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How Can I Tell If My Brain Is Causing My Pain?

This excerpt is taken from an episode of the "Tell Me About Your Pain" podcast. You can listen to the full episode below, or on Apple Podcasts, Spotify, and Google Podcasts


Most chronic pain is caused by pain circuits in the brain that get stuck. But this can be hard to accept because pain feels like it's coming from our bodies. In this episode, Alan and Alon discuss how to determine if your pain is caused by your brain, and they explain why it's so important to embrace this belief.

Alan talks to Greg, a former football player who always assumed his debilitating pain was caused by injuries to his back. By changing his mindset about the source of the pain, Greg completely overcame his symptoms. And Alan helps Denise, who suffers from multiple chronic pain symptoms, determine whether her pain is caused by her brain or by structural problems in her body.

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Alan: One patient Greg, who was a former football player, had more structural damage than anyone I had ever worked with. After embracing that he had neuroplastic pain, he was pain free four weeks later. He offered to join us to talk about how he was able to overcome his old way of thinking and embrace the idea that his brain was causing his pain.

Greg: The pain started way back in high school and continued on through college. I started taking way too much Tylenol, way too many things that I can't even pronounce just in order to function as a football player and even look like an athlete. It would take so long to warm up at practice. It would be 20 minutes before I could actually move with any fluidity. To look like a football player and not an old man crouching and shuffling, and not being able to even stand up straight. It was constant, never-ending. And it didn't stop when I stopped playing football.

Alan: During the whole time that you were in chronic pain, what did you think was causing your symptoms?

Greg: Football and the injuries that I sustained from the constant pounding. Four days a week. Especially as a linebacker; we were essentially battering rams. It was brutality. The pain became real and the pain stayed with me long after my playing days.

Alan: For 30 years you were in pain and you thought it was due to these football injuries. What did the doctors and the MRI reports and all of that tell you?

Greg: It all came to a head in 2014. I fell asleep on the couch one night and I woke up in the middle of the night essentially paralyzed. I finally woke up my wife and asked her to take me to the hospital. Eight hours later I'm still in the hospital and I ask for something to eat since I’d been there a while. The doctors said, “No we are fusing your back today. You're going in for surgery.” I wanted a second opinion. So I got one and they told me I needed rods and pins in my back and that it was totally messed up. It was bone-on-bone displaced and they said I had to have this surgery. And I didn’t want the surgery. I didn’t think it was going to help. If my friends who had multiple surgeries are still in pain, I'll just stay in the pain without the surgery.

Alan: So then you sign up for this [CU Boulder back pain] study. You had an initial consultation with Dr. Howard Schubiner who looked over your slides and got your history. Then you met with me and we talked about even more. And all of a sudden this other idea was presented to you: these disc abnormalities had nothing to do with your pain; it was actually your brain that was causing your pain through these learned neural pathways. What was your initial response to that? What did you think when you were presented with that other perspective?

Greg: Initially I didn't believe it. I didn't think it could possibly be true and yet there was a hint of openness to it. I was at the end of my rope really and when somebody says it might be in your mind, I thought, “I’ve asked everybody else, I’ve tried meds, I don't want to do the surgeries. I’ll listen.”

It didn't make sense and yet it did. Rivers change course. If you scratch a record it will never play the record the same way again. The body is amazing, the mind is amazing. I was thinking it definitely could be true because you had asked me, “Are there instances sitting, standing, running, walking where you aren’t in pain?” And I said, “Yes I suppose there are some.” So there is that possibility that I could actually expand on the numbers of times when I wasn't in pain - which was very, very few - to living a life where I was continually not in pain. That started to make sense and it blew my mind.

Alan: So it seems like that first amount of buy in came from looking back and recognizing there were instances where you should have felt pain but you didn't. Or maybe instances where you shouldn't have felt pain but you did, and it didn't necessarily line up. It's so interesting that you need to be open to the belief in order to get the evidence, but then sometimes you need the evidence in order to reinforce the belief. So it's this chicken and egg thing where you have a little bit of belief and then you're able to get a little bit of evidence. Then you can believe a little bit more and eventually it finally culminates.

Greg: Well I was somewhat reluctant to let go of the pain as much as I wanted to be back pain free. I was reluctant to let it go because it had been a part of me for so long. It was kind of mine and it was kind of a comfort zone.

Alan: Weirdly there's a little bit of a loss because you lived with it for so long. You lived with pain for longer than you lived without pain. You still have 9 mm disc herniation and disc degeneration at every level and all of the same structural anomalies that you had over the years, but you don't have any pain.

Greg: Yes all that is still there yet I live on a daily basis back pain free. It was an absolutely liberating, eye-opening experience that, like you said at the very beginning, you don't have to live this way. And I don't. You gave me permission that I did not have to live my life that way and it was life-changing.

[this is an excerpt only - for the full episode, listen to the podcast above]

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