Podcast episode 2
Welcome to Episode #1 of Beating Chronic Pain - a podcast that helps you learn how to get unstuck from Chronic pain and back to living your life again with ease and comfort.
I’m your host Tom Wilson and I’m so happy you’re here because today we’re talking about your brain and it’s role in creating pain. You’ll discover why it is SO SO SO important to learn how to work with your brain if you even hope to get out of chronic pain.
I want to share with you some of the real basics about pain. We’ll take a look at what actually happens when you hurt yourself. What is the purpose of pain anyway? and what types of things influence it? My hope is that if you understand these basics then they will become like a guiding light in a storm for you. You’ll always know which direction to move in.
As you’ll discover, chronic pain has actually got a lot to do with your habits and your nervous system. So in order to beat chronic pain and find that ease of movement again, you’ll need an approach which addresses your brain and your habits. In this episode I will share with you an introduction to the strategy that I use for helping people out of chronic pain. In upcoming episodes we’ll be looking deeper and deeper into how to actually implement that strategy so that you begin to get results and break downward spiral that is chronic pain.
Lets begin by talking a little bit about where pain comes from. If you are walking down the road and you stub your toe on the concrete it sets off a chain reaction of changes in your body. Starting with the tissues around your toe getting all excited. They send a message up through your nervous system all the way to your brain. Once you brain receives the message it quickly assesses the situation and decides what to do with the pain. If it thinks that your toe stubbing experience is not that big a deal then it will minimize or eliminate that pain signal. Perhaps you’ve had situations before where you’ve cut yourself and you didn’t even feel it. Or maybe you can remember a time when you were playing a game as a kid and you ended up with cuts and bruises on your knee’s but you were having so much fun you barely noticed it.
If your brain deems that what just happened is a dangerous situation then it will create a lot of pain so that you stop and pay attention. I remember working with a guy when I was doing some construction work years ago. He accidentally gave himself a minor cut on his finger and I was shocked when I saw the amount of drama that ensued. He screamed out loud and turned completely white. He stopped work for about 15 minutes to deal with this cut and the panic that he was experiencing. Now just to give you an idea, it was a cut that was maybe 5mm long and it had only just gone deep enough to draw blood. It was very superficial. If I had cut myself in that way I probably would have looked at it for a second or two and then carried on working. Now I don’t say this in order to show how much of a tough guy I am. I just wanted to demonstrate that different people have totally different experiences of pain. It’s not actually about the cut so much as the meaning that we assign to it.
What I’m saying here is that your brain is the boss of the situation - not your body. Your body can send a message but then your brain can completely override it and decide what to do about it.
It was like the other day my 7 year old daughter was in her bedroom and I was in the office doing some work. I heard her scream out for help because there was a quote “huge spider” in her room.
If you think of me as the brain in this situation it’s like I’m receiving a message. I then get to decide what to do with that message. In this case my main concern for my daughter is her safety. I know that in New Zealand there are hardly any spiders that are poisonous. So I immediately know for certain that she is safe. In addition, she has already seen the spider so I’m guessing it’s highly unlikely that she will go anywhere near it until I get there. I also have a belief that it’s a good thing to get used to spiders and know that there is no problem with having spiders in the house - we live in a forested area and there’s no escaping the fact that there will always be spiders here.
My decision in that moment was to do nothing. I didn’t just drop everything that I was doing immediately. Instead I told her I’d come soon, I finished my job and then after 5 minutes went to go talk to her and see if anything needed to be done. This all happened in a split second.
You see, I took into account a fairly wide range of things when it came to that situation.
When it comes to your brain assessing a pain signal coming from somewhere in your body, it’s exactly the same. Your brain takes into account things like your past experiences with pain, your expectations about how much things should hurt, your perception of how much danger you’re in, your fears about pain, your coping skills. It also considers other factors which are perhaps less obvious. like how much sleep you had last night, any relationship or family difficulties you might be struggling with, your feelings… are you depressed or in good spirits? What are your levels of social support like? If you are someone who doesn’t have a lot of social support in your life then all else being equal you will feel more pain than someone who does have that kind of support. You see, your brain makes a holistic judgement of all things in your life. It’s not just your physiology. It’s your psychology and your social life too. And all of this is for the purpose of keeping you safe.
