25 Aug Chronic Pain – When Nothing Works
It is widely acknowledged that current treatments for chronic pain work no better than placebo. So it is no wonder that some 3 million Australians are currently living with persistent pain which nothing seems to help.
Amongst those 3 million, it is no wonder that the 96,000 Australians who struggle with chronic lower back pain due to work injury, are not getting relief, and are costing employers and insurers an absolute bomb.
This appalling failure of current treatment methods represents some $56 billion per annum in wasted doctor appointments, psychology sessions, medication, physical treatment plans, hospitalisation and surgeries. It is wasted because there is no evidence that these things are making any difference, and in fact there is the strongest possible evidence that they make no difference to the outcome for the pain patient, even when it comes to surgery!
Journal of Pain – 2017: Sham (fake) surgery for back and knee pain just as effective as real surgery.
But all those billions of dollars poured down the drain is nothing compared to the human suffering it represents. When a loved one suffers, everyone suffers. And when a pain sufferer is unable to fulfill their role at work, at home, in their family and in their community, the overall impact of their suffering is immeasurable.
So why are current treatment methods for chronic pain failing? They are failing because without exception they misunderstand the true nature of chronic pain, and try to treat it as if it were the same as acute pain, even despite modern research telling us that chronic pain is neurologically completely different to acute pain.
In the case of CBT and mindfulness, these fail because in effect they both blame the patient for their pain, rather than going to the actual neurological cause of the pain. (And by the way there is no evidence at all that either of these are any better than worthless placebo.)
We now know beyond doubt that chronic pain is not due to the original injury, and that the pain is not being generated from that site, even though it certainly feels like it is! And the patient is not to blame for having “negative thoughts”!
Chronic pain is generated as conditioned activity in the brain itself, triggered by activity in a region called the amygdala region. The amygdala region is the exact same region which helps you to produce feelings like fear or anger, and almost everyone is familiar with the fact that these feelings can be accompanied by very strong physical sensations.
The amygdala region likewise triggers very strong pain sensations, as conditioned responses.
So when someone tries to tell you that your pain is in your head, it actually is, but not the way they think.
That pain is absolutely real, and your “head” is producing it. Your brain can produce not only pain responses, but temperature responses (heat or cold, actually altering you skin colour) and inflammation responses, creating actual swelling.
So how to stop your brain from doing this to you?
Modern research comes to the rescue again. If we want to eliminate this conditioned behaviour of your brain then we need to look to exciting research being done in relation to “disruption of reconsolidation of conditioned responses”.
Sounds complex, and it actually is, but there’s a simple way to explain it.
Put very simplistically, we switch off the pain signalling by getting you to focus very intensely and very precisely on the pain sensations, while simultaneously getting you to focus on quite different feelings, combined with sensory stimulation to add to the “disruption” effect. This is not at all a distraction technique – if we distract you from the pain sensations it will not work.
Over the last 20 years we’ve perfected our ability to investigate and identify an individual’s unique triggers to pain signalling, and also our ability to identify the type of “disruptive” thoughts/feelings which will effectively eliminate the pain signalling and eliminate the pain.
What happens in a treatment session?
We might or might not actually start pain treatment in the very first session, because we first have to understand the context in which your chronic pain has arisen, how it impacts on your life, and begin to understand some of your unique pain patterns.
Chronic pain does not exist in isolation from the rest of your life.
However we always try to include some pain treatment if we can, for two reasons. Firstly our primary aim is obviously to give you relief as quickly as possible, even if only temporary. Secondly, we want to give you the experience of being able to switch the pain off, even if for the time being it is only with our help, so that you get absolute proof and perhaps for the first time in a long time, begin to have hope.
Most people (around 60%) will experience significant reduction or elimination of their chronic pain in their first session. Others will need to return for more sessions before they experience this.
Is that all there is to it?
No. This method is not a magic wand that will instantly and permanently eliminate your chronic pain.
Over time we continue to teach you to identify your pain triggers and self treat them with skill. Most people find that they continue to get some pain, and continue to get flaring. However the flaring becomes less intense and less frequent and the pain levels, although continuing up and down, show a downward trend until there is no or little pain, no or little medication required, and they can get back to their lives at work, in their families, and in their communities.
How long does it take to be pain free?
For most people this will happen very quickly, in days or a few weeks, provided they do their “homework” which takes just a few minutes a day. Others will need to be more persistent, and continue to work on their pain, for a few minutes each day, for some months. There are a few people who do not get relief and generally this is because the pain is found not to be chronic, or they are consistently retraumatising themselves through unhelpful and even dangerous procedures such as chiropractic.
Does this method have other applications?
Most definitely. This method is highly effective in working with any issue which has as a component conditioned brain activity. This includes but is not limited to, depression, anxiety, trauma, addiction, anger, and relationship issues, all of which are very common when people have been suffering from pain for a long time!
Finally there is a very rapid treatment that gets people the results they want.