I have practised medicine for over 30 years, 18 of which I have spent as an Integrative Consultant Psychiatrist. Following a personal experience, mind-body medicine is now a special interest, particularly the chronic pain aspect, and especially chronic back pain.
A life changing experience shifted my traditional approach to an integrative one that focuses on mind-body optimisation. I developed chronic, severe, intractable, unyielding back pain...and there was no obvious injury!
My MRI scan revealed all sorts in my lumbar spine - not a pretty picture! I was diagnosed with degenerative disc disease, a degree of spinal stenosis, a herniated disc, nerve root impingement, and referred pain.
I was 42 years old at the time. I went from being a fit and healthy man who went to the gym six times per week, to someone who was incapacitated with chronic disabling pain.
Despite being on a cocktail of prescriptive medication, including sedative hypnotics and strong opioid painkillers, I was only managing, at best, to sleep for two hours at night.
I tried everything, including rest, switching to aerobic exercises, physiotherapy (postural retraining, stretching and flexibility and core strengthening exercises), lifestyle and diet modifications, acupuncture, reiki, yoga, Pilates, and McTimoney chiropractic - you get the picture?
And guess what? Nothing helped in the slightest, and my pain got worse!
I saw the top three specialists in the country, and major spinal surgery was recommended. By that stage, I had already had three failed epidurals and so I refused surgery.
I was crippled by, what I now know was, chronic neuroplastic pain. I felt trapped, alone and desperate. Pain became my constant companion, and every aspect of my life was negatively affected.
It took a long time (several years in fact) before I was pill free, pain free, and back to exercising six days per week.
I eventually stumbled on the work of Dr John Sarno. The medical community was generally quite sceptical about his work. My wife, who found his book in the library, wasn't even sure if I would consider reading it.
But I did. And I also read his other books, and many since. I did not want to become part of the then chronic pain community, and so I had to figure it out, which I did.
I am now 57, and mentally, emotionally, and physically stronger than I have ever been.
From my experience, many doctors who have not experienced neuroplastic pain themselves, don't always understand it, especially when no definitive underlying cause has been identified. Additionally, the mind-body connection is rarely even considered. They often assume that the pain is in your head and ironically, they are correct!
All pain is constructed in the brain!
Chronic pain is invariably neuroplastic pain, a symptom of Mind-Body Syndrome. The brain, through established physiologic pathways, creates pain or other medically unexplained symptoms as a distraction. By focusing our attention on physical symptoms, we keep painful thoughts and emotions repressed.
While much of the pain we experience has a psychological basis, it goes without saying that specific pathological causes of lower back pain must always be excluded.
This includes the following:
- Vertebral fractures, including symptomatic minimal trauma vertebral fractures due to osteoporosis
- Axial spondylarthritis, a chronic inflammatory disease that mainly affects the axial skeleton in young people with a peak onset of 20- 40 years
- Malignancy (back pain is a common symptom in people with metastatic cancer)
- Any infection, such as spinal infections, vertebral osteomyelitis, epidural abscess and rarely facet joint infections
When all of these are effectively excluded, most of the chronic and recurrent pain and discomfort we all experience is either psychologically induced, psychologically aggravated, or if a physical incident did occur, psychologically perpetuated.
Chronic pain is any condition in which pain persists beyond the usual process of healing time and recovery of your injury or illness. This typically three to six months. 80% of spinal disc injuries heal in six months.
Unfortunately, in the process of generating a differential diagnosis of chronic back pain, it is possible that one can be given an incorrect organic cause diagnosis.
This occurs all too frequently, as a physical cause is mistakenly offered especially on the back of MRI back scans that look as bad as mine did 16 years ago (it probably looks a lot worse now!). This invariably results in a treatment plan that is often unsuccessful.
The result of your MRI scan may not have any correlation to your back pain and dysfunction. But do not let anybody tell you that your pain is not real.
Neuroplastic pain is real...very real.
If your pain persists or worsens once you have had all treatable organic causes excluded, it is worth considering whether your chronic pain is actually neuroplastic pain.
Which is where we can help.
Contact us today and let's talk about how The Pain Recovery Program can help you