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Physical-psychological overlap

Oct 27, 2015 10:37 AM

Long story short, I'm 45, 1 year out from a double lumbar disk removal & replacement (fusion).

I just started a 3-month PT program called Pure Healthy Back. So I'm lifting weights for the first time in a decade. Three weeks in, and the soreness from the PT in my upper back and shoulders (one killer kink that just won't subside) is so bad that I'm basically semi-disabled with the amount of laying around I do.

In another thread I saw someone mention their family said it was "all" psychosomatic. I'm a psychology PhD (organizational) and most things fall on a physical-to-psychosomatic spectrum. Most chronic is a mix of the two.

There is an awesome book called Back in Control (Amazon) that explains it. The book is strongly influenced by Dr. Schubiner's Unlearn Your Pain Program (workbook also on Amazon).

I strongly recommend both for all types of pain, not just back pain.

What does everybody else think? Does your pain have both physical causes and psychological causes? (e.g. stressors)

My 2 cents is that we have a better chance of getting better if we treat both the psychological and the physical.

Oct 27, 2015 10:52 AM

I would absolutely agree. Why I know that my pain isn't "all in my head", we all know that stressors can cause a flare up. My life is upside down right now. I've moved away from all of my friends and family and now my marriage is crumbling. I feel like I am letting my children down because I am not the mother I once was or want to be. All I ever do is go to the doctor. It's a very sad, lonely, depressing life right now. I think that is why my CRPS is spreading thru my body so quickly. I am waiting for my SCS implant and then I am going to turn things around! I know it won't cure me or stop the spreading but it will give me a chance to change some aspects of my life. I just have to hold on a little longer!

Oct 27, 2015 11:52 AM

I agree, but I often think that doctors blame our chronic pain on depression. I disagree with that thought process. For me personally, not one of the myriad of anti depressants I've been put on over the past 22, years has helped my pain. When my pain is not under control, I get depressed. Anxiety also plays a big role in my pain. Some have done more harm than anything. Why put someone on a medication to "rule" out a psychological disorder? Anyhow, I believe anxiety plays a huge roll as well. ✌️💜

Oct 27, 2015 3:06 PM

Any doctor who believes depression causes chronic pain is not very scientific. I suffered through advanced nonlinear statistics for a PhD and know how to evaluate the credibility of scientific studies.

I would check out Scubiner's YouTube channel. In his 4-part lecture he cites the research supporting his diagnosis that repressed anxiety and anger cause physical symptoms such as pain.

Now add it whatever physical problems you may have (diagnosed and undiagnosed) and it is easy to see how most pain doctors and nearly all PCP don't really know jack-sh*t about pain.

Sarno, Schecter, Scubiner, and other doctors are (in a rigorous and scientific way) fine tuning their diagnosis and treatment of chronic pain.

Scubiner, himself, has had bouts of IBS for years. I've known him for awhile and was lucky enough to be under his care.

I think you can download the "book" part of the workbook on Amazon for free (kindle chapters 1-5). It's called Unlearn Your Pain.

Oct 27, 2015 4:37 PM

Thank you, I will look for it. Yeah I think most primary care doctors are truly "practicing" medicine. ✌️💜

Oct 27, 2015 8:16 PM

I agree with that. Just like pain medicine does not get rid of our pain, it changes the way we feel about our pain. But pain is real. It is just multiplied or exacerbated by negative feelings and emotions. I think most people here or at least quite a few people here agree that the psychological aspect needs to be addressed either pharmaceutically or by therapy in order for a person to maintain some positive emotions while being brought down by pain.

I really think what it comes down to is what does it take, pain meds, therapy, anti-depressants to make us the most whole persons we can be despite what we are going through to deal with pain, be the most effective spouse, employee, ect.,. That is just my take. Hope I didn't offend anyone. Wasn't trying to.

Oct 27, 2015 8:25 PM

I am reading Rapid Recovery from Back and Neck Pain by Fred Amir. He has followed Dr. Sarno's theory and came up with a nine step recovery plan. It has really helped me to minimize the pain in my foot using my self talk and tapping into my subconscious while becoming more positive. I highly recommend his book. It is also on Amazon.

Oct 28, 2015 9:27 AM

I'm not sure what to think. I've had pain and stress (leading to anxiety and depression, so fun😂😥😵) all my life. They just always go together. It's not one, then the other. They just slam together in a moment. Like last year, during confluence, my group members went to the fish store, and I was so frustrated and dad, but my pain got like 10 times worse, then when they came back, the sophomores yelled at me and I started crying, had to go home from a passion scale 9, but they saw me in the nurses office and asked "what's wrong? where does it hurt" I could only whisper, "everywhere" but they still didn't get it.

