Chronic Pain: It's Complicated

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As a massage therapist, I see many clients who have recurrent issues with pain. Fortunately, research in medicine and neuroscience are starting to get a more complete picture of why many people experience very real, and often very severe chronic pain. More importantly, millions of people who have suffered for years from fibromyalgia, pinched nerves, low back pain, or an old injury are finding long-lasting relief. And it doesn't come from surgery, a pill, expensive equipment, constant acupuncture, chiropractic care, massage, or physical therapy. It comes from within.

Healthcare professionals receive little to no education in treating chronic pain unless they personally seek out special training. The most common treatment options offered to patients are surgery and medication which is often ineffective, costly, and have contributed significantly to the nation's opioid addiction crisis.

This is due in part because of the tendency for chronic pain to be treated the same way as acute pain (pain that comes from an injury or illness and subsides within 3-6 months, often sooner). All healthcare professionals, including doctors, physical therapists, chiropractors, massage therapists, etc. learn about pain as it fits within a bio-medical model which goes as follows:

  • Pain is caused by physical biological forces: disease, virus, pathology, injury, etc.

  • If the trained medical professional can find the cause, the problem may be solved.

While this model is great at explaining acute episodes of pain and has saved countless lives, it is limited in explaining why people still hurt 3-6 months after damaged tissue has healed. In fact, more and more studies are showing that factors such as job dissatisfaction or financial stress are a better predictor of neck and back pain than tissue damage or structural/tissue pathologies that appear on an X-ray or MRI.

So if that old sports injury, or that car accident 3 years ago, or being stuck working behind a desk all day isn't fully responsible for our chronic pain, then what is? The bio-psycho-social model points to our nervous system:

What Does This All Mean?

  1. The brain decides what is dangerous and what is safe based on input from the body and external environment (left side).

  2. Biological input about our bodies travels to the brain via specialized cells that communicate to our nervous system.

  3. Set and setting inputs cause variations in whether the brain registers biological data as dangerous or safe.

  4. Psycho-social inputs based on beliefs and perceptions from past experiences or assumptions cause variability in pain levels.

  5. If the brain registers the overall input as danger, it will output Pain (right side).

  6. This "danger" is both at the conscious and unconscious level (i.e. we may know what our nervous system registers as dangerous, or we may not).

  7. Pain can cause variations in both Movement and Body Physiology.

  8. This output will then further contribute to the bio-psycho-social influences which continues to input information to the brain.

  9. At the very basic level, pain is a measurement of conscious and unconscious fear and anger, and is the result of too much interference from the outside world!

If someone has ever had an injury and/or needed surgery, they probably can relate to the experience of too much interference. Friends, family, and medical professionals will all have advice and opinions. Physical therapy or massage may bring relief, but only if you do specific exercises regularly, don't run, avoid sitting or long travel times, stretch regularly, etc. Then throw in factors such as finances, job obligations, taking care of kids and family...All this input can overwhelm our nervous system without our knowledge, and all of a sudden, everything registers unconsciously as danger.

What Can We Do About It?

While there are no guarantees that someone suffering from chronic pain can become pain free, there are SO many non-medical and drug-free techniques and principles that have been scientifically proven to reduce perceptions of pain. These are ones that I do on a regular basis -- Many involve experience with meditation and hypnosis:

To heal yourself, be the Head Boss In Charge!

  1. ​Healing = Belief + Imagination + Conviction + Expectation

  2. Believe that you can heal. You are not broken or damaged. If you think you are broken, the neurons in your brain will make you feel broken. Fortunately, the opposite holds true.

  3. Imagine - visualize in a relaxed, hypnotic trance or meditative state that your pain is shrinking and dissolving (maybe you imagine looking at your pain through the large side of a pair of binoculars so that it looks far away. Or maybe your pain is melting away like wax from a candle. Go to bed every night visualizing what you would do if you were pain-free, and didn't have to "manage" it with so many treatments and rituals.

  4. Conviction - Put all the energy you were using to manage and treat your pain into the education and process of self-healing. You can "out-logic" your pain by learning about it! Remember: doctors, yoga instructors, alternative care practitioners and other "healers" can only help guide and facilitate your healing. Healing comes from within. Listen to what your body is protecting you from, or trying to tell you. The only person that can heal yourself is you. This blog page (and this blog page) is a great resource (and so am I! E-mail me with any questions!)

  5. Expectation - Expect to heal! Be open an honest with yourself: what is working? what isn't? is there any self-sabotage? is there a secondary gain? Learn from what works, dump what doesn't and move on! And expect that your body expects to heal! If we really listen to ourselves, we may discover that pain is a gift. It can be the eternal wisdom of our unconscious minds communicating to us that something needs to change in our lives.

Other Things To Be Mindful Of:

  • Emotions such as fear, anger, and sadness activate the sympathetic nervous system. Prolonged activation causes chronic pain.

  • Find ways to stimulate your "rest and recover" (parasympathetic) nervous system. Here are just a few:

  • Deep belly breaths. Breath in through your nose, out through your mouth.

  • breathe in for a count of 4. Hold for 7. Exhale for 8. Repeat 5-10 times.

  • Mediation and hypnosis are excellent, but it helps to get guidance from someone experienced a few times in order to maximize your benefits on your own.

  • Positive human touch: hug a loved one frequently, or get a massage regularly.

  • Walk in nature and keep your gaze up. Notice sights, smells, sounds, feels, and repeat.

  • Engage in thoughtful conversation.

  • Sing or hum.

  • Check out my 4-week program that teaches you to take control of your chronic pain!

  • This program includes a personalized treatment plan that will help you heal from within! You will get:

  • A thorough history and evaluation of your personal experience with pain.

  • Education in Mind-body healing.

  • Techniques (visualizations, breathwork, meditations, etc.) based on applied neuroscience to relax your nervous system and reduce your pain.

  • 3 Thai massage sessions that deeply relax your body and mind.

  • Your very own massage tool with instructions!

#neuroscience #health #chronicpain #biopsychosocial #biomedical #massage #hypnosis #mindbody

511 SW 10th Ave. Suite #708. Portland, Oregon. 97205. 503-224-6800