Physical pain management

The Watercooler
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Hello fellow friends on the path,

I am planning to undergo a rather notorious surgical procedure in the next 3 to 6 months, with the hope of curing a long-term physical issue. The recovery is expected to be quite painful for 2 to 4 weeks. It will be physical pain, but I imagine it may also bring some mental suffering along with it.

As a student of the Buddha, I am wondering: what is the best way to approach this?

Is it simply a matter of endurance? I understand that being born with a physical body means it comes with its own defects, breakdowns, and maintenance issues. In that sense, I am prepared to endure the pain, especially with the hope of a long-term cure.

But I would also like to take this as an opportunity to practise the teachings. For those who have gone through significant physical pain, surgery, or recovery, what helped you?

Are there particular practices, reflections, chants, meditations, or techniques you would recommend during the recovery process? Should I focus on mindfulness of pain, loving-kindness, contemplation of the body, breathing, listening to Dhamma talks, or something else?

Any practical or spiritual tips for pain management would be very much appreciated.

Note: For those wondering what the “notorious procedure” is, it is a hemorrhoidectomy. Yes, the path to liberation apparently includes learning non-attachment from the very place we usually sit on. :grinning_face_with_smiling_eyes:

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Hello friend. Here is what I would suggest.

Have you attended any 10 days vipassana courses? If yes, then I would suggest you to practice it, it will help develop equanimity towards those painful sensations, and as a result one’s resilience increases. If not, try practicing mindfulness of breathing daily or like whenever you get time, it will give you something to focus on amid physical pain. Mindfulness of breathing is something you will be able to do even if never done before. Here is a link where you can read about it: mindfulness of breathing. Now along with that, you can also practice metta bhavana, if you can really bring it from your heart you will definitely feel good, but to do that, you would need to practice mindfulness of breathing for atleast 10-15 mins.

Having said that, all the best to you and I hope you get well after the surgery as soon as possible :folded_hands: .

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Please read Girimananda Sutta - AN10.60. It explains all you need to prepare not only for a procedure like the one you are about go through but the reality of life.

With Metta

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Hi five_aggregates,

I have a pain condition called CRPS. One time, I was listening to a Dhamma talk by Ajahn Brahm (I call them Brahmma talks :blush: ) and he was talking about making peace…which is not uncommon for him. But I started to try to make peace with the sensations which arise in my body. I asked my body to forgive me for not paying enough attention.

This really helps the anxiety surrounding the sensations. The sensations are still there, but it seems my mind’s reaction to them is much calmer. For me, when I get anxious about the pain it becomes more prominent, and my thoughts become more scattered, then my mind is all over the place, then the pain gets more prominent, then my thoughts become more scattered…I’m sure you can see where this is going.

So then, for me, it’s time to listen to a dhamma talk or maybe some sutta studies. Sometimes with high pain levels reading becomes difficult. The BSWA has so many talks and studies I can almost always find something that will help focus and calm my mind.

There is one talk that was recommended to me which I liked a lot:

Maybe there is some advice for you here.

Good luck with the procedure. I’m sure you won’t be sitting at the base of a tree afterward…but, whether standing or walking, seated or lying down…

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Your thought to do metta is a good one. Doing pain contemplation while it’s happening can be helpful too but if you find yourself falling into unwholesome mind states then metta is good at countering that.

Ajahn Brahm gave a lecture once talking about how he got a tooth infection some time after he ordained and he had to endure it all night. He said that doing metta toward the pain helped his pain be reduced by 90% because our mental aversion makes the pain seem so much stronger than it is, and by doing metta he was able to accept and embrace the pain much easier.

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I can tick all three of these for the past year. I wouldn’t recommend it. :laughing: Practicing when you are well is much easier and more profitable, generally.

Follow all the instructions from your doctors and nurses, including how you should dose your pain medication. It may make you feel drowsy, but allow your body to rest. This is not the time to be tough. Be gentle.

If you are interested about how pain works, I would recommend checking out some talks by Dr Lorimer Moseley. . Thinking of pain as a protector really changes my attitude towards it. Especially some of the chronic pain I experience. It’s just trying to keep you safe! I began feeling a lot of gratitude for my pain signals, even if they were a little overprotective sometimes. Changing your attitude to the pain is the most significant thing you can do.

Listening to suttas on Pali Audio and SC Voice was definitely part of my recovery. Chanting tended to sooth me too. Especially this chanting of the Girimananda Sutta. It’s subtitled with Bhante Sujato’s translation too.

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Practical tips…Read about your surgery from a variety of sources. Learn about the postoperative recovery and what to expect. Learn about the medicine you’ll be prescribed. Read the medication labels. Know how much you can take at once and the maximum daily dose. Figure out what questions you need answered and get them answered. Read, learn, ask. Essentially, take the initiative and be your own patient advocate in this healthcare encounter and all future ones.

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Exactly.

Being born in a time when there is medicine for pain is a huge result of good karma done in the past.

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mn143 has seen me through many medical procedures. I hear it as if it is being spoken directly to me, for my lifelong benefit. please let your body heal and don’t impose any expectations, practice or. otherwise, rest is the healer.

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Absolutely, discussion with your care givers is of utmost importance. You know your body best so you need to experiment about the dosage of the pain medecine.
Do not refuse them nor become too dependent on them, the Buddha taught the middle path! Ajahn Brahm in his kindfulness talks gave some advice, be also kind to yourself.
I myself “suffer” from chronic pain (suffer is the medical diagnose) due to broken vertebrae – several of them. There are days that i notice the pain more than other days. However, for me, pain is NOT suffering. They are quite different. And I do take pain relief medicine to be able to function normally but always mindfully: how much do i need for today, i ask the body.
I am grateful for meditation practice as it helps a lot in my pain management
Wish you much Metta especially in the coming months

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Drugs and the knowledge it was temporary (impermanent).

I noticed yesterday that samanerie jayasara put up a guided meditatiion on working with pain. It’s about 30 minutes long. I find when I am in pain, stressed etc a guided meditation is much more effective than trying to do it on my own.

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There is so much beautiful and compassionate encouragement here. Ditto!

MN 43 says “The difference between these things is that wisdom should be developed, while consciousness should be completely understood.” The video that Venerable Pasanna shared is a vivid way of understanding consciousness:

I highly recommend watching this video!
In this vein, when I’m say, cold, I direct my mind to the parts of my body that are cold and the parts that are warm. Invariably the cold parts are few so I think about the warm parts and the body relaxes. The same goes for pain. If I am really feeling pain, I analyze which parts are painful and which aren’t and
I can turn attention away from pain more.

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Perhaps you have time to purchase and read "Mindfully Facing Disease and Death by Bhikkhu Analayo. His book will certainly point you to the pertinent Suttas dealing with classical examples of such.

Much of Sutta study I consider pain theory. If you want a leg up putting into place pain practice I would strongly suggest going online to Dharmaseed.org , selecting the teacher Joseph Goldstein and scrolling through his 930 dharma talks to find those dealing with practicing under painful conditions. You can find a dozen such talks - there are 45 years of his talks present there. Listening or downloading are both free.

Satipatipatti

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For anyone interested in the overlap between Dhamma and pain; this talk is a fascinating look at perception and meaning when it comes to physical pain.

CW: there’s. a swear about 5 minutes in, the talk is pretty funny.

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