Yes, your brain creating this pain is actually really healthy. It is designed as a warning system to make sure you pay attention when it’s important. There are even cases of people who can’t feel pain - it’s a disease and it’s a very dangerous one because people don’t know when they have hurt themselves seriously. They can die without ever being warned there’s any problem. So the next time you walk into a cactus [haha] you can be grateful that the pain is keeping you safe.
Now everything I’ve described so far is for the case of acute pain. This is a normal and natural response that you get from an injury. It doesn’t usually last very long.
Now I would like to talk about chronic pain. Chronic pain is the type of pain that has gone on for months if not years. In many cases, this pain has extended long beyond what we might consider helpful or protective. It can become downright destructive in someone’s life - as you may know.
This type of pain can start in a number of different ways.
Firstly it can come from an injury or a surgery and the pain never completely leaves despite the fact that the actual tissue damage heals. In the case of surgery, I looked up some statistics and found that somewhere between 10 and 30% of people are still experiencing pain a year after their surgery. That’s a lot of people considering there’s over 200 million major surgeries performed every year worldwide. So there’s a lot of people who are in this category.
You can also develop chronic pain in places that are separate from where an injury or surgury occurred. This might be due to you changing the way you move to compensate. It’s like when you hurt your foot and then you develop a limp to help you continue to walk, but then that limp starts to make your back hurt on one side. Or perhaps your hip. Sometimes the limp never leaves completely if the pain of the initial injury goes on for long enough.
Another thing that can happen is that chronic pain can emerge from completely out of the blue, with no apparent cause. This is the case with many people who suffer from chronic neck or back pain. It just seems like they hurt and they don’t know why, it just happens. I don’t have any numbers on this, but from personal experience with clients, in most cases their pain does seem to have quite mysterious origins. This scenario is also the way that my chronic pain presented itself. One day, completely randomly, I woke up and my knee and ankle were swollen and painful. Over the course of that week the pain and swelling intensified to the point where it became impossible to walk. I was in this state for nearly a year and I had no idea at the time why it happened, it was a complete surprise. I do now have a much better idea about the causes of that pain. I’ve learned how to explore my body in a way that helps me identify things like that. But at the time it was a mystery to me. I was spending time researching online and trying out various exercises and practices that were reputed to quote “fix me”, all the while I was missing the approach of listening to my own body. This is the approach of deep self-exploration which I will be sharing with you over the coming episodes. But we’ll get to that later.
There are also other less common disease causes of chronic pain. For example, cancer, degenerative nerve disease and arthritis. These may require a different approach for relief.
So, that’s a few ways that chronic pain can start. But perhaps what’s more important than how the pain began is the fact that the pain does persist. It shows up day after day after day and that is something which can have some insidious effects on someones life. The very fact that day after day you wake up and you feel pain means that you become used to it. It doesn’t matter if it’s in your knee or your hip or between your shoulder blades, the pain begins to feel normal over time. It’s still uncomfortable, but it becomes familiar. Another way to put it is that pain has a habitual nature to it and that changes begin to happen gradually which reinforce the pain staying there.
It’s similar to the pile of stuff I can see next to me on the floor in my home. I originally decided that when I’m tidying the upstairs level of my house that I put things in a pile if they need to go downstairs. Maybe it’s empty egg boxes that I take out to collect eggs from the chickens, or cardboard boxes that go down to the fireplace, or shoes or any number of random items that live downstairs. There’s just no point walking up and down the stairs multiple times while I’m cleaning so I do it all at once right at the end. Now this makes sense to me and it does save me time and effort. However over time that behaviour has morphed into one where I put items there throughout the day that I know eventually need to go downstairs but I don’t get to it right away. So I have not only become used to putting things there frequently. I’m also used to seeing a pile of stuff there. The honest truth is I don’t like having things there. It makes the space feel cluttered and messy. I don’t like looking at it and I don’t like how I feel when I look at it. But it has become a habit now. It feels normal and familiar to see a junk pile there.
In much the same way, pain which has become habitual doesn’t feel good, but usually through lack of knowing what to do about it, we tolerate it. It goes on and on and on and eventually we think that there’s nothing that can be done about it. We learn to live with it.
The key point I want you to take from this is that chronic pain is habitual. When you feel it every day it begins to produce changes in your nervous system. Your brain literally changes and becomes used to being on high-alert. Like I said at the beginning, pain has got a healthy function. It is trying to keep you safe from danger. When it comes to chronic pain, nothing has changed. Your brain is still trying to keep you safe. It perceives that you’re in danger and it’s doing it’s best to protect you by creating pain.
