How a physical therapist helped me through my lowest point, Part Two

This is the second part in a series about a life-changing experience I had in physical therapy. To start from the beginning, check out Part One.

I couldn’t believe what I was hearing.  I think Tim expected me to be disappointed, or maybe even to contradict him.  After all, he basically just told this patient who had been in pain for months, thinking that she was injured, that there wasn’t as much “wrong” with her body has she thought.

But I was excited.  My curiousity was piqued.

After all, I knew there was something wrong with me that no one had figured out yet.  I could tell that my body wasn’t functioning normally.  I mean, I was twenty-five, and in more pain than my eighty-six year old grandmother.  I was so happy to have someone propose a theory to me that sounded as though it made scientific sense, and didn’t ultimately hinge upon my “being depressed” or “focusing on the pain too much” (both of which were things I had been hearing from healthcare professionals for years).

******

Tim explained that he and all of his coworkers had attended an advanced training together on recent developments in pain science.  The way he said “pain science” was very specific; it sounded different than what doctors usually meant when they referred to “pain management.”

Tim explained that the training had taught him to view pain totally differently; that he and his colleagues had learned all sorts of things they hadn’t learned in physical therapy school.  After the training, he’d realized that much of what he’d learned about pain was wrong, that most physical therapists and doctors had it wrong.

What he learned is that sometimes, in people whose bodies have been through some kind of painful or traumatic physical ordeal, the nervous system can starts working differently.  It start overreacting to different stimuli, and cause the person to feel pain when he or she ordinarily wouldn’t.

“It’s as though your body has decided that everything is dangerous,” he said.  “And that makes sense, after everything you’ve been through.  Your body has been through so much that it’s like it thinks it’s made of glass, that even the slightest touch could break it.  But you’re actually much tougher than that, and what we’re going to do is help your nervous system remember that you aren’t made of glass.”

I was excited and confused at the same time.  Tim told me not to worry if it didn’t make sense right away, that it might take a few appointments for me to really understand.

The first thing I had to do, he said, was to go home and watch three online lectures, given by the same instructor who’d led his training.  He urged me, in fact, to watch them more than once, to really pour over them and get everything out of them that I could.  But I had to promise to watch each one at least once before our next appointment.

*****

If you’re a longtime reader of my blog, you’ve probably guessed that the person who gave these online lectures is Neil Pearson.

I really can’t say enough good things about his work.

Once I went home and started playing these lectures on the computer, things really began to click.  I have to admit, it was hard to stay focused, but not because it was boring.  Instead, it was because every new thing Neil said made me think of my past.  All of these experiences where I’d felt like a big weirdo, where I’d been too embarrassed to let anyone know how overwhelmed I was by certain stimuli because I knew it wasn’t normal, suddenly made sense.

The lectures talked about how pain isn’t always a sign that something’s wrong in the body.  Instead, it is your body’s way of warning you about things.  And it turns out that the body isn’t always right about what it can and can’t handle.

I realized it was as though someone had come along when I wasn’t looking and lowered my pain and physical irritation threshold.  It was as if I was playing Limbo, and the people holding the stick decided to lower it from the height of my neck to the height of my shins.  You can’t play Limbo when the stick is that low.  And you can’t go through life normally when your “pain threshold” is only a fifth of what everyone else’s is.

As I listened to the stories in Neil’s lectures, I began to recognize myself in them.  I realized that my nervous system had been on edge, for years.  It wasn’t because I was crazy.  It wasn’t because I was depressed.  In fact, it was something that was happening totally out of my conscious control.

At one point in the lecture, Neil began to describe the chemical and physical changes which occur in the nervous system as a response to pain, both within the brain and in the spinal cord.  These changes are what cause the change in how a person experiences pain.  This was so much bigger than “you’re depressed.”  And it was actual science; like, the kind with evidence.

Of course I had a lot of questions after watching these videos, but from that moment on, I knew things were going to change for me.  Finally, an answer that made scientific sense, and which seemed to have a solution.

To be continued in Part 3!

And because I know you’ll want to check out the videos now, they are:

Neil Pearson: Overcome Pain, Live Well Again

How a physical therapist helped me through my lowest point, Part One

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This post is the first in a series of posts about my life-changing experience of pain neurophysiology education.  To see a list of all of the posts, click here!

Part One: Hitting Rock Bottom.

A few years ago, I was at one of my lowest points. A few things happened in my life, all within a short time period, that caused my pain levels to flare up. I had been attacked by a client at the group home where I worked. In the attack, I was thrown against a wall, which, of course, was not great for my neck and back pain. The week before, I had sprained my ankle and was having trouble walking. I was also beginning to experience the beginnings of chondromalacia patella in my right knee.

It was a horrible time in my life. I was going from doctor to doctor, begging for someone to help me, to give me a diagnosis. I couldn’t understand why I was in so much pain; it was like it had taken over my whole body. I was afraid there was something wrong with me, deep down, at a cellular level. I started reading about something called fibromyalgia online, and was frightened by what I read. I realize now that I what I was reading was out-of-date information, but at the time I became very frightened that something in my body’s chemistry was off, causing problems with inflammation.

The absolute worst moment was when I went to see a pain specialist at a highly-regarded hospital near me.

This guy looked great online. He actually listed fibromyalgia amongst his clinical interests. He wasn’t just a random doctor; he was the head of the anesthesiology department. He also had a law degree, which I figured meant he was really smart.

But he was no help at all. Most of the appointment was conducted by a resident (medical student in training). Because he could see many of my records from other physicians electronically, he didn’t seem to think he needed to do an examination of his own. Not once did he walk across the room and look at my back.

I tried my best to express how bad things were. I explained the fears that had plagued me for months, that I was afraid I had fibromyalgia, or a problem with inflammation.  Despite the fact that he’d listed “fibromyalgia” within his clinical interests, he seemed to have no idea what I was talking about.  I also asked him if he could give me some medication for the pain. His eyes got wide, as he suddenly “remembered” that every new patient was supposed to receive a drug test.

I left that day with a lump in my throat and my pride wounded. Somehow, this whole appointment that I had been looking forward to for so long had boiled down to the doctor thinking I just wanted to get high.

*****

The only good thing to come out of that appointment was that the doctor referred me to physical therapy at another hospital in the area. Without going into any detail, he said that a lot of his patients had had “luck” there.

I had actually been to physical therapy at the same hospital a few years earlier, when I had first hurt my back.  I had really liked my physical therapist at the time, so I decided to go back.  As luck would have it, they scheduled me with the same guy.

I filled out my intake paperwork, following the instructions and putting an “X” on the little diagram where they ask you to mark the areas where you have pain. I must have put about twenty X’s on the paper.

When Tim saw this diagram, he paused for a moment. “Hold on a second,” he said. “I’ll be right back.”

When he came back into the room, he explained that he’d asked the secretaries to make a few changes to my referral. He explained that the number of X’s I’d placed on my paper was alarming, that it was a sign there was something more going on with me than just “back pain” or “knee pain.” Instead, there was an underlying factor, causing me to experience pain in so many parts of my body. It was, he said, my nervous system.

“You’re really going to have to trust me on this,” he said. “I know it’s confusing to hear at first, but when people get like this, it’s because their nervous systems are processing pain differently. There’s no way you have injuries in this many different parts of your body, when you haven’t been in a car accident and you’re so young. I am going to teach you about what’s going on. Once you begin to understand that all of this pain is coming from your nervous system, we can start to work with that. You’re going to have to give me the benefit of the doubt in the beginning, but we really can help people get better.”

Click to continue to Part Two.