What Happens If Pain Becomes Persistent?

I meet so many people through my classes who are either resigned to living with and in pain, or they get stuck in a cycle of "treatment hopping" trying desperately to find a fix.

A lot of people are told by health professionals that they have to live with their condition, and take painkillers for the bad days. So they feel their situation is hopeless, and decide to do nothing.

Others become obsessed with finding a fix. They'll try anything - fancy pants pain relief tools, supplements, or whatever's going viral on social media. They might keep doing one thing forever, say physiotherapy, hoping it'll eventually work, or jump from treatment to the next, ever hopeful.

So what happens if pain becomes persistent? Here are some of the consequences:

• Chronic pain, that lasts for more than 6 months, changes your nervous system, immune system, cell physiology and muscle behaviour 
• Avoidance - you deliberately stop doing activities or movements that you believe to be harmful
• Fear - avoidance and catastrophisation (seeing the worst case scenario) leads to kinesiophobia (fear of moving)
• Compensations - Your body adapts around the pain, leading to altered movement patterns that can lead to further pain or injury in the future.
• Finances - have you added up what you've spent to date on therapy, drugs and pain relief tools?
• Energy - being in pain and going for treatment after treatment is draining, both physically and emotionally.

But it doesn't have to be this way.

You CAN take control of pain and how your body feels for yourself, without chasing the next quick fix or waiting for a miracle to happen.

How?

• Ask your body and listen
• Stop focusing on only treating the area that hurts - this is often a symptom, NOT the driver
• Consider your entire life history, including events that may seem unrelated to your  current injury
• Take a holistic, non-linear approach that includes the brain, nervous system, muscles and joints

Read on to step behind the scenes and find out what really happens in a 1:1 breakthrough session with me. Discover how I help my clients unlock the triggers behind their persistent pain and understand what's actually happening in their body that stops them from recovering fully.

Client 1: Piriformis pain, a clicky hip and SI joint

This client approached me for help with lower back and buttock pain, a clicky hip and sacroiliac joint after injuring her piriformis muscle last year.

Physiotherapy helped her piriformis muscle to recover, but left her with the symptoms mentioned above.

She's been coping by being careful in classes, and holding back when doing certain movements, just in case it brought back the acute pain of the initial injury.

What we did to resolve the symptoms =

• Released hip flexors (iliopsoas), adductors (inner thigh), and QL (lower back).
• Re-built safety and trust in certain highly triggering movements

I guess the BIG question here is.... Why not stretch the piriformis muscle, if that was the initial injury?

The standard treatment for piriformis pain are exercises like Swan (or Pigeon pose) and a Figure 4 stretch (ankle resting on opposite thigh and pressing the knee away).

When I observed this client standing, laying supine (on her back) and in side lying, her pelvis appeared hitched up on the right. This was also the side of the piriformis injury.

The client also mentioned that she felt her pelvis wasn't straight when she lay on her mat in Pilates classes.

Typical muscles involved in a hip hitch posture include iliopsoas, QL (quadratus lumborum) and obliques. Very often if the hip flexors become active, so do the adductors (inner thigh muscles).

 My working hypothesis was that the injured piriformis muscle had been traumatised by the suddenness of the incident - the client mentioned that the pain was very sharp, and made her cry out loud in shock - and was now bracing to protect itself.

Stretching ie. pulling on the muscle, might feel nice, but isn't going to change it's behaviour long-term.

If we look at the attachments of the piriformis muscle, they're on the pelvis, sacrum and greater trochanter of the femur (the sticky out L bend of the thigh bone).

The instability and clicking the client felt in her hip and SI joint is likely a result of these bones being dragged off centre, leading to inappropriate muscle tension as the body tries to self correct the imbalance.

During her 1:1 session we worked on these areas to restore ease and equilibrium:

• Rebalance the pelvis and the muscles at the back and front of the body
• Release psoas major (part of iliopsoas and one of the hip flexors)
• Release the inner thigh (adductor) muscles with a focus on rotating the hips externally and internally freely
• Built safety and trust back into her neuromuscular system using the side lying single leg kick exercise - a movement that typically triggers symptoms and pain for this client. We found the body's safe boundary, and gently worked into the muscle tension, before releasing. This gradually increases tolerance to the movement, and relieves the symptoms. 

Results

1. The client reported mild lower back soreness from the QL muscle for 48 hours after the session
2. After 2 weeks, the hip and SI joint stopped clicking for the first time in 1 year. Now, there's only occasional clicking which stops after a couple of repetitions.
3. Once the lower back muscle soreness had eased, the client reported no more pain.

Client 2: Left TMJ (jaw) pain for 7 years

This poor client has been managing severe jaw (TMJ / temporomandibular joint) pain for 7 years, with pain levels hitting 7-9/10.

He's tried pretty much everything out there, including.....

• Seeing 2x doctors (one also diagnosed fibromyalgia, whereas the other clinician dismissed this diagnosis!)
• Osteopath
• Craniosacral osteopath
• Chiropractor

A highly relevant piece of information is a left ankle fracture that pre-dated the jaw pain.

This client is also, by his own admission, a perfectionist, driven to succeed, with a tendency to worry. He doesn't find it easy to wind down and rest.

What we're working on to relieve the pain

• C1/C2 ( the top two cervical / neck vertebrae) and the capitus muscle
• Left ribs and shoulder blade
• Oblique muscles (external and internal)
• Left hip,
• Increasing vagus nerve tone

When I first spoke to this client, I asked him what treatment he felt had helped him the most.

He replied "the chiropractor, who manipulated his upper neck".

