You Can Heal Chronic Pain

pain recovery, chronic pain, healing, karyn shanks md, functional medicine, heal pain, back pain,

Your Seven-Part Whole-Self Roadmap to Healing Chronic Pain

You can heal chronic pain—yes, you will heal. All you need is a team of smart professionals who love and support you, and a strategy that considers the many dimensions of who you are—of your body, mind, and spirit.

Pain is a mysterious, difficult, soul-sapping experience that requires urgent consideration and resolution. It is the near-universal aspect of chronic illness and all-to-frequent companion to fatigue that affects the lives of millions of people all around us–our families, communities, and many of ourselves.

Pain resolution is the ultimate body-mind collaboration. While pain is a distressing symptom, it is also a state of mind that connects to mood, energy, and thought. For successful pain resolution, our understanding of the pain experience and our implementation of a pain resolution strategy must be grounded in all of the elements of a whole-person approach.

Whether you suffer from chronic headaches, persistent muscle or joint pain, back pain, or neuropathic pain, the approaches have many fundamental similarities. The pain resolution journey starts with understanding it within the context of your entire life and health story and working with it from a comprehensive body-mind perspective.

My Pain Story (We’re In This Together!)

I was fifty and had never experienced chronic pain before. I had felt acute pain on many occasions but always managed to find a solution for it. My tolerance for pain was high. It captured my attention but was never a signal that I was in danger or that a disaster was occurring. In fact, it was often a message that I’d accomplished something. Of the many injuries over the course of my life, there was never a question about whether I would recover. I had complete faith and trust in my body.

Then it hit me. I fell while box jumping. I was with my group fitness friends and we were doing the day’s prescribed workout in our local gym. There were some burned-out overhead lights in the box-jumping area and I remember that I was uncomfortable with that, even before anything happened. The sharp edges of those boxes were already my nemesis. On this day, in the dim room, I couldn’t see them very well. But I was tough, I thought. I went for it anyway.

The tip of my toe grazed the edge of the box and I fell—hard. I scraped my shin on the way down and fell flat on my back. Lying there on the floor, I felt my shin stinging but that was all. We were in the middle of an intense timed workout—box jumping followed by facility runs. I jumped up and got back into action, sweat flying and endorphins flowing. Ouch! My shin hurt, but I kept running. I finished the workout with a big bloody gash on the front of my shin. But there was no question in my mind at all that it would heal. I’d be just fine. As always.

Over the ensuing couple of days I developed low back pain. It was quite sharp and initially it was localized in my right sacroiliac (SI) joint. There was something different about this pain than what I had experienced before. It was sharp and especially attention-grabbing in its intensity and persistence, particularly when I sat for a prolonged period of time or when I moved from one position to another. Over the next few weeks my low back gradually tightened up and would not let go. It did not respond to massage, chiropractic adjustment, heat or my other usual strategies for taking care of the occasional ache, pain or stiffness.

I worked hard with my physical therapist and gradually got better over the next six months, with just some residual loss of flexibility in my back—I noticed it when I couldn’t reach back as far in some of my back-bending yoga poses. I continued to do my PT exercises and stretching every day and I never lost the faith that I would continue to improve.

A year later I had shoulder surgery to repair my rotator cuff. Afterwards I became sick from low blood pressure and was hardly able to move for two months. During that time I sat a lot. I went from being highly active–doing yoga, Crossfit, or hiking daily–to sitting and being sick. As soon as I discovered the cause of my illness and recovered, I started to slowly mobilize again and I was smart about it. I didn’t try to dive into my previous high-intensity activities. It was the middle of winter and icy out so I used my treadmill indoors. I gently walked, slow pace, low incline. Within just a few minutes, my very first time on the treadmill, I had sharp pain in my right SI area. It was the very same pain I’d had before, after the box-jumping accident, but way worse. It had a sharpness that made me stop, brought me to my knees and to emotional distress. I was finally free from being ill, I thought, and now this.

