Being a medical professional means putting others first in your daily work is the default. It does, however, make some vulnerable to overload when they continue that intent at times when they should be making more time for themselves. This creates the environment where pain or symptoms start to appear and where the perfect storm for persistent pain can arise.

Here’s a follow-up message for a medical professional who experienced persistent low back pain and started seeing the truth about the pain.

When introducing new habits, resistance will appear, but keep it from knocking you off track. Stay calm and observe those conditioned reactions you've been missing for so long. It’s ok for the pain to stay the same when you move towards observing it without reacting. It’s even ok if it flares, and here’s why.

I've got a question.

Is a sensation felt as pain because of your reaction to it?

I'm pointing out here the speed of conscious and unconscious thought. It's a little like watching the film "Back To The Future" for those who remember it. A stimulus occurs (either internally or externally), initially beyond your conscious awareness.

Here is some advice for a lovely lady who desperately wants to help her daughter in trouble. It is instinctual to help those we love, but our childhood may unconsciously instil the idea that we must fix everything for everyone. It can result in pain through the behaviours of attempting to remedy others' pain.

A guy came to see me recently for a bilateral Achilles tendon problem that he's had for two years. On his assessment four weeks ago, he explained that he understood the link between stress and pain and had recovered from 5 years of low back pain as soon as he read John Sarno's book 'Healing Back Pain' a few years ago.

This was an email trail from a month ago with a lady suffering from back pain. It has more or less disappeared now, but this question below highlights the uncertainty we all feel when we've sat alone with our pain. It gets easier if you can find commitment and consistency, and she is doing that now. Below is a snapshot of her thoughts at the time and my response.

Here's a question I received recently. Do your patients recover without journaling/expressive writing?

What do people think of journaling? Is it helpful? I’ve read from Nicole Sachs and David Hanscom that this is necessary to recover, and Dr Sarno's/Dr Schubiner’s programs were also based on writing.

Do you ever hear someone saying they’ve got a high pain threshold? Is it something you’ve said yourself? It’s interesting as I know I’ve thought it of myself, and I hear it from many patients. That attitude has its value in short-term moments of sporting endurance, workplace effort, and getting through intense situations that involve physical and emotional pain.

Recovery after 24 years of CRPS? it can’t be true, can it? Well, true it is and all down to one last called Susan. Written off by much of the medical community after many failed attempts at recovery or alleviating symptoms. Slowly her life became limited by not only the events of the initial trauma but a collection of signs and symptoms which engulfed her body and mind and made life unbearable.

Many believe that recovery from 15 years of low back pain is impossible. Especially when they have evidence of structural changes to support the belief that damage is the basis for their pain.It is further complicated by the opinions of medical practitioners and investigative procedures that galvanise the fears around the area of the body where the pain is experienced.

When I asked a patient how her day had been, she presented a story which beautifully represented a metaphor for her pain. She explained that she had spent a wonderful morning in the garden. It had been so enjoyable that she glanced through the kitchen window at what she’d just viewed as she re-entered the house.

That secondary glance provided a different view to the one she had just witnessed, as all the birds that had been there moments ago had vanished. The beautiful garden had almost immediately become still, and she wondered why.

A Patient’s Question

When I awake in the morning, I almost immediately get burning nerve pain in my entire upper body. When I take a shower, ending with a cold bit of it, the sensation will leave and then the pain settles back in my hip/leg for the rest of the day. I thought of trying to jump in the shower to try to break the body of the habit of getting this pain in the morning or just sitting with it to tell my brain it is safe and do some somatic tracking. I have tried both, but I know I would need to do it for an extended period to get actual results. Any suggestion which I should try first for an extended period?

Let's look at the story behind the low back pain in this 50-year-old nurse. Here’s how she explained her situation.

‘I've got a spondylolisthesis. I've seen a consultant, and he’s told me that it doesn't need surgery and I'll have to manage it. It’s a ‘Nurse’s Back’ from 30 years of work and all those Australian lifts. My weight doesn't help. I’d like to lose some of it and want to go swimming, but a friend of mine is a physio and said I shouldn't go swimming with my back as it is because it’ll make it worse. I don't know what else to do and am frightened that I’ll just have to live with it.’

Recovering from persistent or chronic pain can come in many shapes and forms. For example, in the monologue in this blog post, one patient describes how her improvement came from three distinct steps.

First, before we come to those steps, let us see how it differs from other recoveries.

I recently read this monologue below, written by someone else with widespread pain and thought it might provide you with another idea about how to approach your situation. It is authentic to the person, but the words are easily relatable.

See if you find it helpful, and keep smiling as you watch the ice melt!

Many people ask me if their pain is a sign of damage, and I've included one such question as the subject of this post. See if the threads within this question relate to you or your pain and explore whether you can consider aspects of the answer to your situation.

After chatting with someone online, I was impressed with her level of knowledge on pain. The circumstances of her pain related to persistent pain following an attack of shingles. She’d had several episodes over the years, and this one had been the worst and left her with residual pain that she found difficult to get rid of despite what she had studied and read. But, of course, this doesn’t always guarantee success as quickly as someone wants because pain is an unconscious process.

How can someone overcome pain which has been present for 21 years?

Surely after being there for that long, it will be there for good?

Not so.

Pain relates to a moment in time. For example, a moment or period of trauma and persistent pain is the unconscious organism responding to a constant stream of messages filtered through a conscious mind seeing only fear and frustration at its predicament.

Have you ever been asked if you speak a particular language? French, Spanish or Mandarin, maybe. That could have happened, but I bet you haven't been asked if you speak pain. Pain has a language of its own, and if you experience persistent pain, then there is an excellent chance that you don’t speak pain. Now is the time to learn because you can choose whether the pain you feel should stay or go once you understand.

I know many of your feel frustrated with pain. My thoughts are that pain can become the voice of someone who feels so frustrated with a situation that the pain starts to speak for them.

It said no to more physical tasks.

It said no to more emotional loads.

It said no to more psychological effort.

And the role it took in the moment the pain started was a protective one because that person may have found it so hard or not had the choice to do anything other than keep going.