Here at The Chronicilness.co of the United States, we know that living with chronic pain can be stressful. But one of the best ways patients can help reduce the stress in their lives is by learning how to relax through breathing exercises.
Deep breathing helps lower stress in the body because breathing deeply sends a message to the brain to calm down and relax. The brain then sends this message to the body. Deep breathing also causes certain things that happen when stress occurs, such as increased heart rate, fast breathing, and high blood pressure, to decrease.
Another good thing about breathing exercises is that they are easy to learn. Patients can do them whenever they want, and they don’t need any special tools or equipment. Patients can also try out different exercises to see which works best.
The following methods focus only on breathing exercises, but there are other ways, such as combining breathing with things like yoga, imagery, and meditation.
The first exercise presented is called belly breathing and is simple to learn and easy to do. It’s best to start there, especially for patients who have never done breathing exercises before. The other exercises are more advanced, but all of these exercises can help patients relax and relieve stress.
Belly breathing is easy to do and very relaxing. Patients can try this basic exercise anytime they need to relax or relieve stress.
Sit in a comfortable position.
Put one hand on your belly just below your ribs and the other hand on your chest.
Take a deep breath in through your nose, and let your belly push your hand out. Your chest should not move.
Breathe out through pursed lips as if you were whistling. Feel the hand on your belly go in, and use it to push all the air out.
Do this breathing 3 to 10 times. Take your time with each breath.
After mastering belly breathing, patients may want to try one of the following more advanced breathing exercises.
4-7-8 breathing This exercise also uses belly breathing and can be done either sitting or lying down.
To start, put one hand on your belly and the other on your chest as in the belly breathing exercise.
Take a deep, slow breath from your belly, and silently count to 4 as you breathe in.
Breathe out completely as you silently count from 1 to 8. Try to get all the air out of your lungs by the time you count to 8.
Repeat 3 to 7 times or until you feel calm.
Roll breathing The object of roll breathing is to develop full use of the lungs and to focus on the rhythm of breathing. It can be done in any position, but while learning, it is best to lie on the back with knees bent.
Put your left hand on your belly and your right hand on your chest. Notice how your hands move as you breathe in and out.
Practice filling your lower lungs by breathing so that your “belly” (left) hand goes up when you inhale and your “chest” (right) hand remains still. Always breathe in through your nose and breathe out through your mouth. Do this 8 to 10 times.
When you have filled and emptied your lower lungs 8 to 10 times, add the second step to your breathing: Inhale first into your lower lungs as before, and then continue inhaling into your upper chest. As you do so, your right hand will rise and your left hand will fall a little as your belly falls.
As you exhale slowly through your mouth, make a quiet, whooshing sound as first your left hand and then your right-hand fall. As you exhale, feel the tension leaving your body as you become more and more relaxed.
Practice breathing in and out in this way for 3 to 5 minutes. Notice that the movement of your belly and chest rises and falls like the motion of rolling waves.
Practice roll breathing daily for several weeks until you can do it almost anywhere. You can use it as an instant relaxation tool anytime you need it.
Caution: Some people get dizzy the first few times they try roll breathing. If this happens, slow breathing down and get up slowly.
Fibromyalgia and Costochondritis are two conditions that often go hand in hand with each other. Over the years we have lost count of the number of clients who were plagued with the hallmark sharp stabbing pains, that often come with Costochondritis. Within this topic are many questions, most of which become a whole lot harder to answer when we factor In Fibromyalgia.
There are many people in the general population who have Costochondritis, it’s not just another issue that comes along with Fibromyalgia. However, as we will come to find when we take a look at some of the research, Costochondritis does seem to be far more prevalent in those with Fibromyalgia.
Costochondritis is the term given to inflammation of the cartilage that joins your ribs to your breastbone, also known as the costochondral joint. Inflammation is a natural response to illness or injury, it’s essentially the immune system’s response to help initiate the healing process, in other words, it is a defence mechanism that is vital to our survival.
Whilst Inflammation is one of the body’s greatest tools, it doesn’t feel all that great when it does happen. After all, the point of inflammation is healing, and this means that more blood is redirected to the area, tissues become more permeable to allow increased blood flow and nutrients to the areas, and the nerves in the surrounding areas become a whole lot more sensitive. If you have ever had a paper cut you will know exactly what I mean. For such a small cut, it sure does impact your day to day activities.
With Costochondritis, the costochondral cartilage, which connects your ribs to your breastbone, and surrounding tissue can become inflamed, making it tender and unpleasant when pressure is applied, and in most cases, simply from breathing or even moving.
The obvious leading symptom is chest pain, typically it is described as a sharp or stabbing pain, and sometimes it is described as more of a dull ache which often becomes worse when moving or exerting the chest muscles. This can also include breathing, which can cause an increase in pain with large breaths. Many people find that even the slightest touch or pressure around the sternum and ribs can fire off a pain response, as the nerve becomes more and more sensitive due to the inflammatory response.
The most commonly reported pain from Costochondritis can be found in the sternum, around the 4th-6th ribs. However, as the inflammation increases, it’s not uncommon for the pain to begin to spread.