I think of it like this sometimes. Earlier this year, I was exploring in the forest nearby with some people I know. There was me, my partner, my daughter and another woman with her 2 kids. We were out there because we wanted to find a good place to leave a night vision camera on and so that we could record some movements of the pigs in the forest. Me and the kids were running through the forest and jumping off things, climbing tree’s and sliding down banks. We were having the best time ever. But the thing I kept on hearing from in the background was the other woman yelling out to her kids to “be careful”. I must have heard that phrase “be careful” about 30 times over the course of an hour and a half. In my opinion, the kids were completely safe. The worst case scenario was that they might get a bruise or a scratch. They were obviously used to hearing this message from their mother because they ignored her pleading and carried on crashing through the bush, getting mud on their pants and laughing wildly all the time. I would consider this type of message “over-protecting”. The intention of their mother was obviously good. She wanted to keep them safe. But I don’t believe it was in proportion to the actual risk. I think that she believed her kids were going to get seriously hurt with all the running around they were doing. But in reality, there was very little danger. And in the end nothing bad happened despite the fact they were not actually “being careful”
This is one way you might think about your brain when you’re experiencing chronic pain. It is like an overprotective mother that is telling you to “be careful” or “be safe” all the time. Except the language of your brain is pain, not words.
Now that’s the brain side of the equation, but there’s also the tissue side too. So if we go back to that example of stubbing your toe, we talked about the way the tissues of your toe send a message up through your nervous system to your brain. Well in the case of chronic pain the tissues in your toe have also become hyper sensitive. The number of messages they send increases. It’s like someone saying “help me, help me, help me, there’s a problem here, danger, danger” or like in the case of my daughter telling me about the spider in her room. It would be equivalent to her screaming louder and louder and panicking more and more. If she had been reacting like that, it is much more likely to get my attention. In the same way, your toe sending more and more messages of pain to your brain, is more likely to get a response...like making more pain!
Now the interesting thing about this, is that that increase in pain messages is not necessarily a reflection of actual damage. Pain scientists have figured out that you can have damage without pain and you can have pain without damage. Heck there are many people with amputations who still feel pain in their nonexistent limb as though it were really there. It’s called phantom limb pain and it’s very real. What this means for you is that you may not have any physical damage at all, but your pain persists because everything is still on high alert. I share that because it can feel like a relief to some people to know that their body might actually be okay, it’s just the alert system we have to ease.
Now there is another aspect of habits I would like to talk about which I think is VERY important. This is the movement aspect. As I touched on earlier you can get chronic pain from compensatory movement patterns like a limp for example. You walk all lopsided and it makes sense that yeah, you might hurt from doing that for long enough because it’s not really an optimal way of moving. However, there’s many more subtle habits of movement which slip under our awareness but have similar effects. Here’s some questions for you… When you walk up stairs which foot do you step with first? If you’re sitting while listening to this, which side of your pelvis do you rest on more heavily? Which teeth do you scrub first while brushing your teeth? Which side of your body do you feel more comfortable lying on in bed? When you look through a telescope which eye do you use?
The reason I ask those questions is to get you to think about some of the habits of movement that you might have and that you may never have thought about before. The thing is, we all have habits when it comes to our movement. None of us are symmetrical and we all have preferences in the way we move which means we repeat these patterns over and over and over in our lives.
I’m not saying that all of these habits are problems - they’re not. But I am saying that SOME of them (which are usually beneath your conscious awareness) are definitely involved when it comes to maintaining chronic pain. For example, one of the things that I discovered when I was getting out of chronic pain was that my left foot was much less coordinated when it came to walking than my right foot. It felt to me more like a block, whereas the right foot felt like it was flexible and the weight could roll through it when I walked. Now this might seem a small thing, but when you consider that every time I stood on my left foot I would brace my torso slightly and that I took THOUSANDS of steps every single day you start to get the idea that this pattern actually is quite significant.
So you see, if you’re in chronic pain, not only are your brain and your tissues hypersensitive, but it’s almost guaranteed that you are also habitually moving in a way that is placing an additional stress upon your system.
