One hidden piece to helping your chronic pain puzzle

One hidden piece to helping your chronic pain puzzle

I have spent the last few years dealing with some chronic pain in my lower back. It wasn't until I got an email from a therapist

about a totally different topic that it made me wonder, what am I missing in dealing with my chronic pain?

Today, I'm going to share with you what I learned in my own experience about chronic pain, the solutions, and what the benefits can be from that. Stick around.

I have had some pain in my lower left back for nearly three years now, and I have done, as they say, treatment. I have gone to physical therapy, I have done yoga, I have tried resting it, I have tried strength training it, I have tried massage, I have tried stretching, and things just would not heal. I kept saying, I feel like I just need a look under the hood.

So I finally made an appointment with an orthopedic physician. Knowing that, more than likely, I was not going to choose.

Surgery, but I wanted some images. The best look under the hood that I felt I could get were, yeah, x rays, but I kind of felt it was more muscular related and an MRI.

I finally went to the doctor, learned what was going on under the hood. And what I learned was I had some things here and there, but it wasn't really telling me what was causing this consistent pain in the lower left part of my back in my upper glutes. 

Then I happened to get an email from a therapist about a totally different topic and she was just talking about the way that the brain works and she mentioned pain and chronic pain in there. It got me thinking, how much of my brain is impacting my pain? So, of course, because this is what I do, I started.

researching and digging in and looking at the research from that research and just learning more and more, that was really helpful to me. And I thought, you know, this is helpful to me. It might be helpful to you. So I'm going to pass it along. But before I do, I want to make a couple things really, really clear.

This episode does talk about the relationship between our thoughts and chronic pain. It is not suggesting that pain is all in your head, or just that positive thinking, you know, that, that just be positive or just pray it away will solve the chronic pain. Yes. Prayer can solve anything. Yes. I believe in the power of God with anything.

However, I am not saying, well, this is just all in your head. Every person's experience with pain is unique and valid. And of course, my experience is going to be different than yours, even if we may even feel that same issue in the lower left part of our back and our upper glute.

So of course I encourage you to see a doctor if. This is something physical and you need help. I cannot help you with this. They can.We will, of course, be talking about the neurology as well. So I am also not a therapist. I am not a counselor. Please find one if This episode brings up some questions or some things that you think, huh, maybe I should explore that. Again, find someone who is qualified to help you with that. This discussion is really just meant to share some information and some possibilities.

I really do not want to invalidate your own experience or just suggest that if you follow the steps in here, it will help your pain or make the pain go away. It looks at, we looked today at one piece of a very complex puzzle and just remember that this is one piece of that. But perhaps this is the piece that maybe you hadn't consideredAnd that's why I wanted to bring it to you.

So just keep all of that in mind. Again, I'm not a doctor, I'm not a therapist, I'm not a, I'm not all of the things. I'm just a personal trainer and nutrition coach who just really likes to do research for all of my CliftonStrength people out there. Input is my number one strength. So this is what I'm good at.

This is what brings me energy and now I'm just passing it on to you.

Let's first start with the definition of chronic pain. Mayo Clinic had a wonderful article on chronic pain that I will put in the show notes and in the blog post that accompanies this episode. So Mayo Clinic defines chronic pain as pain experienced on most days or every day for three months or more.

About 7. 4 percent of US adults have high impact chronic pain, which is defined as pain that limits Their life or work activities most days for three months or more. So this can be caused by a lot of different things. Things that are known, like maybe you have cancer, maybe you have multiple sclerosis.

Even AIDS was mentioned, believe it or not. These are things like maybe rheumatoid arthritis where you. You have actual, and really all arthritis, but you have actual physical reasons for this chronic pain. This is not what I am talking about today. We're talking more about the unknown reasons. And these are reasons that medical tests and lab work and imaging don't show a cause.

This is when you go to the doctor for a look under the hood and they're like, We don't see anything. We don't see anything. And then you're like, well, what am I supposed to do with that? How is that going to help me? And sometimes we have an unfair expectation of our medical team to be able to like, read our mind and just do like the little star, what was it?