Again, this question takes a little research and some critical thinking to answer. There are some good studies that show us that there is a pretty strong connection between fatigue and Rheumatic conditions in general. In one study of patients with different rheumatic conditions, there was found a 54% prevalence of fatigue for those with a single inflammatory rheumatic disease, such as rheumatoid arthritis, systemic lupus erythematosus, or ankylosing spondylitis. However, this prevalence shot up to 82% for those with Fibromyalgia. In essence, from this and multiple other studies, one out of every two patients with a rheumatic disease seems to be severely fatigued.
On one side of the coin, there are many folk in the general population who do have Costochondritis but report minimal fatigue. And on the other side of the coin, we have those with fibromyalgia and Costochondritis, who report major fatigue associated with it. It’s unlikely that costochondritis directly causes fatigue, as both those with fibromyalgia and without it would be affected. However, that does not mean that it does not indirectly cause fatigue.
If you ask anyone with chronic pain about sleep, they will tell you that it’s incredibly difficult to get a good nights sleep when you are in pain. And one of the hallmark symptoms of sleep disturbances and deprivations is fatigue. Therefore, it’s not such a huge leap to assume that someone with Costochondritis, or Fibromyalgia and Costochondritis, would experience fatigue as an indirect result of being unable to sleep properly due to being in pain.
Likewise, many people with Fibromyalgia, often learn and develop certain coping skills for sleeping when it comes to dealing with the pain of Fibromyalgia. It’s very likely that due to differences in the pain experience, Costochondritis may cause undue stress and anxiety which could disrupt sleep also. Pain from Costochondritis is very hallmarked, it’s sharp, disruptive, and can often make people wonder if there is something wrong with their heart. Therefore, many people with Fibromyalgia and Costochondritis may struggle to sleep due to the new pain that comes from Costochondritis.
When living with Fibromyalgia, it is often hard to distinguish what pain comes from which issue. Many people have gone to their doctors with legitimate concerns, only for those concerns to be passed off as just another Fibro symptom.
One example of this is from a consultation we had here at chronicillness.co, some years back. A young woman had been suffering from severe headaches and every time she went back to the doctors it was promptly put down as caused by Fibromyalgia. However, at her consultation with us, and after going through her history, it was blatant that this young woman had Ehlers-Danlos syndrome. What also stood out was that her headaches were immediately cut in severity when she lay down. Suspecting a Cerebrospinal fluid leak we quickly referred her to her local hospital. And low and behold, it was indeed a spinal fluid leak. After a blood patch, and bed rest to closely monitor for leak recurrence, she recovered after around 6 weeks and has never had another headache since.
We have many stories from over the years just like this one, but the point to take is that you should never put new symptoms down to Fibromyalgia.
While working with our clients in the studio, it’s really not uncommon for us to get the “Is my Costochondritis and Fibromyalgia related?” question. And this is a good question, anecdotally you probably know a whole host of individuals with Fibromyalgia and Costochondritis, but are they related.
When looking at the evidence on this topic, it becomes more clear that they are likely linked, as the prevalence of patients with Fibromyalgia who also have non-cardiac chest pain is far higher than in the general population. In a study conducted in 2016 that looked at symptoms of people with Fibromyalgia, across 4 groups it was found that on average, 29.1% of the 313 participants either currently or previously had Costochondritis. And when compared to the general population, it was found that chest pain in primary care it only accounted for 13%.
In an overview of symptoms of patients hospitalised in the US between 1999-2007, there were over 1.7 million people during this time with Fibromyalgia, of those patients, 10% presented with non-specific chest pain (around 170,000 people). While this is closer to the general population we have to remember that these were only the ones who felt the pain was bad enough to go to the hospital, and its worth remembering that when living with Fibromyalgia, it tends to take a much higher level of pain before seeking medical intervention due to living in pain being accepted as normal.
There may well be a few reasons why are more commonly found together:
Sleep If the last few decades of research into sleep and pain have taught us anything, it’s that with lack of sleep comes a prevalence for more pain. Sleep disruptions lead to hyperalgesia pain changes, which means that your brain becomes far more responsive to noxious stimuli, lowering the pain threshold, and even going as far as to impact our own bodies’ ability to realise pain-killing chemicals. For those with Fibromyalgia, sleep is most often a major issue. Therefore, an activity that would not normally be deemed as strenuous, may become strenuous for someone with Fibromyalgia, and could potential lead to the development of Costochondritis, due to inflammatory responses from strenuous activity or movement.
Guarding response For those in pain, it’s really not uncommon to find them adopting postures to make the pain more bearable. Whilst this may help in the short term, over time staying in any one position can become painful. In the instance of Costochondritis, it’s not a far reach to assume that putting prolonged strain on the costochondral joints and cartilage, could potentially cause an inflammatory response causing Costochondritis for those with Fibromyalgia.
Lack of activity The decrease in activity levels amongst those with Fibromyalgia, as well as being in pain, can lead to sensitisation which lowers tissue tolerance to stress before an inflammatory response is deemed necessary. For tissue to be healthy, we need to move, and for those with Fibromyalgia, this can often be an issue. This gives us another potential reason for a link between Fibromylagia and Costochondritis.
