7 steps to take immediately to reverse chronic pain – joints, muscles, migraines and more
Karyn Shanks, MD
7 steps to take immediately to reverse chronic pain – joints, muscles, migraines and more
This fantastic article was written by Karyn Shanks, MD, a physician, founder and director of The Centre for Medicine and Healing Arts, and author of Liftoff. We encourage you to check out her website here!
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. As the near-universal aspect of chronic illness and all-to-frequent companion to fatigue, it affects the lives of millions—our families, communities, and many of our selves.
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 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. 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.
Experiencing a Serious Injury
Then I fell box-jumping—part of the day’s prescribed workout at my local gym. The tip of my toe grazed the edge of the box and I fell—hard. Over the ensuing few days I developed low back pain that escalated quickly. It was different than pain I had experienced before—sharp and especially attention grabbing in its intensity and persistence. And it did not respond to my usual strategies for soothing sore muscles.
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
A year later, after having shoulder surgery, 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 to sitting and being sick. As soon as I discovered the cause of my illness and recovered, I started to slowly mobilize again, and in spite of being careful and smart about it, the pain recurred, worse than ever, bringing me to my knees and to emotional distress. I was finally free from being ill, I thought, and now this.
Physical therapy didn’t help me this time. My pain escalated in intensity and spread to my entire lower back and around my hips. I had it while 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.
Chronic Pain Management: Finding Treatment That Worked
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, trust and faith in my body—that it would support me when I walked and moved and lived my everyday life.
I started working with a new rehab specialist, Conrad, for my chronic pain management. 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. He examined me thoroughly, then started his discussion with me by saying flat out: 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. Pain dominated my life and while I had to take great care to be mindful about every step I took and every move I made, I now knew I would recover.
Conrad worked on me weekly for an hour at a time and gave me carefully selected exercises to strengthen me—which I did faithfully. I had lost a great deal of my strength when I was sick for two months after my surgery. I had to take baby steps to regain it, and 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. As much as he helped with my chronic pain management, he helped with mental management, too. He helped me understand that pain is in our brains and nervous systems, an elegant survival mechanism, but can persist long past resolution of the injury or perceived danger.
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. I kept on: hard work, hope, patience, and trust my recovery: I am strong. I am recovering. I am whole just as I am.
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 taking care of myself. The bones of my recovery were 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 chronic pain management 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.
Your Seven-Part Whole-Self Roadmap to Healing Chronic Pain
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. There is always a solution—always.
Build a Supportive Team
We must seek advice from trusted professionals, perhaps creating a team to help us 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? This journey takes a village.
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. Consider the Nine Domains of Healing to help guide your self-review.
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.
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 healthy 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 may include meditation, self-reflection, or visualization.
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.
Share your pain stories with me—others will benefit from your solutions and inspirations.
Paul Ingraham. Pain is Weird. 4 March 2016. PainScience.com
Brodie EE, et al. Analgesia through the looking-glass? A randomized controlled trial was investigating the effect of viewing a ‘virtual’ limb upon phantom limb pain, sensation, and movement. 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 Plasticity. J Pain 2009 Sep; 10 (9): 895-926.
Visit her writing and her medical practice at karynshanksmd.com.Contact her at email@example.com or on Facebook.
Subscribe to her weekly articles here.