At first I was able to talk myself into approaching it in a reasonably rational manner. Okay, I told myself, I’ve been immobile. I have to take it slow, do all the things I know to do. Roll out my muscles. Apply heat. Go slow. Continue to practice patience. Keep at it without despair.

I went back to my physical therapist for rehab but this time it didn’t help. The pain escalated in intensity and spread to my entire lower back and around my right hip. I had it when I was resting. I could barely walk since each step triggered sharp pain. I felt unstable on my feet. And I felt overwhelmed. The pain came with a tsunami of emotions that I had never experienced before. I felt like I had lost hope, lost the life I knew, lost myself. And I didn’t know what to do. I completely overwhelmed my physical therapist, who was already working hard on my shoulders since my surgery three months prior. She didn’t have time in her schedule to address all my problems. I knew that I needed a fresh set of eyes on me, and a new and more comprehensive strategy in order to recover.

So began my personal saga of seeking help and wisdom about my pain and working diligently and achingly on being optimistic. This was my new mountain to climb. I felt like I had lost everything–all of the physical activities that I loved and brought me joy. And trust and faith in my body–trust and faith that it would support me when I walked and moved and lived my everyday life.

I started working with a new rehab specialist, Conrad. He’s a chiropractor and functional movement specialist who’s smart and creative and takes a great interest in his clients and solving their problems. Our visit started out with a thorough history and exam. He started his discussion with me by saying flat out that I would recover. A bold statement that I hadn’t heard before and that I needed to hear. And it was something that had seemed impossible until he said it. Though my pain was constant and dominated my life–I had to take great care to be mindful about every step I took and every move I made–I knew now that I would recover. Conrad worked on me at least a couple of times a week for an hour at a time and gave me carefully selected exercises that I did faithfully to strengthen my core. I had lost a great deal of my strength when I was sick for two months after my surgery. Now I had to take baby steps to regain it, and I was limited by the pain I felt with every movement, but I knew I needed to move and engage my body to heal. A tricky balance to achieve: a few steps forward, several back, gradual, sometimes infinitesimal, progress, but progress all the same. Conrad helped me plan what to do and pointed out my successes even when I couldn’t see them on my own.

I persevered with my rehab, though it was hard. There were many setbacks along the way and many counseling sessions with Conrad about how pain is in the brain. We talked about how I had to keep on: work hard, hope, believe, trust my recovery, be patient, know that I wasn’t broken. I am strong. I am recovering. I am whole just as I am. These were my affirmations.

I had to take my body through the paces not only to become strong, but to remind me I was safe in movement, that my body had strength and stability and the capacity to heal. I had to practice movements that challenged my previously distorted perception of not being safe and stable, I had to learn to trust myself again. My initial pain story was that disaster had struck and I would never be the same again. I didn’t create this story consciously but it’s how my brain put together the pieces of what had happened to me–of my destabilized-pelvis, on the heels of my low-blood-pressure crisis, telling me that it was all nothing short of disaster. Through my long rehab, I learned that pain is just one part of a larger puzzle.

Fleshing out the details of my personal pain experience was a great deal of work and required a team of many people working with me. I had to pursue many treatments—some which worked (four sessions of prolotherapy—fantastic!), and many that didn’t work but provided valuable insights. And I had to spend time every day focusing on myself and my needs. But in the end, my whole true story was in large part up to me. I had to fill in the difficult details—and truths—about hope and healing. My recovery was up to me. This is the hard, plain truth. But in this message is freedom for us all: Our recovery from chronic pain is a hell of a lot of work but it is work that can be done.

My Pain Story Has a Happy Ending

After nearly three years I am healed. I no longer have back pain. It feels like a miracle and yet it is the result of a carefully laid out strategy—a strategy that I painstakingly put together to serve my complex needs, that required that I insist on finding answers, continuously step up for myself, ask questions, allow for setbacks, and keep the faith. It took work. It took a village. It continues to take daily vigilance to my personal, unique self-care strategy, which includes movement and impeccable self-care—like healthy eating, good sleep, and meditation. There are times when I falter or get sloppy with my movement or posture and I can feel it. I take note immediately to the sensations that evolve from that. Now these are gentle reminders. Not a crisis. Not a catastrophe.

