Dance may be the best way to relieve chronic pain

Researchers at Sydney University are studying the perceptions and beliefs of people with chronic pain and the use of dance for pain management.

Researcher and physiotherapist Benjamin Hickman is on a team which is studying the beliefs of people with chronic pain. The team aims to explore details of these beliefs such as the intensity, frequency, type of pain, background activity and beliefs around using dance to treat chronic pain.

The study will be used to create a dance intervention for people in chronic pain.

Mr Hickman said the goal is to eventually have a dance program to suit everyone, but for now they are looking for people aged up to 65 to take part in interviews.

"While working as a physiotherapist, I was very active in the Latin/African social dance scene and at one point began to teach some classes," he said.

As I became more involved in the two professions and saw clients experiencing chronic and persisting pain, I started to hear stories from them about their pain diminishing when dancing.

"One client told me she struggled to walk for 5-10 minutes on flat ground, yet, she could dance for over an hour when she listened to the music of her home country. I started to investigate the use of dance as therapy for pain, which lead me to a new and growing field called 'dance for health' where the interest is in how the music, movement and social interaction improve different areas of one's health."

Mr Hickman said studies in the field for persistent pain was lacking.

"It seemed that recreational dance classes generally did not cater for those with issues such as persisting pain so I began a PhD into the topic of dance for chronic pain in 2019.

"This research basically arose out of the desire to blend the world of physiotherapy with the world of dance and question if we could use dance as a potential approach to address pain."

Mr Hickman is working with his supervisors at Sydney University to create a dance program to help.

"It would blend education in pain science, different dance genres and something that can be used by other dance schools and organisations in the community," he said.

"Due to the nature of chronic pain, we know that regular exercise, social interaction and community engagement are among the key components to managing periods of pain flare-ups.

"We hope that a dance program will fill this gap, as an enjoyable way to perform physical activity that can be done in a class or a social dance setting. We also hope to show that dance can be anything you want it to be, no matter your ability and no matter the nature of your pain."

Mr Hickman said people who experience chronic pain for more than three months have changes in the nervous system which become more sensitive to pain.

"Over time, when combined with periods of stress and worrying about how this will affect work or daily life, or a focus on the negativity and limits in activities like spending time with friends and family, this can lead to fear of movement," he said.

"This is something critical to identify in individuals with pain, as well as their preferred level of movement. With gradual exposure to dance, and pain education, we hope to engage individuals in a joyful activity and re-educate movements. This may just involve slowly increasing movement combined with music, a choreographed set of steps and a social environment. "

People with persistent pain often feel as though all of the joy has been taken from their life and Mr Hickman said many study participants have expressed this.

"It is a very common statement. They feel they have limited energy, and that limited energy is usually spent on doing the day-to-day activities, at best. Many are not able to engage in a joyful activity and end up cancelling plans to attend social gatherings and events." he said.

"It can be very isolating and taxing emotionally. But when they want to engage in their choice of joyful activity, such as dance, usually there is no right setting to help them participate. Many feel there is a constant need to explain why they cannot do a certain movement or engage in the activity similar to others, when they look 'normal' on the outside.

"It is not always the pain itself that impacts individuals and is emotionally draining, but all other contextual aspects around it. Not having access to what is designed for your need, a constant need to advocate for your pain or explain to others about your pain.

"So, our first aim is to design a program that is accessible to individuals with chronic pain to facilitate their participation. Some may forget their pain and some may not, but still can feel included and engaged and continue joining the sessions.

"With more exposure to activity, we hope to see further positive impact. With this is mind we can then slowly build up the amount and speed of dancing performed in a standing position along with the context of a fun and social environment, which helps to reinforce the possibilities to the mind and body."

While some people mind find dance can be a distraction from the pain, Mr Hickman said dance is mainly a way for people to gain more insight into their body, and that also includes an insight into their pain.

"What I mean by this is that when we can accept the sensations (including pain) of the body and find ways to express, transform and release it through dance, we change our relationship with that sensation. And this is in line with some other research that has looked at how dance helps with acceptance and exploring movement and sensations despite ongoing pain."

To take part in the study, email Benjamin.hickman@sydney.edu.au