It’s 2011, I’m 29 years old, fit, healthy and obsessed with sports. I’m strong. I’m in the prime of my life and don’t know much about physical suffering.
Then after a long day of studying together, in a flurry of excitement and joy I lift my colleague up in the air. It’s the sort of thing I do.
But, out of nowhere, something weird and terrible happens. Somewhere at the base of my spine there’s a pop and the whole back gives in. My friend and I fall to the floor with a thud. He’s unscathed, but I have such throbbing pain in my back and down my leg that I almost pass out.
I can’t put weight on the leg. The feeling in my right foot’s gone. I feel terrified.
The doctor I see soon after gives me Diazepam to alleviate both mental and the physical terror and little by little I return to everyday activities. The pain, however, stays with me. Overnight my whole life changes. The activities that I used to enjoy – like going to the gym, wrestling, and even bridging in Yoga – I can no longer do.
What follows is a long crusade of trial-and-error treatments including: NSAID painkillers, Osteopathy, Chiropractic, physio, MRIs, X-Rays, Mindfulness Meditation, radical acceptance, depression, Bowen Technique, Acupuncture, Sports Massage, Rolfing, Alexander Technique, Feldenkrais, leeches, Shamanism, daily yoga, turmeric, Somatic Experiencing, ice baths, sauna, alkaline diet, gluten free diet, bone broth, sweat lodge, steroid injections, Plasma Rich Platelets, dairy free diet, elimination diet, Reiki, energy healing, herbs, CBD and Kambo. All of them wonderful in one way or another, (apart from depression perhaps) – but none of them really work for my back pain.
Little by little my life is shrinking; the list of things I can do is diminishing rapidly. Even running becomes a no-no. Every time I want to defy the pain and go horse riding or dancing, I’m stiff and in pain for days after. My eyes become brooding, mood-darkened. Anger and frustration reigns. I’m becoming desperate.
Thankfully, something gives me enough courage to continue looking and asking. And eventually there is a revelation. The solution for me was not in another ‘technique’, but in a radical renegotiation with my relationship to pain.
Here’s what I found out.
And, as someone who works daily with chronic pain as a Rolfing practitioner, I think this 3-step approach can work for others too.
My back pain wasn’t in my back – it was in my brain
The conventional medical model was telling me that the reason I was in pain is because, as the MRI and the x-ray of the spine showed, there was a bulging disc compressing the root of the nerve at the L4-L5 discs of my spine. As time passed, however, it became clearer that this couldn’t be the full explanation for years of pain.
It can’t be because we know that disc hernias re-absorb within 12 months, and we also know that MRI images of nerve root compression are poorly corelated with chronic back pain (LINK). In a number of studies we can see that many pain-free people have so-called nerve root compression. We can also see that depression is a much better predictor of chronic back pain then nerve compression theory. So, the same science that Western medicine was using was actually refuting its own approach! This model was obviously wrong because it did not produce any pain reduction despite all the treatments I had that subscribed to it. Then I started looking at the pain science and things began to look very different.
Pain signals can come from the brain when no damage exists in tissue
Conventional, and now largely outmoded, models of pain assume that pain is a sensation produced in the tissues that travels up the spinal cord and into the brain to signal actual or potential damage in that area. However, the latest discoveries in pain science show us that this picture is only partial. Pain is actually a phenomenon produced in the brain, and the connection to tissue damage doesn’t have to be present. In fact, with chronic pain like mine there usually is no actual tissue damage – yet the pain still looms large.
Pain science has also discovered that pain is a context-dependent phenomenon which is modulated by the so-called Body-Self Neuromatrix. The perception of the environment, the emotional state, and the endocrine, immune and nervous systems are all involved in pain creation. Because of its complex nature this mechanism sometimes goes awry, and pain occurs where there actually is no damage. Phantom limb pain is probably the best example of this sort of situation – a person experiences a throbbing knee ache, yet the leg doesn’t exist.
So how does this help me to alleviate my discomfort?
Well if chronic pain is in the brain, not the body, it is important to understand that
a) it’s no less real;
b) the pain no longer serves any useful purpose;
c) the way out of experiencing pain involves convincing your brain of its own error.
Here is a 3-step process that helped me to overcome my chronic back pain, that I hope will work for you too:
Stop unhelpful beliefs that you are physically damaged, or that exercise damages you
Everything changed for me when I realised that my X-rays and MRIs didn’t show any damage that could explain the pain.
When I stopped listening to the medical establishment and learned about pain science, I had a major turning point. First of all, I stopped being afraid of damaging myself. This was a huge relief because it gave me permission to do things I loved doing once again. My mood shifted almost instantly, and with it the burden of the pain itself. In the neuromatrix model, I had shifted one of the contributing factors of pain experience – emotions.
Gradually start challenging the unhelpful patterns of pain by beginning to do things that you were avoiding because of it
As soon as I understood that the pain was in my brain and not in my back, I started orienting my movement practise in the direction of back extensions, bridges and other exercises that were previously no-go. Through a gradual increase in intensity and duration of these movements, I started convincing my brain that my back was fine, and the pain no longer served its purpose of protecting against a long-healed injury. This didn’t mean that the pain disappeared instantly. But neither did it increase when I did exercises my brain was telling me to avoid.
In this way, I gradually taught my system that the movement itself was not harmful. As this conviction set in, my pain began to reduce.
Understand that the pain is a complex phenomenon involving sensory, emotional and endocrine input and you can modulate these inputs to help yourself
When I realised the complex nature of chronic pain, and the role that all bodily systems play in it, I started experimenting with improving my overall health as a way out of pain. To stimulate the sensory pathways, I had regular massage and acupuncture. To help my emotional balance, I ramped up my meditation practise and started journaling. And to help my endocrine system, I began experimenting with cold showers and breathing techniques ala Wim Hof. Regulating sleep and diet, and keeping an everyday movement practise were also important.
For too long we have been fed an old and ultimately harmful view of pain and now it’s time (no pun intended) to take back control.
I hope these points will help you to work through your chronic issues and can be the beginning of a journey into wholeness.
More about Rolfing and back pain
My video series on exercises for a pain-free back