Star Trek, where they had the little one that went, and then they knew what it was like, this is not fair. Our physicians are not magicians. So of course they're not going to be able to tell us everything. So let's talk a little bit about what's happening in our body and our brain with pain. I remember one time I was training for a half marathon, and about, I don't know, it was probably 10 days before the race, which I have to train a lot for these races, like I'm just not a natural like, Oh, I can just go out and run.

So I had been training and training and training for like 13 weeks, right? Shortly before the race. I stubbed my toe like really bad. And of course the pain just radiates up. And my first thought is this better not keep me from running my race. That's how obsessed I was with. And that's how obsessed I get when I do any kind of racing.

So that is more like acute pain or just everyday pain. Or, you know, maybe you have a stomach. Or you cut yourself, or you're like me and you forget to take, I do little temperature prongs in my meats when I'm cooking them in the oven, and I don't know why, but I reached in to get the prong out and did not put a hot pad holder on.

So at 400 degrees, yes, that's painful, that's painful. But when we get pain. No matter what. What happens is we have these pain receptors in our skin, our muscles, and our organs, and it sends a signal through the nerves to the spinal cord. Then, that signal sends up through the spinal cord to the brain. And so when the brain gets the signals, then you feel that pain.

What can happen is the brain and the pathways once those signals get to the brain can change over time and that can reroute the messages with new paths in that central nervous system from so from your skin or from your nerves all the way up your spinal cord to the brainAnd the brain starts reworking all that it is receiving. So this is called neuroplasticity, which can be a very good thing when we are trying to change habits, when we are trying to change our mindset about okay, I, I am a, someone who runs, I am going to work out all the time. Like neuroplasticity is a really good thing.

However, it can go the other way. So, Typically, neuroplasticity helps the brain function more effectively. And efficiently, but as the brain with these pain signals gets faster at processing the sensory signals, it can become so sensitive that it can no longer accurately detect that danger and the pain signals and the messages get distorted.

So when the central nervous system can't accurately detect these danger and these signals, then sometimes it will send frequent pain signals to the brain. which is what leads to chronic pain. 

Then what happens? Then we're stuck with the brain constantly telling us, I'm in pain, I'm in pain, that hurts, that hurts. And then there's a few things that can happen in, really more in our brain than anywhere else, that can impact our pain and how we feel pain, whether or not it's actually there or not.

when our brain has kind of rewired and we have this new neurology, this neuroplasticity, then what can happen is Many forms of the chronic pain are not actually structural. They're not actually like some, you have a torn muscle or you have something that again is identifiable, but it's those learned neural pathways in the brain.

So the pain is very real. Your brain is feeling pain, but it's not necessarily attributed to the look under the hood, to anything that your lab work or x rays or MRIs will will show. This was interesting. I found this as I was doing all of this research. So they did a study at in Northwestern a few years ago and they took 50 patients.

So, you know, in study sizes is pretty small, so keep that in mind. But they took 50 patients who had initial episodes of back pain and they wanted to see if they could predict what percentage of them were going to go on and develop chronic pain. So everybody has back pain. Who's going to get rid of this?

Who's going to. have chronic pain from there. So they didn't take any x rays. They didn't take any MRIs. All they did was take a scan of their brains. They were able to predict, get this, with 85 percent accuracy who is going to go on to develop chronic pain. 85 percent because our thoughts are impact how we have that pain.

And a lot of this can come down to. Two different things that are very similar. So one of them is pain Catastrophizing and one is fear avoidance. And so this in general is like let's take my situation Oh my gosh, I'm 50 years old. My back has been hurting for a long time. It's never going to get better I'm never going to be able to do the things that I want to do.

I'm going to get less and less I'm not going to be able to do the strength and I'm not going to be able to run and I'm not going to be able to feel good and, and just going on and on and on. Like that is pain catastrophizing. The other side of that is, well it hurts when I do this. I don't want to do HIIT.

I don't want to strength train. I don't want to stretch because I'm afraid it's going to hurt me. Because I don't know. And so we start, like, not doing anything. And if you think about our body and this ability to take up a lot of space. space with our arms. If you're watching me on YouTube, I've got my arms way out.

