What does it take to overcome chronic pain?
This blog is a follow on blog from the others I have posted this month. The theme has been:
Why do people in pain struggle to overcome their symptoms long term?
Every week I work with people who are frustrated because they are in pain and their previous attempts to overcome their symptoms have not been as successful as they would have liked.
For most, it’s a start-stop journey. Get some hands on treatment that may help in the short term, but doesn’t really do anything to help them long term. As a result they end up encountering the same (or potentially worse) symptoms in a few weeks or months again.
As I alluded to in this blog , I think part of the problem is that there is very little CLARITY about what it takes to overcome symptoms long term.
And because of this lack of clarity, I decided to write this blog post to help anyone who is struggling with pain to understand what they should ideally be thinking about and acting on.
Here are the basic principles that experience in clinic has taught me are most important.
Please note: Each person will likely have a different path through this process due to the incredible uniqueness of their story but these general principles should alway underpin the process.
1. Perception Change
For almost everyone that has ongoing, intermittent or long term struggles with pain or symptoms, a shift in how they are perceiving their body and their symptoms is often a key part of achieving the result they are looking for.
By understanding that your understanding of the human body and of your symptoms influences your symptoms themselves, you can then uncover lots of potential for change. This includes the beliefs you hold about your body, the labels and diagnosis that you’ve been given, the narrative that has been built up about your body, your previous injuries and life experiences and more…
2. Decreased Fear & Worry
This goes hand in hand with perception changes. By creating clarity where there was confusion, we decrease fear associated with your symptoms and worry associated with your future.
Fear is an amplifier of pain and related symptoms.
By changing how you perceive and relate to the symptoms you are experiencing, you can have big decreases in the fear you have, which in turn have big knock on effects on your symptoms.
Here is a simple example: You get an MRI for your painful lower back and find out that there is degenerative disc disease and a small disc bulge that is not compressing on any nerves.
This may leave you feeling very worried about degenerative issues in your back, afraid that your body will continue to worsen structurally over time, and lead to changed behaviour, more concern, more worry etc.
If you were then told that the findings on your MRI report were normal - they happen to every body as a normal process of aging - like getting wrinkles but on the inside - wouldn’t that reassure you that your structure is in fact, fit for purpose? That should naturally lead to having much less worry and fear associated with your back.
3. Increased Clarity
When you understand what the issue that you are dealing with actually is all about, you can then see the task that is at hand to overcome it. You will see what changes are needed, what movements and exercises you can do to benefit your body and how you could potentially make some simple lifestyle changes to make you feel better.
None of these potential solutions are easy to identify when you aren’t clear on what the actual problem is that you are facing. The presence of pain can often muddy the waters and make it difficult to achieve clarity.
4. Effectively Managing A Flare Up of Symptoms
If you have had pain for a while and are starting to make progress in overcoming it - it is quite likely that you will encounter a few bumps along the way.
As someone who has been helping people with ongoing pain for well over a decade now, I have come to see that a flare up of symptoms is a necessary and important part of the journey of overcoming symptoms.
A flare up usually links with a set of movements, activities or contexts that has previously represented “increased threat / risk” for your nervous system.
As a result of this prior association, your nervous system may conclude that the current scenario represents credible threat and it increases protective activity such as producing pain experiences, altered movement etc.
By managing a flare up effectively, we can demonstrate safety in movement during this flare up and help to change these prior associations. The more we do that, the less likely you are for this to cause a flare up for you in the future.
Flare Ups are opportunities not problems. Learning the tools and skills to manage them will make a big difference to you.
5. Improvement In Your Movement
when assessing movement, it is important to understand:
A: what is possible and normal for the human body,
B: what is ideal for the human body
C: what your human body is currently able to achieve
By knowing all of these things, you can then identify where your body is struggling to access movement. These are important because an area that struggles to move, is an area that is less likely to do its share of the work when helping you to distribute loads and forces through your body as you move.
Take some options away, and the options that remain have more work to get through. By improving your movement, you share the workload so that everything works well together. Thinking about your movement this way is so important when in pain.
6. Reconditioning your tissues
Following on from the last point — movement that isn’t accessible over time become tissues (muscles, ligaments, tendons and joints) that lose capacity to tolerate loads over time.
That increases the need for protection of those tissues from the nervous systems perspective.
This becomes a cycle of protection, movement avoidance, decreased tissue capacity and often leads to higher levels of pain in other areas that are increasingly overburdened.
7. Being Consistent
Here’s the bit that we all hate to hear — overcoming pain isn’t easy at times. It takes some effort and consistency to achieve the results that you may be looking for. It is always more difficult to regain movement, tissue capacity and confidence in your body than it is to maintain it. The boom and bust cycle that a lot of people fall into and ultimately fall out of entirely — is never going to be as effective as consistent, habitual work towards an end goal. In the old fable of the tortoise and the hare, it might feel like being the hare is making great progress but it is the tortoise that gets over the line in the end! Consistency matters.
8. Support Along the Way
Doing all of this on your own is bloody hard work at times.
It’s a big help when you have a support structure that can help you out along the way.
That might be a spouse or family member who really listens, a community who help you to stay on track when that’s needed or just a set of skills and habits that help you to navigate the journey.
These are the principles that have mattered the most along the journey of helping hundred and hundreds of people around the world to move past their symptoms.
Thanks for reading this blog. I’m pretty sure that most of the points above will make sense to you and hopefully will give you a fresh perspective from which to analyse your own attempts to overcome pain. To join my membership community where you can dive in much deeper and work through a clear and structured process to overcome your symptoms, click the link below.