Not everyone’s pain journey will require so many steps, so many participants or so much effort, and I am happy for all of you for whom this is true. But for those of you who perhaps recognize yourselves in my story, try not to feel overwhelmed. I didn’t accomplish all of this over night. It was a three-year journey and I am still discovering things. And I realize that I am also very fortunate to have already had a background in Functional Medicine, systems thinking, and body-mind principles. I knew I had to approach this from a variety of different angles and if one expert didn’t have answers for me, I moved on to the next. It is my intention, through the telling of this story, to help you think about those angles for your own journey of recovery from pain.

Your Seven-Part Whole-Self Roadmap to Healing Chronic Pain

Through my story I have challenged you to think about pain in a way that is perhaps new and different, and hopefully empowering. I would like to lead you on a journey of reflections and action steps to help you work productively with pain on the physical level as well as to harness the power of your minds to morph pain’s message into something more balanced and comfortable–and more hopeful.

Get Started

  • We must get smart about pain: knowledge is power.
  • We must be patient with this process, take baby steps when necessary, and never give up.

Build a Supportive Team

  • We must seek trusted advice from professionals. We may even need an entire team of professionals to help sort it all out. Is there injury requiring repair? Is there tissue damage that needs intervention? Is there an ongoing stress to our tissues that requires resolution? I needed a whole village of people to support me with my pain healing and I had to keep searching until I found just the right people who cared about me and who could deliver a message of hope and commitment to follow through.
  • You may need a chiropractor, massage therapist, physical therapist, sports medicine doctor, psychotherapist, or a combination of them all. Start somewhere and build as necessary.

Get to the Root Cause by Considering the Antecedents, Triggers, and Mediators of Pain

  • What predisposed you to the pain? A previous injury? Weakness? Hypermobility? Serious injury? Tissues made vulnerable by suboptimal nutrition, immobility, or inflammation? These answers are the nuances of your pain experience that will guide your approach.
  • What triggered the pain? A traumatic event or injury? A stressful situation? Illness? Infection or allergy? Poor posture? Weak muscles?
  • What may be mediating the pain? Not paying attention? Lack of self-care? Lack of sleep? Poor nutrition? Not getting needed rehab? Loss of hope about your situation?
  • Make a list of all of these attributes—these are our inroads to modulating your pain experience.

Physical Approaches to Pain

  • Deal with new and persistent pain now, before it becomes more complicated and entrenched.
  • Work with manual therapists who are smart about pain, healing, and function. Fix what you can with their help.
  • Be vigilant with self-care practices that make you feel more comfortable—these decrease our overall level of distress and engender a sense of safety and comfort that reduce the alarm signals moving through the nervous system. This could be massage, healing touch, chiropractic, physical therapy or others.
  • Work directly with the painful body part to change how it feels. The sensation of touch, massage, applying a salve, taping, bracing, vibrating, acupuncture needles or electrical stimulation can reduce pain, especially if it is new.
  • Eat well: many foods irritate our tissues and promote inflammation, exacerbating and at times triggering pain.
  • Sleep is non-negotiable here. Lack of sleep will always make pain worse.
  • Move your body. The improved energy, blood flow, and endorphins will reduce pain.
  • Work on posture and balance to enhance stability and trust in your body. Work with Chapter Eight: We Move Our Bodies With Purpose.

Heal Inflammation

  • Start a food plan that eliminates all pro-inflammatory foods and potential irritants. Work with my Liftoff Gut-Immune Restoration Intensive Nutrition (GRIN) Food Plan.
  • Use Anti-inflammatory foods and herbs like turmeric, ginger, and boswellia. Eat healthy anti-inflammatory fats, like omega-3 fats from fatty wild-caught fish, pasture-raised beef, chicken, and eggs. Include plenty of high fat plants like avocados, coconut, and olives.
  • Work with your healthcare team to diagnose and heal any persistent allergies, infections, or toxicities.

