Is it possible to heal chronic pain?  I don’t have a definitive answer yet, but I’m on a journey to find out.

Chronic pain has been part of my story since I became seriously ill in 2004, and never fully recovered. The degree of pain has waxed and waned over the years, but in recent years it intensified.  

As a result, my doctor ordered an MRI of my lower back, which revealed a bulging disc.  She promptly gave me the diagnosis of spinal stenosis, something she had told me I definitely don’t want to have.  

But due to good fortune, I teamed up with a remarkable physical therapist who is also a certified Therapeutic Pain Specialist and practices orthopedic manual therapy as well.  

A significant part of my physical therapy involves brain retraining because ongoing pain is more than a tissue issue.  40% of people whose scans reveal a bulging disc do not have any pain whatsoever. Curious, isn’t it? Although the percentage may vary, you’ll find this is true with many pain conditions.

What Is a Therapeutic Pain Specialist?

So what is a Therapeutic Pain Specialist?

Certification as a Therapeutic Pain Specialist, which is available to a spectrum of licensed healthcare providers, not just physical therapists, includes training in the neuroscience of pain, graded motor imagery, pacing, graded exposure, and other aspects of cutting-edge pain treatment. 

It’s important to know that not all physical therapists are created equal.  Some receive advanced training like Therapeutic Pain Specialist certification or orthopedic manual therapy certification and some don’t.  

If you’re dealing with chronic pain, be selective about your physical therapist.  Do some research and ask questions about their training so you can locate a physical therapist who can best address your needs.

Chronic Pain and the Brain

Thanks to neuroscience, we now know the brain and the nervous system are the main contributors to chronic pain.  In most cases, tissues heal in 3-6 months. Yet most physical therapists focus primarily on muscles, ligaments, and joints in the treatment of chronic pain, neglecting the brain and the nervous system entirely.

Standard physical therapy may work perfectly for some individuals.  But for many others, it only provides limited or short-term relief.  Why is that?

As it turns out, about 1 in 4 people who experience a painful event end up with an extra sensitive alarm system that never returns to baseline once turned on. That extra sensitive alarm system keeps them in chronic pain.  In many cases, chronic pain is more about sensitive nerves and the way your brain processes sensory information than tissue damage.  

That doesn’t mean your pain is psychological or just “in your head.”  It means your brain adapted in ways that have fostered an ongoing experience of pain.  To heal more fully, you may need to focus on retraining your brain, not just on rehabilitating tissue.

Graded Motor Imagery for Chronic Pain

One tool my physical therapist employs is called Grade Motor Imagery.  GMI exercises the brain in three different ways:

• Left-Right Discrimination

• Explicit Motor Imagery

• Mirror Therapy

Left-Right Discrimination, in this context, is the ability to discriminate between left and right images of your painful body part.  It could be your lower back, your shoulder, you knee or some other body part.

As I’ve progressed through the different levels of Left-Right Discrimination using an app called “Recognise,” I’ve seen my pain change in fascinating ways, which gives me confidence that healing is taking place. It’s not unusual for your pain to decrease and then increase or change the way it expresses before it decreases again as you move through the program.  I haven’t worked with Explicit Motor Imagery or Mirror Therapy yet.

I’ve completed 7 out of 8 sessions of physical therapy sessions; I missed one due to inclement weather.  They have included pain neuroscience education, physical mobilization, and brain training in graded motor imagery using the “Recognise” app on my Smart phone between sessions.  My entire upper body feels liberated.  I can move with so much more freedom and there’s been a significant reduction in pain in my lower back.  In fact, most days there’s no pain or restriction in my back whatsoever.

My pain has not resolved entirely. These sessions focused on my lower back, but I’ve experienced pain throughout my body.  I hope to receive another 8 sessions of physical therapy to take the healing further.  Until that’s approved or not, I’ll continue working my way through the stages of the “Recognize” app.

In my case, I believe it’s the combination of orthopedic manual therapy, pain neuroscience education, and brain retraining of the sensory system that has brought about a positive outcome.

I can’t promise this combination will work for everyone with chronic pain, but remember I’ve had chronic pain for 15 years. So don’t just shrug it off thinking it could never work for you. If you’re living with chronic pain, it might be worthwhile to check out these cutting-edge treatments of complex pain and movement problems. 

Always Well Within on Hiatus

I like to set goals, but I’ve found life has a way of taking me where I need to go regardless of my expressed in intentions.

This year, circumstances have led me in the direction of self-healing, starting with the physical therapy program I shared above.  Over the next three months, I will do my second round of Smart Body, Smart Mind, a trauma recovery program. The course focus is to restore nervous system regulation through polyvagal informed education, practical neurosensory exercises, and interactive support.  

I haven’t written much on Always Well Within since the start of the year because my attention has been on self-healing.  I suspect it will be the same the next three months because I want to give myself space to engage even more deeply in Smart Body, Smart Mind.  Instead of leaving you wondering if I’ve disappeared off the face of the earth, I’ve decided to formally announce a three-month break from new blog posts.

You can still connect with me by signing up for my personal Wild Arisings E-Letter, which will continue to come out at least once a month and/or in my Always Well Within Circle of Joy Facebook Group.   

And if I feel inspired to write on the blog, I will! In fact, as soon as I decided to take a break, a new article started to percolate. But I don’t want to promise that.

Here’s to healing for one and for all!

Of course, this is not medical advice. You should check with your doctor before engaging in any form of physical therapy.

Thank you for your presence, I know your time is precious!  Don’t forget to  sign up for Wild Arisings, my twice monthly letters from the heart filled with insights, inspiration, and ideas to help you connect with and live from your truest self. 

You might also like to check out my  Living with Ease course or visit my Self-Care Shop. May you be happy, well, and safe – always.  With love, Sandra