Hypermobility It has been shown in a number of studies that there is a link between hypermobility and Fibromyalgia. One study showed that 46.6% of the Fibromyalgia patients participating, scored at least 4 or more on the Beighton scoring system (A method used to determine hypermobility), compared to 28.8% of the control group. When we look deeper at the connection between Fibromyalgia and Hypermobility, the issues surrounding chest pain and Fibromyalgia can be further explained.The high prevalence of misdiagnosis in the hypermobile population, most likely contributes to the increase of those with Fibromyalgia experiencing inflammation of the chest. A common symptom surrounding hypermobility, is that of joint subluxation/dislocation, due to the genetic make-up of collagen. And a common issue associated with this is rib subluxation. We wrote an article around hypermobility rib subluxation earlier this year, which you can find here. Hypermobility may account for the prevalence of Costochondritis in the Fibromyalgia population, as slipping rib syndrome is pain from inflammation of the cartilage that.
Chest pain can be terrifying when it happens, it can even be severe enough to mimic the symptoms of a heart attack. I remember when I had my first experience of this, I actually thought I was dying and it wasn’t until I was in the hospital, that I found out that I was fine. But, none the less it was a pretty scary experience, as I couldn’t breathe properly because of the pain, and it felt like a tight band around my chest.
The good news though, is that Costochondritis is it is not cardiac related, so it isn’t related to the heart. When there is inflammation in the chest this often leads to shortness of breath, due to us trying to breathe in a more limited fashion to reduce the pressure on the chest. This change in our respiration will often lead to us not taking in as much oxygen as we normally would, and can leave us feeling like we can’t breathe and panicked. But, again, Costochondritis is it is not cardiac related.
Living with Fibromyalgia is bad enough, but when adding Costochondritis to the mix it can seem a whole lot worse. But can Fibromyalgia make Costochondritis worse?
Fibromyalgia often leads to central and peripheral sensitization where nerves are a lot more sensitive to noxious stimuli, so it will take less pressure on the chest before these nerves fire and alert the brain of a potentially dangerous stimulus. This would make it feel a lot more tender to the touch than it should normally be. Think of a turn dial that usually likes to sit at 1-3 unless something is wrong (like inflammation) and is then turned up when there is an issue. With Fibromyalgia though, the dial is already sitting at 7, so when a potential threat is noticed this can turn it up to 10. This can result in more painful sensations than are usually warranted. So, given what we know about the current pain mechanisms, having fibromyalgia is likely to make having Costochondritis worse than it would be for someone without fibro.
Your first port of call when it comes to Fibromyalgia and Costochondritis should be your doctor. Anti-inflammatories will help to deal with a lot of the pain from Costochondritis, but this isn’t a long term solution. As we previously mentioned, having a healthy and happy rib cage means that it needs to be able to move freely, so this should be your second port of call: focusing on relearning to move your ribs.
We would also suggest that you check to make sure that you are indeed not Hypermobile and that the pain doesn’t arise from a rib subluxation.
We often get asked about Fibromyalgia and Osteoarthritis from our clients, because more often than not, they have been told numerous scary stories by consultants. Likewise, many of the people we speak to have read many articles online, that are laden with misinformation. Osteoarthritis as a whole, gest a bit of a bad reputation, despite being completely normal and inevitable.
In fact, even the name Osteoarthritis is somewhat of a misnomer, as “Osteo” means bone,”‘Arth” means joint, and “Itis” means inflammation. And when we realise that Osteoarthritis is a degenerative condition, not an inflammatory one, we can start to see why there is likely so much misinformation around fibromyalgia and osteoarthritis, especially considering it’s not even named correctly!
For those of you reading, we can appreciate that having more labels attached to you can be a scary thing. A lot of the time people have only just gotten used to and accepted the Fibromyalgia label, before being hit with another in the form of osteoarthritis. Unfortunately, for most people, a quick google of Fibromyalgia and Osteoarthritis brings up many horror stories and a tonne of misinformation. This misinformation has the potential to not only make your pain worse, but ultimately make your world smaller and smaller as you inevitably try to protect yourself more and more over time.
So, in the following article let’s take a look at a few things that we should know about when it comes to Fibromyalgia and Osteoarthritis.
Osteoarthritis is defined as “Degeneration of the joint cartilage and underlying bones, usually accompanied by pain and stiffness, and most commonly found in the hips, knees and thumb joints.”
In a healthy joint, a coating of tough but smooth called cartilage covers and protects the surface of the bones, helping them to move freely against each other. However, when a joint develops osteoarthritis, part of the cartilage thins and the surface becomes rougher. This means the joint doesn’t move as smoothly as it should, causing the protective cartilage on the ends of your bones breaks down, potentially causing pain, swelling and problems moving the joint. When cartilage becomes worn or damaged, all the tissues within the joint become more active than normal, as the body tries to repair the damage. This can result in swelling and inflammation of the joint.