Oct 28, 2015 10:41 AM

I agree that our pain is exacerbated by our emotions however there are many doctors who are too quick to say it's psychological. I suffered with anxiety and depression long before my pain issues began. I maintained my demeanor all the way up and until it was so bad, I couldn't work any longer. Ferretbandit said it very well, they just kind of come crashing together. I've been to therapy, I've been to counseling, I feel no difference in my pain. Weather changes, mood changed all have effects on my pain but sometimes I think doctors need to realize that it becomes a vicious cycle of pain, stress, more pain, anxiety, more pain, depression... It's a crappy way to have to live but if you have families like THIS one, it makes all the difference in the world. I'll take care of my peeps over getting depressed over my own pain. I hope everyone is having a peaceful and less painful day. Love, {{{Hugs}}} and prayers.💕🙏🏻🌻

Oct 28, 2015 11:13 AM

I absolutely agree. I have been in a pain/depreession cycle for over20 yrs. I don't know about anyone else, but the more stressed I get, the more upset I get, the more depressed I get, the more pain I'm in. The more pain I'm in, the more depressed I get, the more stressed I get. I can't get off the merry go round. I found that I can distract my brain from the pain and depression with simultaneously using my tens unit on my back.. it's just the icy hot one from the drug store, and doing 20 min of meditation. It calms my brain, and then I can think. My pain eases because the tens unit cuts off my brain pain as I call it.

Oct 28, 2015 8:49 PM

I don't do much meditation, but I find yoga, and trying to be in the moment super helpful. Ì also feel that I already have become pretty good at meditating. That's what I did without meds. Just let the pain happen, absorb it. Almost become it. It's simultaneously the most peaceful and most painful experience I've ever been in. I guess that's part of why I don't think that meditation and pain relief go together.
I'm trying to break some of my own depressed/anxious/triggered stress/extreme pain cycle but it's hard. I find talking to people more makes me happier, but I need extra sleep and down time, which might make school work more stressful.
Or today, which was absolutely terrifying. In my writing class, we had a lock down. A little context: my school is next to a school for making up credits if you didn't graduate and (unfortunately) there's an extensive high rate of crime. We are also near one of the 2 normal high schools, so if anything goes wrong at one school, all three are locked down. Anyway, we suddenly went and hid for maybe 10 minutes. Turns out, someone at the other school had a gun, but we didn't know that until afterwards. My roommate's teacher is former military, and was up to protect the students, but I was in one of the annexes, squished together with the choir class.
Anyway, super stressed, body on high alert, and my shoulder's flaring. Go figure.

Oct 29, 2015 8:17 AM

Fbandit, I can't meditate b/c of the pain. I'm going to think about what you said, however. Very profound.

As far as the stress, I was stressed just imagining a lockdown! Most of that is normal reactions to stress. It is the scary, unmentionable things our unconscious that I believe cause the pain. Journaling seems to be the only way to get it out (for me).

Oct 30, 2015 12:08 AM

I know the nervous breakdown I had 26 years ago was all in my head, but also due to a chemical imbalance brought on by hormonal changes postpartum. I've had depression & anxiety on and off since. And once again, this time it's a chemical imbalance of serotonin.

I know beyond a shadow of doubt that my pain is real, of its own accord, not caused by the depression. I've been depression free from 2000 until 2011-2012, when I began to realize my health was getting worse and I wouldn't be returning to my job. My spiraling physical health brought on this depression and anxiety.

Yet Mayo put "somatization" in my documents and verbally mentioned "central-sensitization" to me. The main doc said, "It is in your head, but not as in psychiatric psychoses. It's a physical disconnection from one synapse to another. Your brain has been deprogrammed due to excessive pain signals." OK, and??? I've researched both. I don't know if it's the fibro fog or what, but I can't seem to wrap my head around it. This is one reason I'm going to start counseling and return to the pain clinic. I sure hope someone can explain in terms my brain can understand. I hate this fog!!! Anything too technical or educationally profound, and I feel like a dummy eating a since cap! The old me would have understood it from the get go. ***sigh*** party of accepting the new me I guess. 🙏🌼

Oct 30, 2015 12:10 AM

dummy eating a since cap = dummy wearing a dunce cap!

Nov 05, 2015 10:55 AM

People at Mayo are just people, not all-knowing gods.

When he says, "it's in your head," that is really code for:

"I didn't develop compassion because I was not held enough as an infant" ;(

Whether I'm right about that docs root cause or not, the problem lies with the doc, not you.

It's not your fault they can't figure out how to diagnose and treat what ails you!!!!!!

Nov 05, 2015 8:34 PM

Rkolle01, You made me laugh!, thanks! 🙏🌼

Mar 23, 2017 10:10 PM

Unlearn your pain is one of the best investments one can make. At one point I was actually pain free, and it truly was because of that book. The thing is that you have to do the work. Now I have PHN pain that may never go away, however if it were not for the skills I learned there I know my pain could be much wosre.

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