Chronic Pain: A New Perspective | Georgie Oldfield | TEDxUniversityofManchester

In May 1988 I got married and settled into this night life in a new home and very much enjoyed my career as a physical therapist and yet, just two weeks after our honeymoon, I woke up one morning and saw a man at the end of my bed. I remember I automatically extended my hand and when I realized that my husband was still there, I got out of bed yelling strangely at the man as he began to quickly walk out the bedroom door, my husband left this bed towards me and once that he was able to exercise. What I was trying to tell him, he ran down the stairs after the thief and hit the road completely naked, unfortunately when he got there all he could see was my car driving away on its own with what we later realized was a all. carrying my belongings, I'm sure you can imagine the sheer terror I experienced that day, but life goes on and after having a burglar alarm installed that same day we settled in and settled into married life in our new home, four months after. there and it was the first time my husband left me alone for a night and even though I was nervous I decided to go to bed but I'll wait until I hear the van stop outside and then I went to sleep because what did I do but I fell asleep and the next thing I knew was that the bedroom door opened.

This triggered a massive stress response within me and the terror of the robbery arose instantly, but of course, when I realized it. It was just my husband, I was able to calm down, roll over and go back to sleep, what I didn't know at the time was that repressed emotions can manifest as very real physical symptoms and although I wasn't aware of this at the time. The time I certainly experienced it in a very personal way, the next morning when I woke up in absolute agony, the

pain

in my neck was so bad due to the severe spasm in my neck muscles that the only way I could get up from the bed I was literally lifting the weight of my head in my hands now I remember trying to figure out how the hell I could have hurt my neck in my sleep without even realizing it and the only way I could explain it at the time was to think well maybe.

I caused whiplash by suddenly turning my head when my husband walked into the room, although I know we can't cause injury by deliberately turning our head, no matter how hard, but there was no other medical explanation for this at the time. time looking back, although I had actually gone to sleep shortly after an intense acute stress response without discharging any of the emotions that had actually been triggered now, an animal when being threatened will actually discharge its emotions by fleeing from the predator or fighting the predator or sometimes through body trembling while being physically shaken, what did I do?

I rolled over and went back to sleep. My interest in

pain

as a physical therapist began many years into my career, but the more experience I gained, the more baffled I became. for a number of things, for example, I wondered why so many people had

chronic

pain and yet they hadn't had a real injury and, if they had, it was something completely harmless, like leaning over and picking up a pen or shaking hands. lap. In bed, many of my patients had already had numerous tests done, medical tests that ruled out any physical cause, and I examined them and couldn't find a physical cause for their pain, and even when the pain could be or had been attributed . to something, say a curvature of the spine or a bulging disc, then I wondered why they improved with my very gentle treatments when this physical abnormality was still there and even when there was a particular physical incident that had triggered the pain.

I asked myself why. because this was often something they did without any problem, so as a personal example of this, I used to take my car out of the garage every morning before going to work and yet every once in a while when I lifted the garage door up to my neck. would go and had been paying for a week or two or more. Actually, I don't think I've ever asked myself why I was in pain that day and not the day before or any of the days in the weeks before. I think I was actually too busy blaming the weight of the belt on the garage door or, to be more honest, blaming my husband for not putting a strong enough spring on the door, finally, through frustration, determination and a large dose of tenacity while trying to find an answer to In all of these topics I came across the work of dr.

John Salley now dr. Sano was a professor of rehabilitation medicine in New York and, like me, had become disillusioned with the poor outcomes of people with

chronic

pain; As he realized through his education, his experience had cornered him into a very narrow view of his patients' ailments and they did not take into account any of his own observations, it seems that we are often bound by things we do not know instead. of things we do know, so what was it, but this American doctor found it to be so innovative in the past? In the 1970s he identified that 88 percent of his patients with chronic pain had at least one stress-induced condition (for example, attention headache, heartburn, or irritable bowel), he also realized that , although many of his patients had spinal degeneration on MRI scans, very often the symptoms his patients presented with did not actually match the scan findings, but this is very small and very important, but ever MRIs had been performed on people who had no pain, actually no, no, not until the mid-1990s and Since then, there have been a growing number of studies showing that spinal degeneration is common in people who They don't have any pain, so I'm sorry to say this, but in reality from the age of 20 our bodies begin to degenerate physically.

By the time you are 50, 80 percent of you will have disc degeneration and 60% will have bulging discs. There is really nothing to worry about because these are just physical changes that occur with age, like gray hair or wrinkles. in 2011. The UK osteopath actually reviewed a number of studies and looked at the studies that would focus on back pain and his results were really interesting because he couldn't actually find any link between pain and spinal degeneration after poor posture or biomechanical factors, for example, poor posture. core stability, but it's also not just about that pain because there were actually a number of studies that used MRI scans on teams of elite athletes who were pain-free and the findings were that 44-40 percent of core players baseball players had torn or torn tendons in their dominant arms in basketball players almost 50% of them had torn cartilage in their knees and expected that 70 70 percent of ice hockey players actually had pathological changes or more of a wear and tear on their hips and groin now.