As we mentioned earlier, Osteoarthritis isn’t really properly named, because whilst there can be inflammation present, it’s the degeneration that defines it. After all. we already have a name for inflammatory arthritis which we call Rheumatoid arthritis.
There is a good chance you are reading this because you have Fibromyalgia and Osteoarthritis, and you want to know if they will affect one another. Well, having fibromyalgia does change a few things when it comes to osteoarthritis, but it’s mainly not anything to do with the actual tissues, and don’t worry, we will cover these other factors in this article. But, before we get into how Fibromyalgia may affect osteoarthritis, let’s start with a question that’s a little easier to answer for: why do we get Osteoarthritis in the first place?
As we age our bodies incur wear and tear from just being alive. Our hair grows thin and turns grey, our skin thins, and we developed wrinkles. It is essentially just part of the human condition, and just as we degenerate on the outside of our bodies, we also degenerate on the inside.
No, they don’t, well not physically anyway. Anti-wrinkle cream is a multi-million-pound industry, so it’s evident that wrinkles do cause some emotional distress for the majority of us!
So then, if degeneration on the outside of the body doesn’t cause us any pain, then why would degeneration on the inside cause it?
Keep in mind also, that we are way more sensitive to changes on the outside of the body than we are on the inside. There are a great many people right now, with very severe degeneration, who have absolutely no pain. Likewise, there are also people with very little osteoarthritis, who are in a great deal of pain. Before we get into the complexities that is Fibromyalgia and Osteoarthritis, it’s important to remember that this wear and tear is a normal part of ageing. In fact, in the next section, let’s take a look at a few studies that show us that normal wear and tear can actually be painless or not correlate to damage.
As we mentioned before, there is a lot of misinformation around Osteoarthritis, and probably even more around Fibromyalgia. So, let’s take a look at some studies and start to break down those damaging narratives that you have likely been told or have read.
One study focusing on professional football players found that 92% of football players had at least 1 spinal degenerative condition, but in some cases, more than 6 were found. The interesting thing was that none of them reported any pain. This is a nice study that helps us look at the complexities of pain, as when it comes to chronic pain it isn’t always about the tissue.
There is a ridiculous amount of evidence that shows us that pain is not tightly linked to tissue damage. And when it comes to Osteoarthritis, there should also be evidence of people with severe degeneration shown on a scan, but who feel fine, and vice versa. This study of 113 people found exactly that, a huge disconnect between degeneration and pain. In which they found that the people with less degeneration had more pain, and those with more degeneration had less pain!
It kind of changes your opinion on some of the stuff you have been told doesn’t it.
Another study looking at the general population, wherein the focus was on the difference between structural changes in the knees and symptoms, found that there isn’t a great connection between the severity of the condition and pain. However, they did find that the symptomatic group had a slower walking speed, longer stride and standing times and reduced strength. Which, when you think about it, makes complete sense. If you are in pain it’s unlikely that you’re going to be moving quickly, but rather taking your time in an effort to not increase pain levels.
That was the only real difference that this study found between those with Osteoarthritis who had pain and those with it who had no pain. Keep in mind also, that another study found that cartilage defects were found in around 11% of those under the age of 40 who had no pain. This percentage jumped to 43% for those over the age of 40, but still without pain. As you can start to see, that actual amount of degeneration doesn’t really correlate with the amount of pain you would expect someone to have.
In this study, it wasn’t just the cartilage they focused on, but also tissue. There were instances of meniscal tears in up to 19% of the study, bone marrow lesions and even bone spurs were present in 12-24%. I think a good place to end this section is to look at a study from 20 years ago, that will really challenge your beliefs about osteoarthritis and pain.
This study showed that people who received a fake arthroscopic knee surgery for Osteoarthritis had results just as good as people who received the real surgery. And in 2008, the New England Journal of Medicine added more experimental evidence to the pile, reporting that “surgery for osteoarthritis of the knee provides no additional benefit to optimized physical and medical therapy.”
In the years to follow, there has been an exceptional level of evidence showing that arthroscopic debridement has no benefit, showing that it is no better than a placebo.
We have established that the amount of Osteoarthritis doesn’t really correlate with the amount of pain a person experiences. So what is going on then if it’s not about the actual degeneration? Well, this is where Fibromyalgia can start to make things a little bit more complicated.
When we look at the pain and symptom severity of Osteoarthritis, historically, cartilage damage was believed to be the hallmark of Osteoarthritis. However, since cartilage is an avascular, aneural tissue, the mechanisms of pain are likely to be way more complex than first thought, and most likely influenced by non-cartilaginous structures in the joint including the synovium. The current body of evidence points to pain sensitization, and molecular pathways, as the possible main driver of Osteoarthritis pain.
Like we said before, when it comes to chronic pain, it’s not always about the tissue. We know chronic pain changes the brain and nervous system, causing the brain to take note of inputs that it really shouldn’t be. Hence why so many with conditions like Fibromyalgia often developed other conditions such as allodynia.
The Simple answer is yes, it is more common than you think, in fact when you are going through all the tests to get your Fibromyalgia diagnosed, you’ll most likely be told about degeneration somewhere in the body.
