“Understand your pain and you will control it”
As a Physiotherapist I spend a most of my day assessing and treating people in pain. I spent the first 10 years of my career attending a plethora of professional development events, learning about all the latest and greatest techniques to help my patients get fast results.
About 4 years ago it began to become more apparent to me that those of my patients that were not responding to my big bag of tricks and were in what most know as a “chronic pain state” were generally the ones that had been indoctrinated by harmful pain metaphors by and range of health care professions they has previously seen as well as our friend Google.
Degeneration comes up a lot, probably because of its repeated use in radiological reports. How do we really know how our patient interprets this information and subsequently experiences pain? Some of my favourites are, “Slipped discs, crumbling back, my back has gone out, its bone on bone……. STOP and think about it for a minute……. These crazy “painful” words hurt just saying them! Try to imagine your patients going away and repeating them over and over in their mind when they go home. Levels of stress chemicals in the body such as adrenaline and cortisol are elevated which makes the sore area even more sensitive. No wonder so many people are in pain!
So as my interest in pain exploded into an “explain pain obsession”, I took my team to learn from the best. David Butler and co from the Noi group. These guys are all over it and make me excited to see how pain research and management will transform over the next decade. I have continued this obsession with further CPD and readings on the “biopsychosocial” model of pain management. Essentially the news is good for pain sufferers!
So my team and I at Platinum Physiotherapy certainly didn’t stop there. Yes it was great that our understanding of pain had exploded, but were we prepared to do something meaningful with it? I started talks with Dr Rodney Beckwith, director of the Reliance GP Super Clinic about an ambitious idea to start a pain clinic based on our detailed model. He was just as motivated as I and after lots of planning and development, we have now launched what we believe to be the most integrated, dynamic and evidence based Pain Management Clinic on the NSW central coast.
According to the Australian Physiotherapy Association, one in 3 people suffer from persistent pain. Ouch! While Physiotherapists (including me for the better part of my career!) spend a lot of time rehabilitating with various loading strategies, I have since adopted a key message, which has become the frame work of our Pain Clinic. “Understand your pain and you will control it.”
Pain is not a reflection of tissue damage, pain is a message sent from your brain based on perceived threat. This perception is derived from a cumulative past experiences, feelings, emotions, health, belief systems and more. Essentially neuroplasticity is what got you into a pain state and on a positive note it will get you out of it!
Understandable most chronic pain patients are desperate to ground or validate their pain.
In the clinic we aim to provide meaning to the patients symptoms. By providing meaning and explanation the “threat value” is usually decreased. In effect the central nervous system learns to take a breath and stop being so damn touchy! Now pain is complex so the process is not easy, but if you commit to it, it works.
Where do I start?
Unload your back pack. That’s a metaphorical back pack team. Unload all the harmful metaphors that have led to your central nervous system being hypersensitive.
Watch understanding pain in 5 minutes. A light bulb will go on and you are already on your way to a pain free life. Next one of the team at Platinum Physiotherapy can guide you through your journey to a pain free state.