You can get your legs way out. And the visual that I get with this fear avoidance is we start pulling our arms in. We start pulling our legs and we start, you know, contracting our abs and just making our, the space that we take up literally smaller and smaller because we're afraid of doing something to make the pain worse.

Whatever that is, whatever your pain is. 

 things like pain catastrophizing and fear avoidance can really impact our pain because again, it gets going in our brain and that brain is what is receiving those pain signals. 

another thing that can impact our pain is psychological stress. There is a theory called the Cognitive Activation Theory of Stress that offers insights into how stress impacts our health. So according to this, it's called CATS, for short, C A T S, individuals perceptions and interpretations of perceived stressors are crucial.

So when you feel Helpless or hopeless, like with that pain catastrophizing, that fear avoidance, then those stress responses will persist. And that can lead to even more illness or disease, and that can certainly lead to the continued neurological pathways that we are now reinforcing In our brain.

Like, I'm stressed and this is only getting worse. I have experienced this first hand. I have seen it. When someone is in, you know, generally like chronic pain and then you start to get really stressed. I mean this has happened to me. I have went through a period 

where I had a lot of stress in my life, like psychological stress and my back would just flare up. It would feel even worse because all of that is going on in our brain.

this is one consistent I found in a lot of the research that basically more and more, they're finding out that a lot of chronic pain is not caused what we think it's caused by. It's not because I injured myself on a run. It's because something happened on a run and it was tweaked and then my brain For whatever reason decided, okay, we're going to stick, get stuck on this.

We're going to ruminate on this and we're going to catastrophize this. So it's caused by these neural pathways in the brain, in the brain often. So the great thing is just as this pain can be learned in our brain, we can also unlearn it.We've talked about neuroplasticity in our brain on the podcast before, I think I talked about it with Dr. Michelle Banks in one time. I think I talked about it with Dr. Richard Harris and how our thoughts really can make a huge difference one way or another in our body, in our health. And again, changing those thoughts can work for good.

Absolutely. But they can also go against us and we can start making short circuits to the bad, to the pain. So what do we do about this? Well, there's several things I found that could be helpful. I have been integrating these either more or for the first time with my own journey. And I'm going to say that as I speak, as I talk, it is better. It is not fully gone. So this is a process because I'm also changing some.

structural things in my body. I did learn that I have some hip impingement, which means I'm having to make sure that I'm not taking my hip out of location and that kind of stuff. So this is not to say that if you do this checklist, your pain will go away. This is to say this is part of the puzzle. Just like I said earlier, I really want to make that clear because I'm not saying just think your pain away, but I am saying, Pay attention to your thoughts and what are they telling your body about your pain?

So here are some solutions potential solutions that you can try and I would say give it some time

Just like it takes a while to rewire our brain one way, we've, it's going to take a while to rewire our brain the other way. So I don't have a specific amount of time for you. I'm just saying give it some time and just commit to yourself. What's a reasonable amount of time that you're going to try this?

Maybe three weeks, maybe a month, maybe six months. But, but give it time. I will remind you of that. Mindful breathing and meditation has come up. A lot with pain managementI have been on my own journey with mindful breathing and meditation for a while and this is something that I have seen and actually can help with pain management. Another thing to consider is responding to your pain with something more positive. So if I'm walking along and I'm feeling that twinge, I can say, ugh, here it is, this is just with me.

Or I can say, I know this won't last forever, or this will heal, or this is bothering me now, but it's not going to for the rest of my life. Like I kind of want to naturally do. Another thing you can think along those lines as well, I'm not feeling great right now, but I know I have felt better in the past and I will feel better again in the future.

So recognize that it hasn't always been this way and make that connection in your brain that it doesn't have to always be this way. Another thing to do is to kind of change your relationship with pain. Going back to that fear, catastrophizing, that fear avoidance, you can kind of acknowledge like, Hey, this, this is kind of scary.

Sitting is scary. If you're feeling your pain while you're sitting, walking is scary. But I know that there's nothing wrong with it. So kind of talk back to yourself that, okay, the MRI says we're good. X rays say we're good. Labs say we're good. I can do this. And you can be gentle with yourself, right?

