Cobra before running outside!” says de Wet, who practices the posture every day. This simple routine has paid off. De Wet cycles, swims, gardens, and practices martial arts – all pain-free.
For those who aren’t ready for any activity, meditation can help bring relaxation and relief from pain and the associated anxiety. Some say suffering is directly related to your resistance of it; the more you resist, the worse you feel. You can eliminate the resistance, and thus limit the suffering through meditation.
“It’s a scientific fact that pain is a sign of oxygen deficiency at cellular level,” says Keith McFarlane of the Heal SA pro ject in Johannesburg.
“Once you have an understanding of the pain and it’s source, you can work to bring the key ingredients of healing – oxygen, circulation and energy – to the target area by focussing on it. Becoming mindful is not about getting rid of pain,” he explains, “it’s about going into it, expanding the mind, and focussing energy on it to bring relief.”
Meditation is a way of listening to the body, McFarlance says, and the key is in the breathing. “We’ve had phenomenal results with cancers and fibromyalgia among others, with very simple techniques”, he says. One of these is the “nose, heart and body” technique.
For Coetzee, these alternative treatments have helped her cultivate a deep sense of joy, self-love, and self-acceptance. “I’m stronger, clearer, and better able to take care of myself. I’m able to focus on other things besides my pain.”
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