be your own pain doctor: to heal your body

What Chronic Pain is,

How injuries start,

How to rehab an acute injury,

Where to start with chronic pain that "should have healed by now"

Click the sections above to skip through to where you need help -or read the whole thought process!

it is important to remember That

chronic pain is rarely caused from one single event.

That is really important to remember as we discuss this topic because it would be so much simpler and easier to move out of it, if it was caused from one single event.

Normally chronic pain starts with an acute injury.

Examples of how the acute injury could be caused:

1. You fell down

2. You awkwardly lifted something heavy and maybe twisted at the same time

3. While playing football, another person fell into you in the tackle

The point is something specific happened that you can pinpoint as the cause - this is an acute injury.

All these examples are situations where a physical tissue was overloaded and overstretched.

"It would be great if we lived in a world where after experiencing an injury, we had access to the perfect resources and the compassion needed to mend during the time of healing."

Fast forward to reality, where we have responsibilities such as: jobs, kids, houses, mortgages and caring for loved-ones.

Face it. Life does not say:

"Hey, no worries. I will ease off for a bit. By all means, put your feet up."

This is critical.

Persistent chronic pain is often a reflection of the stress load and how little resilience was in your cup when the injury happened and how little time, support and resources were available to you while needing to heal.

So if I had just lost a loved-one, survived a pandemic, been stressed financially, was living paycheck-to-paycheck, facing redundancy at work and then unexpectedly broke my ankle...

...well my stress hormones and the state of my emotions would be tending towards a negative frame (for most people who are not Zen monks).

That is really reasonable, right? Why would this be relevant?

The Fact is that pain is deeply complex.

Our thoughts, feelings, experiences and beliefs affect our experience of pain, which feedback into our nervous system and body wide response.

We have sensory nerves in our tissues linked to:

1. Pressure

2. Movement

3. Temperature

4. Stress

5. Immune function and inflammation

6. Blood flow

When we are in pain for a long period of time:

Even a gentle prod/brush hurts more due to these nerves becoming more sensitive.

1. Think about bumping your toe on the same foot where you have a broken ankle currently healing in the cast.

2. In serious cases of sensitisation, a feather brushing the skin can hurt like hell.

3. This sensation experience has been measured, recorded and is REAL.

People report more arthritic pain when they are cold.

If you hurt yourself while bending over, your body remembers and becomes more sensitive to the act of bending.

Higher levels of stress hormones in your blood makes their corresponding receptors more sensitive to stress hormones released over time. It is a vicious cycle.

Immune function and inflammation can recreate back pain, or any other issues we have had in the past. When we are ill, it is a type of nervous system wide memory.

Blood flow, or the lack of it, can cause pain.

This offers the blueprint to any good healing strategy.

Gentle therapeutic touch works to desensitise pressure sensing nerves.

• This is a key part of my approach to manual therapies.

Heat is a wonderful tool to use with muscles that are chronically contracted.

Mindful movement strategies that reduce alarm signals from when you hurt yourself.

Being aware of your stress levels in everyday life and finding ways to reduce them

Eating meals from whole ingredient foods while also reducing intake of caffeine and alcohol

Making sure throughout the day you get up from your desk and move a little.

So if you are going to go it alone, without a professional helping you out of this mind field, what would be the best advice I can give you?

Start with the basics. Have the tissues physically healed yet?

This helps us contextualise what's happening reducing fear responses

This is such an important step to ask yourself about the healing process.

In a lot of cases it will significantly reduce your anxiety and fear.

Fear that you might not even be aware is there. It is there subconsciously.

When people experience a lot of pain frequently, or if it feels different to normal, a usual response is to ask:

• "Is something really wrong with me?"

• "What does this mean?"

• "Am I in real trouble?"

• "This much pain must mean something is really wrong?"

• "I don't know if I can live with this?"

• "This is too much?"

• "How am I going to function?"

These are the '2 AM thoughts'.

The undermining insidious thoughts that actually make your tolerance to the feeling lower.

This heightens our pain experience in the process.

So have your tissues already healed?

Ask when did all this start?

Weirdly your answers hold clues.

You need to distinguish what kind of injury occurred at the beginning.

Check out the resources in our other blogs for more information.

If you are struggling, paying for just one session with a qualified therapist you trust will:

• Help relieve your concerns.

• Help you get clarity on what is happening and to safeguard you incase you need to see your GP for something serious.

• Help you create a streamlined actionable plan that is highly achievable.

• Help relieve physical tensions in the tissues and jump start your healing through hands on treatment.

If your injury is still within the average healing time for that issue - good news. You have the power to prevent chronic pain occurring in your body!

Below are a list of common injuries and their healing times, again more information can be found in our blogs and chronic pain treatment journey sections.

Common healing times for musculoskeletal injuries:

• Grade 1-2 muscle tears (strain) generally heal within 2-8 weeks.

• Grade 3 muscle tears (strain) heal on average between 3-6 months.

• Reactive tendinopathies respond to changes in load within 6-10 weeks.

• Degenerative tendinopathies usually respond within 3-6 months of intervention.