Both diagnoses have overlapping symptoms such as pain, stiffness, and limited range of motion. It’s also not just Osteoarthritis and Fibromyalgia, but other rheumatic conditions. One study showed that between 20-30% of those diagnosed with Fibromyalgia, also had co-morbid rheumatic conditions. When we look at the data for just Osteoarthritis, we find that between 10% – 17% of those living with Fibromyalgia also have Osteoarthritis
As we mentioned earlier, Fibromyalgia does indeed have the potential to complicate Osteoarthritis.
Those with Fibromyalgia suffer from abnormalities in the way that the brain deals with pain. Supraspinal processes have a top-down enhancing effect on nociceptive processing in the brain and spinal cord. Studies have begun to suggest that such influences occur in conditions such as fibromyalgia. This means that those who do have Fibromyalgia may be far more sensitive to noxious stimuli compared to the general population. Factoring in changes at the joint, those with Fibromyalgia may be more prone to reacting to these changes byways of producing pain.
There have been a few studies that have looked into how Fibromyalgia may affect Osteoarthritis. One such study published in the European Journal of Neuroscience, measured brainwaves in response to short painful laser pulses on the skin of patients suffering from osteoarthritic and fibromyalgia pain, as well as test subjects who had no underlying pain. Scientists discovered that the insula cortex part of the brain increased its activity when expecting a painful pulse, as it predicts the extent and intensity of the patients’ own chronic pain.
It is important to keep in mind, that increased activity in this brain area has been linked to a number of phenomena, including body perception and emotional processing, which might explain the greater pain perception in some patients.
In essence, there are a lot of factors that come with fibromyalgia that can make osteoarthritis worse, when compared to individuals without it. One such factor is sleep disturbances. It is well documented that with sleep disturbances and lack of sleep, comes an increase in pain. For those with Fibromyalgia, getting a good, restful night’s sleep can be somewhat of a challenge due to pain. Meaning that it has the potential to create a breeding ground for worsening the symptoms of not just fibromyalgia pain, but also the pain of Osteoarthritis.
With chronic pain, also comes the prevalence of mental health issues, which can also make symptoms worse. It is well established that mental health issues can be a large driving force behind chronic pain. And for those with Fibromyalgia, they may be more prone to experiencing pain with Osteoarthritis, whereas those without fibromyalgia may likely not even notice these degenerative changes.
We have taken a look at what Osteoarthritis is, how it’s caused, and how Fibromyalgia may affect it. All that is left now is to look at some of the things that can help you when it comes to Fibromyalgia and Osteoarthritis.
Massage It has been shown that massage can be particularly effective at lowering pain in osteoarthritis and Fibromyalgia. An analysis of 9 studies found that massage helped to improve pain, anxiety, and depression associated with Fibromyalgia.
Stay hydrated It is estimated that around 70% of your cartilage is made up of water, and when we are dehydrated this is going to affect the joints, as the more lubricated a joint is, the less friction there will be. This is important when we remember the studies into those with Fibromyalgia being more sensitive to noxious stimuli. We want to reduce the amount of noxious stimulus coming into the nervous system.
Cold showers The benefits of cold showing with Fibromyalgia can be found in a comprehensive blog post we wrote, which you can find here. The benefits of cold showering with Osteoarthritis can help by reducing pain, decreasing swelling, and constricting blood vessels.
We hope the above has helped to answer the questions you have about Fibromyalgia and Osteoarthritis, and we wish you the best of luck on your journey.
Pain can be broken down into two categories: acute pain, such as a cut on the leg, a tension headache, or a bone fracture, and chronic pain, pain which lasts longer and can be more serious. Let’s take a look at the major differences between the two.
Acute pain is normal pain that lets the body know it’s been hurt. For example, breaking a leg, banging an elbow into a door, or putting a hand on a hot plate and feeling the burn are all considered good pain because the body is announcing that an injury has occurred.
Acute pain starts suddenly and usually doesn’t last long. When the injury heals, the pain stops. For example, a broken leg will hurt during recovery but will get better as time goes on.
With chronic pain, the pain itself actually becomes a disease. When the injury heals and the patient continues having pain beyond the time of expected recovery, that’s chronic pain.
Chronic pain lasts for weeks, months, and even years. Generally, it’s diagnosed after three to six months of pain. In some cases, the pain comes and goes. With chronic pain, one’s nervous system is sometimes altered, making it more sensitive to pain. As a result, painful sensations might feel more severe and last longer.
In some cases, certain chronic diseases cause chronic pain. Arthritis, for example, and cancer, diabetes, and fibromyalgia are other diseases that can cause continuing pain
Unfortunately, doctors cannot always find the cause of chronic pain. In a minority of cases, the cause is unclear. Patients should talk to their doctor about their pain if the pain lasts longer than reasonably expected. Some guidelines have defined “chronic pain” as pain that lasts longer than 3-6 months, but whenever pain lasts longer than reasonably expected, it’s crucial to treat it to keep it from worsening into chronic pain. An example of this would be a small cut or burn which normally wouldn’t cause pain after a month; if it does, a doctor should be called rather than waiting for three months.