So that's where we started in session 1, with some DIY craniosacral osteopathy on a soft Pilates 7cm overball. These exercises are super simple, and help to realign C1 / C2, which can be misplaced when you're tense or worried. An added benefit is they also help to increase vagus nerve tone, which promotes rest and sleep...Happy days!

Then we continued with an eye differentiation exercise to make sure the eyes and head were synchronising with each other. If the eyes and head get out of sync, it can lead to all sorts of symptoms, like jaw pain, deep toothache, eye strain, sinus pain, dizziness, and tension headaches.

As we were working I noticed that he seemed to be holding his body in the side reflex of compensation - this is one of the 3 stress reflexes described by Dr Thomas Hanna.

Going on intuition, I decide to move away from working on his jaw and neck to working on his ribs.

We finished session 1 with mobilisation exercises to release his shoulder blades and ribs, and a side bend movement to restore control of his external oblique muscles.

Apparently none of the other clinicians he'd seen had examined or worked on his ribs. And before you think I've lost the plot and how can the ribs possibly be involved in jaw pain, hear me out.....

The muscles overlaying the ribs and shoulder blades - serratus anterior, trapezius, rhomboids and posterior deltoids - all connect to the neck vertebrae via other muscles, such as the scalenes and levator scapulae. These then feed into the capitus muscle that attaches at C1 / C2. The capitus muscle and it's nerve have direct links to the optic nerve of the eye, which is closely associated with the trigeminal nerve. 

The trigeminal nerve passes behind the sinuses and connects to the back teeth and jaw - hello, TMJ!

In addition, the external oblique muscle overlaps with serratus anterior at the front of the rib cage. These 2 muscles close the ribs and move them in a downwards direction towards the pelvis.

After session 1, the client reported that pain levels had dropped to 2-3/10 for 7 days, and then settling at a 6/10. He acknowledged that he had been stressing about returning to work during this 2nd week.

When returned for session 2, he commented that he'd become very aware that his pelvis and shoulders were unlevel. His right shoulder looked higher, and he had a right hip hitch (right hip higher than left). Looking at him, his left side looked longer and more stretched than his right side.

During session 2, we worked on another vagus nerve stimulation exercise - the Half Salamander, described by Dr Stanley Rosenberg, and used by him to treat symptoms of PTSD, ADHD and autism in children and adults.

Then we moved onto a more advanced version of the initial Side Bend exercise. This time we incorporated both external and internal obliques with the full movement pattern.

The aim was to equalise the right and left side of his body, releasing the right hip from it's hitched position, and continuing to restore movement to his ribs.

My working hypothesis is that, his left hip is being dragged down, and his left rib / shoulder blade complex is basically frozen. This has locked and immobilised his entire left side, leading to an unrelenting downward pull on his neck and jaw.

Can you see how this would create the painful tension in his jaw that isn't responding to conventional treatmens?

Why would his body immobilise his whole left side from moving? Remember that old left ankle fracture.......not a coincidence!!

Results so far

• Pain reduced from 7-9/10 to 2-3/10 immediately after session 1, settling to 6/10 two weeks later.
• Tilted pelvis and shoulders with spinal C-curve corrected back to level after session 2.

I can't wait to hear what improvements the latest adjustments bring for this client. However, having been in severe pain for 7 years, this will be an ongoing journey and there will be physiological changes to overcome, such as central sensitisation and increased levels of pain neurotransmitters (Substance P / C-reactive protein / inflammatory markers).

I hope this 2 case studies give you an insight into how to uncover the root triggers behind persistent pain, and inspire hope that even long-term conditions can be improved.

You DON'T have to live in or with chronic pain, and there are alternatives to finding relief without taking powerful painkillers that often have horrible side effects on the body.

WAYS TO WORK WITH ME

1) Unlock Your Body breakthrough session

This is a powerful 1:1 session designed to help you find the root drivers behind a persistent pain or injury. You'll leave with a deeper understanding of what's triggering pain in your body, and a clear action plan to get lasting relief. 

Apply HERE  ,and I'll be in touch to arrange an initial complementary consultation.

2) The Befriend Your Body Method for Pain Management & Relaxation community class

Next date: Sunday 18th August, 1.30pm to 3pm (just 3x spaces left). Book HERE

A small group, tranquil mindful movement class for pain management and relaxation, with a deeply soothing sound bath meditation.

During the class, you'll learn how to use small movements to successfully rebalance your body, release muscle tension and reduce pain. 

Then immerse yourself in the calming sounds and healing vibrations of the crystal singing bowls, ocean drum and rain stick. You'll leave feeling fully rested, deeply relaxed and rejuvenated. 

This class is for you whether you're looking for a natural way to manage pain with a mindful movement practice, or simply to quietly rest in a peaceful sanctuary.

Click HERE for all the details, including how to book. Numbers are limited to a small group to nurture a friendly, inclusive and supportive community for all members.

Other ways you can find help with managing pain or an injury are:

• Book into a Stretch or Pilates class with me - these are a good introduction to the movement explorations of The Befriend Your Body (BYB) Method  for pain management and relaxation.
• Get your copy of my free E-guide "How to Get Relief From Back Pain and Muscle Tension in just 10 mins a Day". This introduces the 3x universal stress responses that can keep you stuck in pain, and explains the 4x pillars of The BYB Method. There's also 2x 10 mins video tutorials showing you how to release muscle tension from the front and back of your body in the comfort of your without expensive equipment. Download for instant access HERE
• Subscribe HERE to receive "The Movement Chronicle", a weekly e-newsletter delivering mobility and pain reduction tips directly into your inbox every Monday morning,

You can connect with me through any of these channels:

• Email at norma@unicornhealthandfitness.com
• Follow me on Facebook and DM me on Messenger https://www.facebook.com/norma.pearsonfitness
• WhatsApp message to 07801 867361.