I recently read an article in the New York Times written by Lena Dunham, the writer, and star of the sitcom, Girls. In the article entitled, Call Me Cozy, Lena describes the challenge of living with chronic pain and how, because of it, she takes the cultivation and preservation of comfort seriously.
This article got me thinking about my patients. My practice is focused on treating people who suffer from chronic pain in the face, jaw, and head. Their pain is usually caused by muscle fatigue, spasms, and tightness related to temporomandibular disorders, commonly referred to as TMJ. TMJ can have many origins but it is most frequently associated with bruxism – tooth grinding or clenching while asleep or awake.
Over the years, the more I’ve learned about temporomandibular disorders, the more I’m able to link them to the stressful lives of my patients, most of whom live in the NYC and Tristate area.
When you walk down the streets of New York, it’s easy to be reminded that life today is lived at a frantic pace. Everyone you pass seems to have an urgent mission to accomplish – no matter what the price.
(Jaywalking was once considered risky behavior, but now, people cross in traffic with their eyes glued to their phone or their phone glued to their ear. Even more dangerous!)
And, the frantic pace doesn’t end when we get home, either. The temptation to stray from the task at hand is ever-present – whether it be a work task or something done just for fun.
Our minds and bodies are in perpetual motion. Downtime is limited. Fatigue is common.
So, if cozy can be defined as a feeling of comfort, warmth, and relaxation, it’s easy to see why it’s become so elusive.
The challenges of daily life may seem superficial in nature and minimally impactful on the body and mind. Consider this: in addition to living in a frantic state, many people also struggle with anxiety, anger, and loneliness. And others, many of whom were subjected to trauma at an early age, regularly deal with the repetitive re-living of the trauma, often daily.
Anxiety, anger, loneliness, and the effects of trauma all have an impact on your body. The sense of being in danger all the time is proven to increase cortisol and adrenalin levels in the bloodstream and activate the fight-or-flight system – a sense of being in constant danger.
The feeling of being in constant danger causes pain and muscle tightness.
When pain and muscle tightness is present, your brain reacts to the danger by reducing blood flow to multiple regions of your body, causing a decrease in tissue oxygen levels. This, in turn, leads to biochemical changes in your muscles as irritants such as lactic acid accumulate fuel nerve excitation and lead to lowered pain thresholds.
Precisely the condition of most of my patients when they first arrive at the office. They’re living with chronic pain every day.
Unfortunately, it’s not easy to avoid these biologic insults, particularly when the source of danger is ever-present and often unforgettable. Although life’s stresses have confronted every generation, the challenges in front of us today seem to be more invasive, more penetrating, and most importantly, inescapable.
To make matters worse, video cameras are everywhere, recording our every whereabouts. And, text messaging and emails are inescapable and demand immediate answers. Instagram and Snapchat fill our lives with snapshots of what others are doing 24/7 – often making us feel left out or jealous.
These forms of technology clutter, replace, introduce urgency, and disrupt whatever calm is present in our lives. This is real and concerning.
Today, finding cozy is difficult, if not impossible.
The majority of my patients arrive at the office seeking relief from jaw and facial pain. They’re just like most people – they’re constantly barraged by life’s stresses. They don’t have the time, or the ability, to find some personal space or even a moment of quiet that could help maintain the proper balance and calibration to maintain normal pain thresholds. This holds true for any age group, including teenagers.
Cozy is unattainable, and the stress often lands in their jaws and before you know it, they’re living with chronic pain.
If that describes you, how do you find cozy in your life?
There are time-tested strategies that work and for my patients living with chronic pain, we recommend one or a combination of mindfulness meditation sessions once or twice a day, focused efforts to control and slow breathing during the day (Buteyko breathing), Tai Chi, restorative yoga, guided imagery, or progressive muscle relaxation techniques. It takes some effort to dedicate time for this every day, but the results are often dramatic.
The ability to escape from life’s predicaments and memories may not always be possible, but if you can change how your body reacts to these stressors on an everyday basis, it can make a huge difference, especially if you’re living with chronic pain.
When your brain is continuously given an opportunity to turn down the volume on how it responds to stress, you can actually reduce daily pain and muscle tension.
Healing is a process – not an event.
Pain issues and sleep challenges do not have to be lifetime afflictions. You need someone who listens and possesses the knowledge and compassion to get your pain and sleep problems under control.
I am that someone – and you’re in the right place.
Dr. Donald Tanenbaum, DDS MPH