People with disorders that cause chronic pain should also talk to their doctors about treatments that provide relief or help them to cope with pain. Treatments include pain relievers and other medications, acupuncture, biofeedback, relaxation training, hypnosis, distraction techniques, and transcutaneous electrical nerve stimulation. With this last method, patients use a TENS device to pass a mild electrical current through the skin to reduce pain.
Most patients with pain don’t need to see a pain specialist, but if the pain lasts much longer than expected, or a primary care doctor or specialist hasn’t been able to treat the chronic pain satisfactorily, asking for a referral to a pain specialist may help.
Patients should go to a physician specifically trained in pain so they’ll receive a medical exam to diagnose their problem, as well as proper pain management. Typically, these pain specialists come from the fields of neurology, anesthesia, psychiatry, and physical medicine and rehabilitation. Then they undergo additional training in pain medicine.
People generally have some issues with the specific hypermobility knee exercises that are currently out there. They either don’t work or they yield very little results. This is largely due to the simple fact that the current treatment around exercises for those with hypermobility, are built on a false premise and simply do not take into account the nuances that come with this population.
The gold standard at the moment for hypermobile knee exercises, and indeed any exercise for those with hypermobility, seems to be the old “build muscle around the joint to help stabilise it” approach.
This old outdated approach that has seen many hypermobile people simply lose interest in, after seeing it return such little results, comes with 2 main issues. Issues that most people don’t really talk about.
Building muscle requires sufficient load and consistency to do so. How is anyone with unstable joints supposed to use such load required to build muscle and not get injured?
Muscle gains are slow. If we use women as an example, and whilst ensuring that training and diet are on point, we could expect to see around a 10lb gain in muscle mass over the course of a year. However, there are no studies that follow muscle gain in those with hypermobility. So how much muscle are we supposed to add to create stable joints: 5lb, 25lb? and how are we supposed to even add muscle tissue when we can’t handle the load required to build muscles in the first place?
There are also other issues, such as why do women with high muscle mass still dislocate, whilst others with less muscle mass dislocate less?
The current treatment seems to fall apart somewhat when we start to question it. No wonder this current treatment has caused so much distress and gaslighting to those with hypermobility when it doesn’t even make any sense. We have seen so many people in the studio who have all reported the same thing, they did their physio, it didn’t work, and they were blamed for not trying hard enough.
Many people have used many different forms of exercise to help stabilises hypermobile knees, and whilst we often see swimming or hydrotherapy as a form of great exercise, please remember there are issues with these.
We live on land and we need to be able to deal with the various forces that enact upon us. Whilst swimming can be a great form of cardiovascular exercise, it is not doing a great deal in the form of stabilising our joints, and it takes away the loading forces that will help up in the long run, which can decondition us further.
There is also an issue with the use of hydrotherapy, those 39-degree waters will vasodilate our blood vessels, forcing our hearts to work harder to pump blood around, as well as causing blood pooling, potentially making us dizzy and faint. Which is not want we want when we are in a large body of water.
Load is a crucial part of stabilising joints, however, it needs to be the right form of load. Open chain exercises such as the leg extension machine you would find at any gym, are a good example of bad load, putting large leverage forces through tissue, which those of us with hypermobility can not properly handle(yet).
A good hypermobile knee exercise needs to be transferable to everyday life, meaning the benefits of it cross over to other movements and other activities.
There seems to be much demand for a simple and effective hypermobility knee exercise. So, below you can find one of our favourite hypermobility knee exercises, which is aimed at helping those with hypermobility and Ehlers-Danlos syndrome, by addressing some of the real issues that need to be addressed.
Keep in mind, that a large problem with hypermobility exercises, in general, is that individuals tend to have trouble contracting the right tissues or even feeling the muscle they are exercising in the first place. This is why a tactile cue, used with a closed chain exercise, is a great way to train the tissue and your brain, in an exercise that is transferable to everyday life.
For this type of exercise, it is far better to use time, rather than sets and repetitions. You can start off performing this exercise for up to 1 minute twice per day, and spend the next 3 weeks trying to get up to a total of 4 minutes.
Headaches are one of the hallmark symptoms of living with Fibromyalgia. Headaches can be debilitating and make everyday life seem almost impossible. But what is a Fibromyalgia headache and is the mystery surrounding them accurate?
It’s no secret that many of our new Fibromyalgia clients, both online and in studio, suffer headaches that disrupt their daily life. By the end of a programmed their headaches are either completely gone or reduced so much they’re almost unnoticeable. There is one key part of a programmed that all of our Fibromyalgia clients must go through; Understanding what Fibro is, but more importantly, what Fibro is not!
Take a look at the Fibromyalgia recovery stories we regularly post to our page and many will say the same thing: the programme is hard! But not in the way you might think. Let’s take an inside look at how our clients get rid of their headaches and how they get their Fibromyalgia success stories.
One important thing to realize when it comes to Fibromyalgia headaches is that Fibromyalgia does not cause headaches, for one simple reason: Fibromyalgia is not a clear cut pathology.
