Pain is a symptom. Symptoms are the feedback that the body generates when it faces problems with its delicate internal balance (homeostasis). Without symptoms like pain, thirst, nausea and fevers, it would be very difficult for us to maintain a healthy body in the same way that it would be hard to drive a car safely with no dashboard display.
Be Sick Of Your Pain
People who have suffered a manageable amount of pain seek relief, while those who have suffered an unmanageable amount of pain seek resolution. Resolution of pain means wishing for it to go away and never come back. Both relief and resolution are possible for most pains. But in order to take a realistic shot at pain resolution, most people need first to make a mind resolution. A resolution to do whatever it takes to reclaim their life, relationships and health from the grip of chronic pain and underlying causes.
The happy news about chronic pain is that it’s virtually always treatable with tools and methods that already exist. The ‘cures’ for chronic pain are not out in the future of pain science; they are right here in your lifetime.
After 25 years of managing pain, when I receive emails from people who claim to have ‘tried everything’ for their chronic pain, I feel genuinely excited for them. Because I know that if they have truly had enough, they are almost guaranteed to get better – given some time and effort.
As I have slowly realised just how manageable most chronic pain really is, I increasingly found myself feeling a bit sad and angry. And I still do sometimes feel like that about it. Not angry at anyone in particular. Just angry that there are millions of people suffering so unnecessarily. There is something extra frustrating about the thought of suffering that is unnecessary and easily avoided.
But so many people struggle to resolve their chronic pain. You could be forgiven for assuming it is nearly impossible to treat. Yet, armed with the right tools and methods, the vast majority of chronic pains are very treatable. But there are challenges to overcome. The contextual challenge is that quality pain management is not always easy to access. The personal challenge, on the other hand, is mostly just mindset. Then, once the healthcare and the mindset are right, healing the body is often found to be the least challenging piece.
There is a surprising truth about pain sufferers that many find a little hard to swallow. It’s easier to predict the likelihood of recovery by looking into their eyes than by looking at their scans. Because wanting to be pain-free is a lot like wanting to lose weight or get fit. One of life’s challenging but achievable physical goals. Yet, only once we are fully committed to change.
When I was 8 years old, my father took me birthday shopping for my grandmother. It was her 65th, and he was a doting son. So he wanted us to get her something special, and he wanted me to choose the gift. So we went shopping in London.
We went to Liberty’s in Knightsbridge, and I remember being amazed by all the colourful fabrics. We looked at all sorts of bags, clothes and accessories. My grandmother loved scarves. Liberty’s is definitely the place to buy a good scarf. But in the end, I chose a hip flask, the kind you put whisky in. It was wrapped in luxurious floral fabric and had leather details. My logic was that it looked just as lovely as all the other things but was way more practical. Because I knew my nanna liked whisky.
I didn’t learn this until years later, but that hip flask would cure my grandmother of her alcoholism in a flash.
On the morning of her birthday, my nanna opened her special gift over breakfast. But it didn’t generate the intended feelings of appreciation and love; in fact not even close. Years later, she would tell me how she felt when she realised what it was. She felt like her own shame and self-hatred could swallow her up. These feelings were so intense that they changed the course of her life.
Unbeknownst to me, my nanna had been drinking very heavily for 40 years. Since the trauma of her first husband (my grandfather) vanishing without a trace. He had said he was going to buy some cigarettes one evening and simply never reappeared. This had left her suddenly alone with three children, no support, and almost no money. The shock and grief of this had driven her into the depths of addiction. All of which needed to be reconciled with her uninterrupted efforts to be the perfect mum.
She’d been a high-functioning, heavy drinking and deeply ashamed closet alcoholic for four decades. Still, she held herself together through sheer East London grit, mostly for the sake of her children, who she adored. She managed to hide the extent of the issue but not the fact that she drank. Hence, her grandson knew she liked to drink whisky.
My 8- year old self didn’t even know what an alcoholic was. I just knew that my nanna liked to drink whisky sometimes. But for my nanna, who’d been hiding a severe addiction for 40 years, that hip flask held deep symbolism.