I can probably imagine that ice hockey players or any elite players like this will put more demands on their joints and therefore will probably be more likely to suffer wear and tear than the general population, but Remember these athletes didn't have any pain, so they might be thinking: I'm saying all pain is in the head, not at all, unless you're referring to the brain because of course the brain is in the head, but All pain is processed by the brain and our perception of pain is affected by a number of things, for example what is happening.

Right now, our previous experiences, our fears, beliefs, and even our expectations, we know through pain science that pain is actually due to neural pathways that are learned and sensitized. We also know that pain is not related to tissue damage. This could be explained, for example, if I have ever broken a bone. I certainly have broken that leg. It can be extremely painful, but the interesting thing is that once the bone is protected with the cast, the pain goes away very quickly and long before the bone heals, and also if someone has had a limb amputated, they can sometimes suffer from something called phantom limb, so this is the perception of pain in the limb that in reality no longer have catastrophic injuries such as severe tissue trauma in a war zone, initially it is not painful and this is because The main function of the brain It is to preserve life and only when the individual is safe will the pain pathways be activated.

This allows us to focus on the preservation of life and then move towards protecting the injured area from further damage, so in effect, chronic pain is part of our protective or stress response in response to a threat, now the threat It can be very real, as in the case of an angry dog ​​attacking us, or it can be perceived as in my response when I heard my husband enter the bedroom door even though he was not there. a threat to me, so I hope you can now see that sometimes unresolved emotional pain can manifest into physical pain, but one of the things that really helped another and that really baffled me at the time was that often, for For example, many of my patients would actually have pain that if they had not had severe tissue trauma and had recovered, and people with less trauma or no injury at all, the pain would persist and I wonder if the pain is related to the tissue trauma Why does pain persist when the tissues have healed and there are a number of factors related to that, but none of them include the extent of the tissue damage;

In fact, they include, for example, whether the individual was feeling anxious or depressed at the time of the injury, whether he had lost hope. for the future or whether they had had negative beliefs about the pain being permanent and also whether they had had previous trauma and the latter is interesting because it would suggest that it is not very common for someone presenting for treatment with chronic pain to be asked if they have experienced previous trauma and yet evidence showing, for example, that the strong link between adverse childhood experiences and poor health, including chronic pain in old age, has existed for about 20 years, unfortunately not It is very well known;

It is only now becoming more evident. well known and yet the link is irrefutable. I'm not saying that every reader who has had onion pain has had to deal with prior trauma, obviously, but what I am saying is that we as healthcare professionals need to consider this in order to provide the best care possible. appropriate treatment and also give them the best chance of recovery now we also know through the studies that emerged due to the stressful experiences of today's lifestyle. Now the factors at play here include our personalities, our beliefs, and the behaviors we learned growing up.

Dr. Sonner realized this because he recognized that most of his chronic pain patients had certain personality traits and these included being a people pleaser having a need to be good and perfect being overly self-conscious and these are actually really important because all of these many This actually means that we can create a lot of self-induced stress through these traits and our perception of stress has more to do with how we deal with what is happening than what is actually happening, so emotional pain unresolved can manifest in physical pain, but these are just a sign that there is something unresolved that unfortunately we have not dealt with, without this awareness, these sufferers are very often overlooked and it is as if someone called the door and no one came, you are not stronger, so the pain could start with a twinge or a simian will develop and become stronger and canned and present as pain if the underlying signal is missed, so the system that warned us that we must defend ourselves from a saber-toothed tiger seems to be more to warn us of emotional conflicts while trying to protect us from what it perceives as very dangerous emotions so that the body will be as phenomenal as ever.

It's just that the human race has been too busy trying to change things on the outside but is ignored and distracted from the signs and emotions that are within. Consequently, recovery from chronic pain can occur once the more serious cause has been ruled out, it can be achieved through education and self-empowerment. Simple strategies like learning to be emotionally aware, learning to safely express how we feel, can all help. our recovery, whether due to past or current stressful situations, learning self-compassion, how to calm ourselves and regulate our emotions, all can help as we become more resilient, there is finally hope andoptimism, first and foremost, as we face the inevitable stress in our lives and I urge you to listen to your bodies instead of simply having to deal with the pain that will manifest and persist if the signs are ignored, so next time you feel a unexplained twinge in the wrist or back or have a migraine. or the small intestine, instead of talking about your pain, pause and with all the self-compassion and maternal compassion, you can gather yourself to tell yourself how I feel and on a very simple level, I will suggest that, in instead of looking for a pain reliever that you actually choose. grab a pen and paper, everyone grab your laptop and talk freely about how you feel for 10 to 20 minutes.

There is a significant amount of evidence showing the health benefits of journaling and you never know, this could be the tonic you and your body need in the face of the saber-toothed tiger of the 21st century.