Fibromyalgia is a culturally adopted label that we use to describe a common set of symptoms that appear together. Hence the name Fibromyalgia “Syndrome”. A syndrome being a group of symptoms. In my opinion, as a Fibromyalgia specialist, the hardest part of any recovery is objectively looking at our own understanding of Fibro and our circumstances. It is incredibly difficult to change our understanding when there is so much information available that states the contrary. This bad info usually comes from Doctors, Physiotherapists and other reputable healthcare professionals. Throw Google in the mix and the outlook on Fibromyalgia can be a gloomy one.
It is incredibly easy to believe information that is freely available but is not actually correct. For example, have you heard of the following?
Goldfish have a 3-5 second memory? (Not true!)
Bulls are angered by the colour Red (Bulls don’t have the colour receptors to see Red)
The evil queen from Snow White…what does she say to the mirror on the wall? (Go ahead Google it, it ain’t “mirror mirror on the wall”)
Keep in mind that until very recently (1967) women were not allowed to enter Marathons as it was thought their wombs would fall out! It is no different with Fibromyalgia. There is an abundance of really bad info which simply is not correct. The first step of a programme involves breaking down the Fibro label. When you understand what Fibro is, the whole process becomes so much easier. So let’s take a look and prepare for some against the grain advice and support…
Fibromyalgia is a culturally adopted label for a set of symptoms with no known cause. It is usually diagnosed via a process of elimination. Once all of the “red flag” nasties have been ruled out, a diagnosis of Fibromyalgia is given and we’re put in a box and forgotten about. Been there, done it, got the T-shirt! We are then left to fumble in the dark without any understanding of what’s happening or hope of getting better.
Sound familiar?
Many of our previous and current clients experience the same thing. So bearing in mind Fibromyalgia has no pathological cause (no blood markers, no imaging findings, no sample findings, no diet findings.) Can there be headaches caused by Fibro?
The National Institute of Clinical Excellence (NICE) and the International Classification of Headache Disorders (ICHD) do not recognise Fibro as a cause of headaches.
And this is where most people struggle. The headaches and pain are very real. I’ve personally had pain dismissed as “all in your head” with the age-old advice of “try some meditation or Yoga.” If it was that easy none of us would need help. If we can change our understanding of Fibromyalgia from a disease to a syndrome we stand a much better chance of recovery.
So what is a syndrome? Well, it’s a common set of symptoms that group together with no known cause. Some common Fibromyalgia symptoms are:
If you can change your outlook on Fibro, then recovery is possible. If not, people enter a never ending cycle of trying all kinds of different treatments then accepting life as it is. At this point, things only get worse. Please don’t be one of those people!
A few paragraphs back I mentioned NICE & ICHD do not recognise Fibromyalgia as a cause of headaches. Having worked with the Fibromyalgia community for several years now, I’ve noticed there are several types of headaches that are prevalent and also recognised by the ICHD. These are:
A very common scenario we see in studio or online is people suffering from one of the above headaches which have been passed off as a “Fibro headache.” This can pose a lot of problems, the main one being you will not receive the proper care for your headaches if they are simply passed off as being caused by Fibromyalgia.
It comes as no surprise that if you are in pain, stressed out, and unable to partake in the life you want to live, headaches are most likely going to occur. Let’s look at the cold hard facts of the common headaches we see frequently.
The sensation of tightness or pressure across the forehead or on the sides and back of the head
Tenderness in the scalp, neck and shoulder muscles
A Tension-type headache is a diagnosis of exclusion, a catch-all term used to describe a headache that isn’t a migraine. It is a pretty vague term.
Whilst the etiology of TTH is thought to be multifactorial, involving genetic and environmental factors, the most common theory supports a heightened sensitivity to pain in people who have tension-type headaches. Increased muscle tenderness, a common symptom of tension-type headaches, may result from a sensitised pain system. Hmmm…. sounds a lot like the people diagnosed with Fibromyalgia, doesn’t it? When diagnosed with Fibro, moving can be an absolute nightmare. The threat of a flare-up can all but make us a hermit. This lack of movement and a sensitised system may be a large contributing factor in causing tension-type headaches. We know that stress and anxiety naturally cause us to tighten up which throws further fuel on the fire.
Fibromyalgia headaches can also come with a cocktail of meds. GABA drugs, amitriptyline drugs and opioids like Tramadol amongst others like Codeine/Morphine. Starting a course of these drugs can cause horrific headaches and cognitive impairment (brain fog). Do you feel like a zombie after taking Tramadol or Pregabalin? I certainly did and I was still in pain! Getting off meds is just as bad.
Probably the most guilty of this are the GABA drugs; Pregabalin and Gabapentin. A little known fact about these drugs which shocks a lot of our clients (it may shock you too!) is they are primarily used an anti-epileptic drug. In other words, they dampen activity in the brain. Check out the NHS & BNF descriptions of Pregabalin and see for yourself its uses and side effects (Spoiler; It’s headaches amongst other nasty stuff) No wonder we feel like a zombie!
The secondary use is for nerve pain. So if you’re an epileptic with nerve pain, this is the drug for you. If you suffer from chronic pain, this drug is may contribute to the problems of brain fog and headaches. When our clients lay their Foundationsand start to see results, we then start to have them dose down their meds with their doctor when they realise it’s doing them no favours.