This situation, if it continues, starts to become a descending negative spiral. I remember when I was in pain it felt extremely difficult to engage with other people in the same way. People would always ask me how my pain was doing? It was the same conversation all the time and I got sick of it. I didn’t have much new in terms of life-experience to bring to the conversation because I wasn’t out and about doing things in the world. Everything started to revolve around the pain. My day consisted of lying on the couch, or sitting at a chair researching. My nights were interrupted with pain and I felt constantly tired. Other people were going about their lives, having wins and losses and fun and sadness and work and play. These things I missed dreadfully. It took me 20 minutes just to put my foot on the floor in the morning while getting out of bed. My life began to feel very repetitive and unenjoyable. I couldn’t laugh anymore. I was depressed. I didn’t even like eating with other people anymore (which for me is a BIG issue). I felt like such an outsider as though I was outside a window looking at all the people inside having a party together.
This type of situation is common with chronic pain, though not always to this extreme. But what I often hear from my clients is that their world gets smaller and smaller with chronic pain. It becomes difficult to move and to engage with their lives in the same way they used to. And as we now know, this is something that the brain considers when generating pain. If you’re socially isolated and you’re depressed and you’re not having any fun in life, it generates even more pain because it’s trying to keep you even safer.
Now I was only in this state for a year, but perhaps you can imagine what this may be like to have chronic pain for years or even decades. The pattern just gets harder and harder to shift.
What I’d like you to take away from this is that chronic pain is very habitual in nature. It includes not only the habits of our brain and our movement, but also our environment, our psychology and our social lives. This is a holistic problem and the best time to deal with it is NOW before it becomes any more embedded.
In order to stop chronic pain and to begin to move with freedom again we need to address the habits that are in the way. I hear so many people who seek treatments from practitioners where there is a “fix-me” approach and push this -prod that -crack this type of bodywork to release the tension. Often the pain temporarily disappears, but in short order it’s back again. The habit has not been changed and all the familiar pain-supporting patterns are still in place.
Now I’m not saying bodywork doesn’t have it’s place - it does. I’m just saying that an approach which ignores the nervous system and the habitual nature of pain, it’s guaranteed to just be a temporary change.
So now that I’ve shared what I see DOESN’t WORK… lets talk about an approach that I have seen work over and over and over again. This approach takes people from chronic pain back to experiencing ease, enjoyment and fluidity in their movement again. It changes that descending negative spiral into an ascending positive spiral.
To change your habits of pain you need to approach it from at least these 3 angles.
The first approach is to send your brain signals of safety and health. If your brain is being an overprotective mother then it’s important that you let her know that everything is okay and that there’s no danger. This is the only way that she can begin to calm down and stop creating pain. In upcoming episodes I’ll create a series which discusses the skills you’ll need to develop which will help you create this sense of safety. These skills are invaluable when it comes to working with your brain. They also set the stage brilliantly for the next approach which is...
You need to start becoming aware of your habits of movement and then find new and improved ways of moving. This takes a real exploratory approach and it’s what I guide people through in classes. This exploration of movement has a powerful effect on your nervous system and this is where some dramatic changes can happen.
The third angle that I believe is important is to consider the other things in your life that may be contributing to your brain being in high-alert mode. Perhaps you have got a relationship difficulty that needs some attention. Maybe you’re in a job that you hate and you need to fire your boss. Perhaps you’re on a path in life that doesn’t align with your skills, passions and talents. Maybe you need to stop sleeping next to that snore-monster for a while.
When you use those 3 angles to approach your pain you will find that things begin to change. Your overprotective brain can start to produce a different kind of experience in your body. You get to feel ease, comfort and pleasure in your movement. You sleep better. You have better social connections. You can laugh more, play more, be involved with life more. Everything begins to change and become more expansive. You break the habit and move into an upward spiral.
Now if you have been struggling with chronic pain for some time, I hope that the approach I shared gives you some hope that things can change. I know that this experience can be an enormous burden on someones life and I love to help coach people through this process of flipping the spiral.
If you would like to hear more details about how to actually take these steps then join me in upcoming episodes where I’ll be guiding you through how to overcome chronic pain and get back to moving with freedom, ease and even pleasure again.
Thanks for joining me today and if you enjoyed what you heard, I would really appreciate it if you could subscribe and give me a rating on itunes. This podcast is brand new and I would love your support to get it out into the world. That’s all from me and I look forward to connecting again soon.