Balance Stress: Unload the Brain-Thyroid-Adrenal-Mitochondrial (BTAM) Axis

  • In other words, relieve yourself of unnecessary stressors and support your body’s inherent ability to create energy on demand. Work with the lessons in and practices in my Energy Recovery 101 series: Part One and Part Two.

Harness the Power of the Mind to Modify Pain

  • Once we have resolved ongoing or recurrent injury, or stimuli that we interpret as pain, we must take the journey within. We must mobilize our inner resources that allow us to work with our pain story and reduce our suffering. This journey could include meditation, self-reflection, visualization, and others.
  • Write out your pain story. Include all of the elements. Tell it in great detail as best as you can (as I did). Consider that this is a story. And it’s your story. What might be missing? What does the pain have to teach you? How does the pain benefit you? Is your pain story about disaster or catastrophe? Consider the impact of this thinking on your stress response and nervous system. How can you re-write your pain story? How would you like it to end? Can you imagine it?
  • Change your pain story (move from catastrophe to understanding).
  • Practice hope (hope always reduces pain).
  • Work with breath (deepen breathing, enhance oxygenation of tissues and move the energy of pain and emotions with the breath).
  • Work with emotions: fear and anxiety always make pain worse.
  • Create new meaningful experiences for the brain: relationships, projects, inspiration—anything that engages the brain and reduces the priority of the pain experience.
  • Never dramatize or exaggerate your pain or you’ll soon believe your own stories. People often do this to make others take their suffering more seriously. If you are not getting your needs met, move on, but don’t make this into something it is not.
  • Find and heed the messages in your pain: slow down, be less excessive in your efforts, open up dormant parts of your life.
  • Let pain guide you on a journey of deep personal exploration: new positive habits, deep mindfulness, balance in all things, expansion of possibilities.

Send me your chronic pain stories. I want to hear about what worked for you.

Resources:

Paul Ingraham. Pain is Weird. 4 March 2016. PainScience.com

Brodie EE, et al. Analgesia through the looking glass? A randomized controlled trial investigating the effect of viewing a ‘virtual’ limb upon phantom limb pain, sensation and movment. Eur J Pain. 2007 May; 11 (4): 428-36. PubMed#16857400

Moseley L, et al. Is mirror therapy all it is cracked up to be? Current evidence and future directions. Pain. 2008 Aug; 138 (1): 7-10. PubMed #18621484.

Fisher JP, et al. Minerva. BMJ 1995 Jan 7; 310 (70).

Sae Young Kim and Yun Young Kim. Mirror Therapy for Phantom Limb Pain. Korean J Pain 2012 Oct; 25 (4): 272-274.

Lorimer Moseley, The Mirror Cure for Phantom Limb Pain. Scientific American, April 16, 2008.

Alban Latremoliere and Clifford J. Woolf. Central Sensitization: A Generator of Pain Hypersensitivity by Central Neural Plastiity. J Pain 2009 Sep; 10 (9): 895-926.

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Karyn Shanks MD

About the Author

Karyn Shanks, MD, is a physician who lives and practices in Iowa City. Her work is inspired by the revolutionary science of Functional Medicine, body-mind wisdom, and the transformational journeys of thousands of clients over her twenty-eight year career. She believes that the bones of healing are in what we do for ourselves.

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2 comments


  1. Heal Hope

    Thank you for sharing your chronic pain journey. I am going through a similar experience right now of trying to change my neuromatrix. I am reading Moseley’s book called Explain Pain. I will also check out some of your resources.

    Reply

    • Karyn Shanks MD

      You can’t go wrong with Moseley’s teachings. He understands the brain’s role in pain and the potential we have to unravel pain. Keep hope alive!! Thanks for reading and reaching out…

      Reply

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