• Ankle ligament tears usually respond within 2-12 weeks depending on severity.

• An MCL (middle side of the knee ligament) tear usually responds within 6-8 weeks.

• An ACL tear (cruciate ligament inside the knee between thigh bone and lower leg) requires surgery and has an average healing time of 6-12 months.

Remember that these are averages across a population. They do not take account of age, access to resources, avenues of support and social or economic factors.

So please do not do what I did and think that:

"The normal healing time has finished. I should be good now - right?!"

This led me down some really dark alleys that are not kind, not helpful and not good for healing outcomes.

I would advise against it. Instead I kindly remind you that we are all individuals and there are some massive factors that can skew these times, shorter or longer.

You are not your pain.

You are a human being that deserves kindness and compassion and not just from me or anyone else. You deserves this most importantly from yourself.

working out what the initial starting point to your pain was is a very good place to start.

The next step is to choose an appropriate rehab program to meet the needs of your injury.

I have given some examples below:

Herniated Disc strategy (click to expand)

You picked something up awkwardly and your back now hurts.

You have shooting pins and needle like pain down one leg and the load was extremely high.

You had extremely sharp pain in your back when it happened.

You lay on your back & lift that same leg straight up and recreate the same shooting pain down the leg

You have likely herniated a disc.

If our person rehabbed the area thoughtfully, listened to their body and gently mobilised the area and strengthened it, in a balanced way, without going too hard or too quickly challenging their body...

...then the odds are they are going to recover in eight to ten weeks without any further intervention from a healthcare professional.

Back Strain strategy (click to expand)

If you had sharp back pain when you lifted the heavy item

But instead the pain has reduced to a duller ache and is still uncomfortable

But now it only gets sharper when you twist or bend to the side

Odds are you have strained a muscle in your back

- street name "pulled your back".

In this instance, taking a similar approach where you mobilised and strengthened your back, in a balanced manner

Usually it would recover well in approximately 2-8 weeks.

Please see our other blogs around specific injury management and conditions.

Now here is the thing: How you think matters.

Approaching movement and rehab in a balanced way is key.

It requires you to listen to your body and respect when it feels pain.

Once your therapist has given you rehab exercises that are specific to your needs

You need to feel into the movement

And whilst moving still be able to breathe deeply in a relaxed manner

Most of all while you are doing the full movement - it should not cause pain beyond a 3/10 - preferably it does not cause pain at all.

You repeat this process each day & each week, gradually expanding the pain free range.

At this stage it is all about patience.

As you build the movement range back only when it's fully there do you start strengthening it.

Again these strengthening exercises need to be done in a pain free range.

The ability to move without pain & with breathing, in a relaxed manner - is the key to preventing chronic pain.

It is really important to have this patience and gentle persistence - respecting and listening to your body the whole time.

Healing does take time, it can't be rushed and definitely doesn't arrive like amazon prime overnight.

in this process it's important to keep reassuring yourself

• Ask for help: reach out to friends and family

• Gently challenge your body to do slightly more each week - pain free

• Be your own cheerleader - you can move out of pain

• Check your plan is a good one.

• If you need more help - reach out to a therapist you trust and check in

What if I am beyond the normal healing time?

What if my pain is now in the chronic phase?

Again even having one session with a qualified and trusted therapist is a hugely valuable investment.

It gives you a starting point, gives you more clarity about the process ahead of you

And reassures you that it is possible to become pain free.

The journey with chronic pain is longer...

It requires a lot more persistence & patience.

These are the key qualities to keep an eye out for:

finding any movement that you can do pain free is key - this is your starting point.

celebrate your pain free movement baseline everyday & practice it.

In chronic pain, your nervous system becomes hypersensitive to pain - which is not your fault.

The way you start to reset this setting is by highlighting your pain free movement & repeating it.

This may be really small - honestly stick with it & trust yourself.

Keep repeating that tiny baby step everyday - however small.

Doing this, creates a new relationship with your body where you're building trust that you will listen to your current limits.

Doing this means your body can start reducing its hyper stimulated state of flight or fight.

express yourself - either to a notepad or to a trustworthy friend:

Thoughts & emotions go hand in hand, like twins.

Sometimes they might be non-verbal.

But how we perceive the world changes when we're in pain.

We start reacting more.

We're on the look out for danger more.

We can feel more nervous than usual in any situation - in a conference, class, yoga session with new people, at work - you name it.

If we have a bad encounter with someone it can lead us to conclude that they're awful, they're wrong.

They might not be great, but black & white thinking is a hallmark of being in a hyper-stimulated flight or fight state.

Creating safety in your thoughts and in yourself starts by witnessing with empathy where you are at.

It is not your fault at all if you are experiencing the world this way.

But it does not have to be this way.

In the long run I believe happiness comes from being able to see a situation from multiple angles and know that almost no one behaves badly without themselves hurting on the inside.

If you can, start by just splurging it all onto a page. That may be all you need to start reseting these patterns.

I would highly recommend however working with a trauma informed psychotherapist or psychologist who has experience with chronic pain and fatigue.

