
This may seem controversial, but your symptoms from osteoarthritis, such as pain, stiffness and functional difficulties, may be more likely due to beliefs, personal fear and expectation than your body’s actual physiological changes.
Our bodies are amazing
As we grow & age, our bodies adapt to the various stresses and strains that we put through it. That is: the repetitive tasks and postures we adopt or habituate; the healthy strengthening of our soft tissues and bones as we use and load our system in day to day life and exercise; and the changes that occur through lack of movement and loading. And the beauty of this, is that this adaptive process continues throughout life, right until the very end, albeit somewhat slower in our latter years.
All of which makes up our body is living tissue
This is important to remember. Our bodies are living tissue and continuously growing, replacing themselves, healing after injury, adapting and remodelling. For example, if the cartilage of our joints thins in places over time - eg with significant excessive or under use - the adjacent underlying bone thickens &/or widens to compensate to help support the changing loads on that body part.
But this adaptive process is not a painful one. It occurs over a long time-span, often years, and is more akin to greying hair and skin wrinkles. Indeed from our 20's and 30's onwards, these adaptations can often be seen on X-ray/scan & will be referred to as osteoarthritic changes.
This wonderful, living, adaptive and supportive physiological process continues without our awareness. More so, our bodies have been evolving for millennia to be able to fulfil this process so well. I remain in awe of this incredible, really quite miraculous feat of nature that we each hold within us.
The effects of fear and expectation on symptoms
It is, in fact, often our fears, emotions and beliefs from inaccurate or misguided knowledge or mis-interpreted experiences that can lead us to feel pain as a result of considering these normal physiological adaptations.
As you may already know, neuroscience has shown us that all pain is produced by the brain & is dependent on the brain’s perceived evaluation of how much danger it concludes us or a body part to be in: so, it is now well documented that we can have no physical trauma yet significant pain; and we can have significant physical trauma yet no pain at all. Perhaps surprising to hear, but so true.
Think of the placebo effect. If you believe that something will have a positive effect on you, up to around 70% of the time it will. But the same is also true for the nocebo effect. If you believe something will have a negative effect on you, it probably will no matter its inert nature. The power of our beliefs and subconscious on our wellbeing is huge.
The influence of culture
With regard to osteoarthritis, our modern culture has incorrectly taught many of us that it is inevitably a painful process. As imaging with X-ray and scans became available last century, the medical professions logically began to attribute people's pain to those physical changes that were seen on film. Then, as a lay person, possibly lumping all arthritis conditions under one heading, and hearing stories of our granny who ended up disabled & in pain, perhaps in a wheelchair, this generated tremendous anxiety & fear when we were given the diagnosis of arthritis.
Helpful research
However, as time passed, good quality research on pain-free people found that most of us from our 20’s onwards have varying osteoarthritic changes developing in our joints – our spines, hips, knees, shoulders, etc – and that these changes are in fact a normal, painless process of life and time.
And even more recent research, which is incorporating a whole person approach, is proving it's most often our emotions & fears, stresses, worries and concerns, that are the true underlying causes for many of the recurring pains we may feel.
A personal story of mine
To illustrate, a couple or so years ago, my knee started feeling stiff and painful when I knelt on the floor. I didn’t remember doing anything in particular to it.
Embracing the information I’ve shared above, I realised that even if there were some minor strain that had occurred in everyday life & exercise, my amazing body would soon sort it out. I gently continued to kneel without fear of the future, not worrying about it, considerately kept up my exercise programme, and gave it time to settle, and sure enough within a few weeks, it had self-resolved and I’ve had no problems since.
On the other hand, if I’d thought something along the lines “Oh no. I’m in my 50’s now. It’s the beginnings of arthritic changes and the effects of age. It’s only going to get worse from now on” and started becoming hyper alert as to how my knee was feeling throughout each day, I expect my knee would have become more painful more often. I would have avoided kneeling, probably over-protected it & opted out of activities & exercise. And perhaps now I’d be identifying myself as having a knee problem and increasingly avoiding exercise & missing out on joining in with family and friends’ active fun.
Another helpful story of mind with body
A number of years ago (just prior to my SIRPA training & my mindbody knowledge), I went through a particularly hectic & stressful few years. I ate for comfort and let exercise slide – I'd felt that something had to give, and I chose for that to be my own self-care. (I now know what a daft choice that was!!)
As I learned about the mindbody approach to wellbeing & the vital importance of daily self-care, I returned to exercise – Figure 8 Fitness & Dance on my Amazon Fire stick. Great fun, great music and great movements. However, my right hip didn’t go anywhere near the range of movement required or the equivalent range of my left hip. And it hurt to try.
Embracing the information above that I’d recently learned and was delighted to accept and embody, each day I gently encouraged my right hip to nudge into the pain and stiffness, knowing that my amazing body would gradually adapt to the range of movement it needed to reclaim. I didn’t have any fear and I expected it to eventually get there. And it did – perhaps over the next 3 months or so. My right hip became as mobile and comfortable as my left hip once again - & its coordination & speed of movement caught up too!
Without this knowledge that I shared above, I might have decided my right hip was damaged – that troubling arthritis was on its way – and that I shouldn’t do any exercise or movement that provoked the pain. The movement would likely still be limited, probably lessened further, the pain worse and I’d be thinking I had a dodgy hip – avoiding certain activities and exercise - & maybe expecting & fearing the possibility of surgery in the future (although hip replacement surgery is generally very successful - alongside the huge placebo effect of surgery).
I wonder if you can see the effect of how misguided information, fears and expectations can lead to less movement & function, and worsening symptoms over time?
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I appreciate this may feel a long-winded way of explaining the effects of fear and expectation on our symptoms, yet I hope it's been a useful one!
Your Way Out and Forwards
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