Like, let's think about when we talk to our kids and we're talking them off the ledge because nighttime is scary and they are afraid of monsters under the bed. We're very gentle with them and we kind of start to like, okay, but we looked under the bed and I can't even think. My kids were actually, this is a terrible example because my kids were never afraid of that.

However, I know that that is an issue with some kids, but you get the point, right? Like let's be gentle. Let's have gentle talk, gentle positive talk. another reframing in our mind is these kind of go hand in hand, but one is self efficacy and another one is just the

So self efficacy is defined as just the individual's belief in their ability to perform tasks or achieve goals, and it can serve as a buffer against those heightened stress levels, which can set off our pain. This can enhance your motivation and it can kind of shape your pain experience by just fostering that confidence in your ability to withstand that suffering, to withstand that pain.

this runs parallel to the positive self talk that we were talking about just a seconds ago a second ago and you know just having that identification of resilienceThat can also play a vital role in just kind of buffering against those stressors that could impact your pain. So, you know, just kind of thinking to yourself, okay, I, I can do this.

I can get through this. this is not forever. And that will help. And it's going to help buffer or block some of those external things that make us think like, that make us go down that spiraling path. Oh my gosh, I'm going to have this forever. Like all of that catastrophizing and and fear. 

Another thing I can't help but not say is it's worth questioning what is going on underneath the surface. We had a

We had a great sermon, gosh, several months ago, and the pastor was saying, what's the thing beneath the thing? And I could give so many examples of, I mean, let's just talk about arguments within spouses. How many times have we argued about? Something and it really, it wasn't about that thing. Like I have a friend, they now have a catch term in her, in their marriage.

And it's, it's not about the deli meat because her husband was upset because she went to the store and she got the wrong deli meat and she brought the wrong deli meat home and it blew up into a, an argument. Well, really it wasn't about the deli meat. It was about that he felt like she wasn't paying attention to him and she wasn't listening when he said, Hey, can you get this at the store?

And so that was the thing beneath the thing. And I want to be very gentle in this, but I would very gently ask, is there something from your past and particularly trauma That might be causing your pain, because this is a true correlation. There's a great book called The Body Keeps the Score. It's been referenced a couple times on this podcast.

I actually referenced it in my first book, Your Worthy Body. And

The author, Dr. Bessel van der Kolk, uses scientific advances to show how trauma literally reshapes the body and the brain And how therapy, particularly cognitive behavioral therapy, can help sufferers capacities for pleasure and engagement and self control and trust.

Again, this is something that a therapist. So I'm going to talk a little bit about trauma and what it is and what it needs to be part of your team for. But trauma actually does have a, a big component to our chronic pain and that can be physical trauma. It can also be emotional trauma. He did a lot of work with Vietnam veterans.

So. You know, combat trauma. There's a lot of different types of trauma. It's don't think that well because I didn't Because I wasn't in a terrible car accident that I don't have trauma. It there's a lot of different things and particularly psychological trauma that can impact our pain. This article from Mayo Clinic also recommended several other mind body techniques that I'm just going to throw out really quickly for you to consider and maybe it's like, Oh, I can try that.

But they recommend mind body techniques like again, cognitive behavior therapy, biofeedback they call it spirituality. I'm going to call it prayer because most of us are Christ followers in this community. Yoga. Massage therapy, acupuncture, deep breathing, and music based interventions. And I think with that one they were talking about like the bowls and the all of that kind of stuff which I've never really done. So those are a couple things from Mayo Clinic. And then the other thing I would add is adjacent to this reframing our thoughts.And that is Noticing Transcript. Good things in your day and writing them down at night. Actually go through with your pen, with your pencil and write them down. The phone is good, but there is something that happens that I am not qualified enough at this point to talk with, or to talk about, but there's something that happens with our hands when we write it down.

And that may not even be associated with pain, but it's just noticing the good things that happen in our day and writing them down will help your brain start to try and notice those good things. So again, that goes back to the neuroplasticity and retraining our brain to think about the positive things rather than constantly, my back hurts, my back hurts, my back hurts. When we do these things, And I'm not saying do all of them. I'm saying consider this a menu and choose what looks interesting to you. But it gives our brain a way out of the loop of pain. And we have to intentionally do it. If I want to get a stronger back, I have to intentionally do more pulls. I have to engage my back muscle and that is going to be pulling.