She concluded from the nature of the gift that I saw her as an alcoholic. And was so overwhelmed by the wave of feeling this generated that she gave up alcohol immediately; after 40 years of extremely heavy drinking. She just couldn’t bear the pain of it.
That hip flask was something like a bolt of lightning through my grandmother’s nervous system. One that jolted her out of years of severe addiction. It was also the catalyst for her quitting smoking 12 months after she stopped drinking. That was a big deal, too, as she had smoked 20 per day since she started working as a typist in her late teens.
It’s doubtful that the hip flask increased the pain my nanna had inside of her. It’s more likely that it just ‘cracked open’ the pain that was already there. I honestly believe she hadn’t fully felt the depth of her own suffering until she opened that gift. Having ‘pushed it all down inside‘ for decades – and numbed it with alcohol, of course.
She had suppressed her suffering so successfully that it had been somewhat tolerable. But once she felt the full depth of her suffering, she was instantly done with it. Chronic pain is often very much like this. When we are done, we are done. But generally, that takes some kind of rock bottom to be hit.
In order to cope with pain of all kinds, many of us learn to ‘push it into the background‘ or ‘disassociate’ from it. This makes it a lot easier to live with. But it can also create layers of apathy about resolving it.
We all have a unique fingerprint when it comes to how much pain we will accept, both emotionally and physically. With chronic conditions like pain, addiction, depression, and obesity, there tend to be long periods where we suffer; but are not fully resolved to get better. Yet thankfully, most of us have a threshold where we shift into ‘no matter what it takes’ mode.
People who truly heal from chronic pain all have one thing in common. They are like my grandmother after she received the hip flask. A day, month or year came when, for whatever reason, they were willing to do whatever it took to get better.
The mystery is in how widely we differ in our willingness to endure chronic pain. Some people only need one week of bad back pain to decide they will do whatever it takes to make sure it never happens again. Others experience a great deal of apathy about their pain, even after years of terrible suffering. It is quite a mystery. But core beliefs most probably play a big part.
Admittedly, however, many pain sufferers are forced to maintain a state of determination for years at a time before they find solutions. Nonetheless, it is that determination that all the real success stories have in common. Every part of them wanted to get better. ‘No matter what it took’.
Conversely, those who are fed up but haven’t quite reached the ‘I am definitely done with this’ or ‘by any means necessary’ stage don’t heal anything as reliably. These people tend to have doubts, fears and other priorities that are simply ‘making more internal noise’ than their desire to get better.
Most of us know that outcomes in education, sport, weight loss, fitness and even dental health are significantly determined by mindset. Yet we seldom think of pain rehab in quite the same way. Maybe because we are taught to believe chronic pain is essentially a non-communicable disease that doctors either treat or fail to treat.
A note of caution to those who go to the other extreme.
The role that hard work and mindset play in the rehabilitation of chronic pain can be misinterpreted. It doesn’t imply you need to meditate for 2 hours a day, live on kale and do 25 hours of yoga per week. For a percentage of pain sufferers, the ‘extreme self-care’ pathway can be a trap all of its own. One that often goes with a tendency to try and ‘fix it’ without professional help, which is seldom advisable. Extreme ownership is excellent, but best under guidance from a professional who has experience with many similar cases.
The ‘hard work’ of pain rehab is made up of highly specific activities. Like seeing the right practitioners regularly. Being willing to fail a few times at finding the right practitioner. Sticking with the right practitioner even if there are a few challenges. Making lifestyle changes. The long-term persistence with highly specific exercises and self-care. None of which is particularly extreme or time-consuming. It just requires sustained effort, sustained trust, and some targeted methods.
So, wonderful news! Chronic pain is seldom outside your control. Getting pain-free is like getting fit, so once you’ve truly ‘had enough’, your pain tends to become very treatable. You just need to check in with yourself and make sure that every part of you is determined to get better, with no room for ‘buts’.
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John is one of those rare gentlemen who has continued to play competitive soccer well into his late 50s. He is in really good shape, which you need to be to play football at that age—good shape except for his left leg. His left leg is not in good condition at all. In fact, once you get to know his left leg a bit better, it becomes apparent that it’s miraculous that he’s able to run at all, Let alone the type of running required to play competitive soccer against younger men.