How to Heal Chronic Pain
Pain is not due to tissue damage
We used to think pain was caused by an injury sending a pain signal to the brain. We now realize that pain is not necessarily related to tissue damage.
Some people have a lot of pain, but no significant findings on an x-ray or MRI, and others have significant findings on imaging, but don’t have pain. In fact, research has shown that 1 out of 3 people over the age of 30 who do not have pain have abnormal findings on an MRI of the shoulder and 40% of people who have a bulging lumbar disc don’t have any pain. The moral of the story is that pain does not equal tissue damage!
Pain is the brain’s response to threat.
It is a warning signal meant to get our attention and change our behavior. Once the treat is removed (for example, we realize we aren’t seriously hurt after a fall, or our injury has healed), the alarm should turn off.
To understand pain, you have to understand that whether there is danger or not, pain can be triggered if the nervous system BELIEVES there is a threat. It is a physiological response to perceived danger. The alarm is meant to get you to pay attention and assess the threat level.
For example, I’m afraid of snakes. It I see something coiled up on the path in front of me while I’m hiking in the woods, my nervous system will react to keep me safe. My heart rate will go up, and I’ll start scanning my environment to plan a route to safety. If I realize a few seconds later that the snake is not a snake, but in fact a coiled up rope, my nervous system will relax once I realize I am safe. In this story, nothing changed except for my relationship to the object.
When it comes to pain, the way we think about an experience really matters, and if we can change our minds, we can change our relationship to pain. The key to healing chronic or persistent pain is teaching the nervous system how to feel safe.
A Sensitive System
You know how some cars have alarm systems? Ideally those alarms would be triggered only if someone was breaking into a car. But have you ever seen a car with a really sensitive alarm system? One that seems to go off any time there is a breeze or someone brushes up against the car? The same thing can happen to you body’s alarm system.
For some people, that alarm system is overactive, and the nervous system continues to perceive a threat even after the danger has passed. This is why some people have pain long after an injury has healed.
If the alarm is activated for a long time, it can become more sensitive, and small things can set it off, including a change in the weather, or lack of sleep. When the body’s alarm system is sensitive, other parts of the body besides the place of injury start to get a little stressed. They are constantly hearing the alarm, and they too start to go on high alert. This explains how your original pain can start to spread. Maybe you originally had pain in your right knee, and now your left knee is hurting. Or maybe you originally had pain in your arm, but now your hand and neck start to get worried about the alarm, and they start to get sensitive too. Understanding the nature of pain can calm your nervous and quiet the alarm.
To Heal Chronic Pain, You Have To Heal Your Nervous Sytem
With pain neuroscience education, we can calm down a sensitive system so that the alarm is not so easily activated. This involves:
Decreasing the perception of threat;
Balancing the nervous system,
Gradually increasing tolerance to the stimuli to which your body is sensitive.
How I Can Help
I’m a Doctor of Physical Therapy and a certified Therapeutic Pain Specialist. I also lived with chronic pain for years before I learned how to heal my nervous system, so I understand pain from the inside out and the outside in.
Unlike traditional physical therapists, I can help you understand your pain and why you hurt, and I can also help you heal your nervous system. The reason traditional physical therapy often doesn’t work for people with chronic pain is that it takes a local, mechanical approach to treatment, when what you need is a systemic, holistic approach to healing your nervous system.
01 — Assess the root causes of your symptoms
If you’ve had pain that has lasted for more than 6 weeks, chances are your injury has already healed and now you are dealing with a sensitive alarm system. We’ll start with a comprehensive evaluation of your movement system. If you do have tissue damage, we will work together to help your injury heal. If you don’t, we’ll help you understand why you hurt & what you can do about it.
02 — Map Your Nervous SYstem
The nervous system has two speeds: Fight/Flight/Freeze/Fawn (sympathetic mode) and Rest/Digest (parasympathetic mode).
When you are in sympathetic mode, your energy is shunted to the periphery to help you mobilize to run, fight, or hide. This means that your body stops prioritizing things like digestion, reproduction, and rest. It also means that your body is flooded with hormones that keep your alarm system on alert.
Step 2 is to map your nervous system, understand your triggers, and help you see pain as a whole-body response to threat. You will learn all about pain science, and by understanding pain, your nervous system will start to feel safer.
03 — Create A Safe environment for your Nervous System
Because chronic pain is a sign that the nervous system detects danger, it is important to reduce the sense of threat. We’ll meet every 3 - 6 weeks to support you on your journey to healing your nervous system. At each session, we will explore embodied, somatic practices like CranioSacral Therapy, Energy Healing, and Therapeutic Yoga to restore your nervous system’s natural rhythm and break the pain cycle. We’ll also work together to develop a personalized wellness plan, including nourishment, rest, yoga, self-care, and pain science practices to help your nervous system feel safe and quiet the pain alarm.
04 — Reduce the Sensitivity of YOUR NERVOUS SYSTEM
Once your nervous system feels safe, we will gradually help you build your tolerance to your triggers so that you can return to living your life fully. You will learn how to interpret your body’s signals, and how to reintroduce movement and activities you love without tripping the pain alarm and getting trapped in a pain spiral.
05 — Continued support
This package includes one 90-minute assessment and three 60-minute healing sessions to get you started on a path to healing your nervous system. Each person is different, and this process takes time, especially if it is something you have been living with for a prolonged period of time. We’ll assess and develop a plan for continued support or periodic tune-ups beyond the initial package for as long as you need based on your unique needs and goals.