There's no other way for me to get a strong back, which I want to to prevent osteoporosis. There's no other way for me to get a strong back other than pulling heavy things, whether they're bands or weights. In order for us to get our brain out of the loop, out of spiraling out of control, we've got to change our thoughts.

And absolutely, again, I want to emphasize that there may be a structural problem in your body with that pain or that is causing your pain. So I do not negate that. I'm saying these are situations where nothing has shown anything and we're all at a loss. And finally, I really want to encourage you to try some meditation, try some mindful breathing.

I will have a guest on mindful breathingcoming up later this season. I also had an episode way back in season 12 that aired in August of 2021. So it was a while ago, but it was with Dr. Michelle Bankson and it was titled Christians, Why You May Need to Rethink Your Perspective on Meditation. So I will put that in the show notes, and you can go back and listen to it.

But I think mindful breathing has so many wonderful qualities. Absolutely, we can integrate our faith into that. I'll just show you one thing with you that I'm doing right now. My mindful breathing, breathing has a tendency to ebb and flow. And also I do different things, but one of the ways that I am really centering myself right now is, you know, getting calm, setting a timer and I inhale and I breathe in and I thank God.

And as I exhale, I say, you are. And God fills in the word that comes after you are. Maybe it's you are good. Maybe it's you are a healer. Maybe it's you are with me. Maybe it's you are in charge of my day. But just, That for me has really helped me to center and to invite God into that mindful breathing, which does impact the brain that he created and that he gave me.

Several years ago in 2019, I was vacationing in the Bahamas And I contracted a horrible, horrible seafood poisoning called ciguatera. So ciguatera is actually listed on rarediseases. org. And basically, I ate toxic fish.

And it was a big fish that had been feeding on smaller fish that had been, you know, going down the food chain. And there was just a lot of toxins in the water. So much so that this one fish had gotten a lot and it was horribly toxic to me It was a six week ordeal. I actually made a YouTube video on it way back in 2019 and it has gotten I still get comments on it today because it's such a helpless feeling It was like six weeks before I felt better But when I first got it, I was trying to figure all of this out and what, you know, there's all these things that you can't eat and how I was going to like, it was like chicken, eggs, pork, nuts.

I know alcohol was on there. Like there were some more things I can't even remember, but it was like, what in the world am I going to eat? Like I didn't, I wasn't even sure. And my neighbor went to the grocery store and she picked up some oat milk for me because, I can't do dairy anyway. And then like all of the almond milks, I couldn't do that.

And the coconut milk. So she was like, I got you some, some oat milk. And she gave it to me. And she's like, you know, Amy, I was thinking about this and you were made to deal with this, You, more than anyone else I know, can figure out how to feed yourself and you can figure out how to clear these toxins out of your body because this is the type of thing that you love learning about and that you do.

She was like, you were made for this. You can do this. Now, did that change anything about my situation? No, I still couldn't eat like half of the things that I love to eat, but it sure did help my mindset. And yes, I did get better from the Sigma Terra. I will put that in the show notes if you want to see.

That was, again, five years ago but the, just the change in the mindset and having someone say, you can do this was so helpful. If you have no one in your life to tell you, you can do this. Yes, you do, because I am telling you, you can do this, you can change your brain, and you can tell yourself that. We have the power to change our resiliency, to change our thoughts, and to take control of our body.

Again, I want to be very clear, this is not a prescription for how to cure chronic pain. This is one piece that maybe would be worth you considering. Changing. And so I hope this is helpful. If you have dealt with chronic pain 

I know I quoted a lot of stuff here, I will put all of those resources that I mentioned in the show notes. if you know someone who is dealing with chronic pain, I invite you to share this with them if you feel like they would be in a good space to receive this. Not everybody is ready for this. And so let's be gentle and cautious and considerate of our friends who may be in different spaces than we are. But if you know someone who might benefit from this, I would be honored if you would pass it along. Okay, that's all for today. Go out there and have a graced day.