I know an exceptional therapist and would highly recommend this work - if you would like to.

Being in pain is not purely physical and starting to recognise your thoughts and emotions can help your nervous system to start settling again.

try to take mini-breaks mentally throughout the day and breathe

Learning any relaxation breathing technique and mindfulness meditation is a wonderful way to start turning down your nervous system and resetting its pain pathways.

Chronic pain occurs when our nervous system has become hypersensitive to pain.

Our breath is a powerful mechanism that remains at our disposal to start consciously resetting our system and returning it to ground zero.

Find a comfortable spot with your feet planted flat on the floor in a relaxed manner.

Place your hands on your belly.

There is no need to sit up straight.

This practice is all about being relaxed in your body.

Breathe in expanding your hands at your belly.

As you breathe out see if you can relax even 0.000001% into the chair.

Let the chair take more and more of your weight.

I say to myself , "Maam, you can put your bags down now."

It makes me smile, it also is the line that links into feeling like I am carrying this weight around with me. Whether that is an emotion, a to-do item or a physical thing.

It enables me to just ahhhhhh and be.

This practice takes time and tiny micro-practices.

Think of it like accumulating one to five minute "go's" - like a child does - turns at the game.

Do not expect too much at the beginning. As you accumulate hours, things will change.

learn to trust your body again:

Often times when we are in pain, it can feel like our body has betrayed us.

I believe we live in a world that values productivity, in a pretty toxic way.

When did it become more about our work output than taking the time to allow our bodies to heal right, back when we first hurt ourselves.

When did mind over matter become this thing where my body had to scream at me before it got my attention. Even then my reaction was, that is a massive inconvenience!

Pain can be really bloody scary. I have experienced some things that I never thought were possible and learned the hard way. I am stubborn like that!

My advice would be manage the injury the best way you can in the first place.

To heal it, we have to feel it.

Not all of it.

Definitely not all at once.

But we have to start letting the pressure off gently. Opening the valve and taking some of the massive hyperstimulation state off.

To do that often some form of expression is needed.

It does not have to be tears or tantrums. It does not have to be physical shakes and thunderclouds.

It does require us to get in under those feelings and start sitting with them and listening.

Welcoming the parts of you home that have been mistreated, ignored, disparaged or even shunned.

And this takes us to my last and perhaps biggest point.

When you find the belief that drives the feeling and let it go...

that's when healing has concluded.

The Power of Beliefs and Pain

Beliefs are incredibly powerful and often subconscious. They are things we have inherited—through family, school, media and society. These beliefs slip into our minds because we hear, see and feel them so often on a subconscious level.

The Shift in Your Inner Voice

One day, you might notice that you no longer hear those beliefs as voices from outside (like your mum’s voice). You instead start hearing them in your own voice and in your own thoughts. That is when the change begins.

Pain and Its Meaning

Pain is one of these deeply ingrained beliefs. But here is the truth: getting older doesn’t mean you have to “just put up with” pain.

Your value has never been tied to your work, your to-do list, or your exercise routine. You are enough just as you are. You are beautiful, even if you did nothing else with your time. Your presence on earth is meaningful.

• You touch the lives of your friends, family, colleagues and loved ones every single day.

• Your body shape or size has nothing to do with your value, beauty or kindness.

  
  

Pain is Not a Reflection of your Worth

Being in pain does not mean something is “wrong” with you. Instead it is an invitation to make peace with your body and mind; an invitation to find greater meaning and happiness.

A Shift in Perspective on Pain

When I changed my beliefs about pain, everything shifted for me. When I feel pain in my body, I do not panic or judge it. Instead I try to approach it with curiosity.

• I label pain instead as just a sensation; something that I can sit with.

• I give it space to express itself. I allow the meaning of the feeling to come to me.

• I do not interrogate the sensation. I sit with it for as long as it needs.

During this process, I gradually come to understand it more deeply. Sometimes I cannot even put it into words. I know that by sitting with it, the pain slowly shifts and resolves.

Discovering Peace Under the Clouds

With time I have found that every time I sit with pain, another layer of “sunshine” appears under the clouds of discomfort. Each time, I can return to the peaceful feelings I have discovered before and move through the next layer of emotions and sensations.

My Advice on Pain

Pain is complex. It does not always serve as a warning system. Nor does it always signify tissue damage or injury. It is nuanced, just like you. -of course it is.

1. If you are really worried, seeking medical help is essential.

2. If you have had scans and your tissues are healed, then pain is an invitation to create more space and compassion within yourself.

3. Pain is an opportunity to get curious and listen to your body. To become more compassionate with yourself.

4. It is an invitation to grow into spaces of healing and understanding you never thought possible.

A Personal Journey

This perspective comes from years of living with chronic pain myself and treating countless people. I once thought that reading enough literature would provide all the answers. Over time I realized that the key to healing is supporting individuals to find their own clarity and compassion.

Let Me Know What You Think

Please share your thoughts in the comments below.

I would love to hear your perspective.

Much love and keep going x

Carmen