The Pain that doesn’t go away.

First rule out biology -BIO – there are many reasons for pain. Far too many of them are not detected through blood tests or imaging. Too often, we doctors miss the diagnosis. Then by the time the diagnosis is made, the acute pain has become chronic.

Tissue damage, inflammation, nerve damage – they are really hard to treat when there is chronic pain. Especially nerve pain is hard to treat. From the age of thirty, most of us have some form  of osteoarthritis. Unfortunately – the only treatment for that is exercise, stretching and surgeries – like back surgery or joint replacements. Surgeries usually help, but they don’t always help.

The biological part of pain is very complex. Severe tissue damage leads to scarring and nerve inflammation. The nerves and surrounding tissue change. Changes that are meant to help healing – inflammation – can eventually cause toxicity in the cells if the problem is present for more than a certain time (this can vary from injury to injury and person to person). So pain messages continue to flood the brain due to these changes.

Say you have a severe accident or even an accident which causes a feeling of great threat (like a car accident where you could have died or domestic violence), then the alarm center is altered. Central sensitization happens if the injuries are not immediately ‘fixed’ – which seldom happens if there is severe tissue damage or when you can’t escape a ‘bad’ situation at home.

Once we have exhausted the biological part – we’re stretching, we’re moving, we’re taking the medications that we can, and still there is not relief, then we really have to concentrate on the other areas of pain. BIO-PSYCHO-SOCIAL.

PSYCHO – TRAUMA – physical trauma, illness, environment, toxins and past childhood and adult trauma. Chronic pain is a trauma in itself. It robs you of power.

SOCIAL – Pain makes it almost impossible to use your energy to spend time with others. There is sometimes only enough energy to get through the day. It can cut you off from everyone.

Dealing with the biological part means that the nerve inflammation and tissue damage needs to be sorted. Use cold for swelling – 10 minutes on 10 minutes off; heat for comfort and soothing, stretching the fascia gently, and ventral vagal breath.

When the pain hits, if possible, immediately relax (very hard to do in pain) speak to the limbic system and say “you’re safe” then take ventral vagal breaths. It sounds so silly, but if you pull a face, or wince, or scrunch up, the alarm center is reinforced that there is danger and the pain pathway gets harder, stronger, more set in your brain.

Start with work on the alarm system. It is broken if you have chronic pain. It is very important to recognize that the pain messages you are receiving are false alarms. They do matter! They are causing your pain. But they are causing too much pain for the tissue damage that is present. You can’t trust your pain signal.

Start with making sure you get up every day at the same time. Get dressed, no matter how hard this is. Do your make up if that is what you used to do before you became ill. It is important to make these steps to normal.

I now the breathing. Judy and her bloody breathing. People don’t know how to breathe to lower alarm. Step 2.

I know you want to work. I know you link the work with your self image. And work at least gives you power and social connection. It gives you self respect. Work if that is what you need, but the most important is load! Pacing. If you have chronic pain, you have to take every 20 minutes off for at least 10 minutes to practice breathing and something like super brain yoga. You can do this in the chair. See this and the breathing in LOWER INFLAMMATION


Every 20 minutes – 5-4-3-2-1, superbrain yoga and a deep breath.

Chair yoga 3 times a week. Even if all you do is sit and watch the videos. Eventually do a few movements. Eventually you WILL complete the program. Commit to 3x a week chair yoga.

More to follow


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