Migraines are another common finding with Fibro. Some people have true migraines, others have a lacklustre diagnosis after seeing a GP several times with previous headaches. You may then be prescribed a drug like Amitriptyline or Sumotriptan and left to it. If these drugs help your headaches, then it is likely that you are suffering from a true migraine. However, if they don’t, they may be contributing further to your headaches. These drugs are also guilty of causing incredible jaw stiffness, which can further add to the tension-type headache described earlier. Diagnosing migraines is a difficult business.
Any good Doctor will give you a headache diary and compare it to the diagnostic criteria to come to the conclusion of a migraine. If you were given a migraine diagnosis after presenting with a headache, I’d consider reconsidering! It may be a simple fix and save you years of angst.
Another guilty party when deciphering the headache puzzle is the dehydration headache. It seems so simple and is often the first call to action when addressing headaches….How much water do you drink? Not orange juice, tea, coffee or pop, but clear tap or bottled water? For many, the answer will be incredibly low. Sometimes our brain needs to bathe in the liquid gold which is water. Ever had a hangover and a stinking headache? It takes time for it to go away and plenty of fluids.
Our NHS suggests we drink 6-8 glasses per day. That’s often a big ask for even the most active person. But I would trade off not having a headache for needing to pee any day of the week.
When we look at the paragraphs above one thing is clear: Fibromyalgia does not cause headaches: because it’s a word and a label.
People experience headaches for a variety of reasons. The reason headaches are so prevalent in those with Fibromyalgia is likely from the various biological, psychological and social stresses that come with being in pain. From a career of helping people with Fibromyalgia, I can tell you that headaches do not go until all of these stressors are either eliminated or mediated.
It can be hard to follow the advice that is against the grain. Our clients are always tedious when it comes to headaches as they can be one of the worst experiences of chronic pain. It’s not easy to read and accept that Fibro is a culturally adopted label. You may have spent years being told it is an incurable disease and this is life now.
If you trust me on anything it should be this; Fibromyalgia doesn’t need to be your life. We post recovery stories on a regular basis of people just like you. People with debilitating pain, headaches and mobility problems. The only difference between you and them is the context in which chronic pain is viewed. For those that realise recovery is possible, it’s just around the corner.
We’re on a personal mission to lift the veil on Fibromyalgia and Fibromyalgia treatment. What we do has been shrouded in mystery for years but now we’re finally being recognised as the cultural authority on Fibromyalgia treatment and we want to help as many people as possible.
We’ve all been there and taking the plunge is scary. But it’s worth it.
Sciatica refers to pain, weakness, numbness, and/or tingling in the leg and it is caused by injury to or pressure on the sciatic nerve.
The sciatic nerve starts in the lower spine and runs down the back of each leg. Not only does it control the muscles of the back of the knee and lower leg, but it also provides sensation to the back of the thigh, the sole of the foot, and part of the lower leg. When there is pressure or damage to the sciatic nerve, sciatica occurs.
The most common causes of sciatica include pelvic injury or fracture, tumors, herniated discs, and piriformis syndrome (a pain disorder involving the narrow muscle in the buttocks).
When a herniated disc presses on nerve roots, it can cause pain, numbness, and weakness in the area of the body where the nerve travels. A herniated disc in the lower back can cause pain and numbness in the buttock and down the leg. Sciatica is the most common symptom of a herniated disc in the low back.
If a herniated disc is not pressing on a nerve, patients may have a backache or no pain at all.
Sciatica pain tends to vary from patient to patient. Some may feel a mild tingling, dull ache, or burning sensation, but in more severe cases, the pain is sometimes intense enough that a patient is unable to move. Though it usually only affects one side of the lower body, patients occasionally experience pain on both sides.
Symptoms of sciatica are burning or tingling down the leg, pain in the rear of the leg that is worse when sitting, shooting pain that makes it difficult to stand, and weakness, numbness, or difficulty moving the leg or foot. Pain may also extend to the foot or toes depending on where the nerve is affected.
Pain can also start slowly and get worse after standing or sitting for long periods of time, at night, when patients sneeze, cough, or laugh, and when patients bend backward or walk more than a few yards (this most often occurs with spinal stenosis patients).
After sciatica is diagnosed by a pain management specialist, the next step is determining and treating the underlying cause because sciatica is a symptom of another medical condition. In certain cases, recovery occurs on its own and no treatment is required.
The main objective of sciatica treatment is to calm the symptoms and reduce inflammation. Applying heat or ice to the painful area is a good idea, as well as taking over-the-counter pain medications such as ibuprofen (Advil, Motrin IB) or acetaminophen (Tylenol). Patients should reduce their activity for several days, though bed rest is not recommended. Also, avoid heavy lifting or twisting of the back for the first six weeks after the pain begins.
If patients still feel pain, injections to reduce inflammation around the nerve may have to be given. Other prescription medications may also be prescribed, along with physical therapy exercises. Since nerve pain is typically difficult to treat, patients may want to see a neurologist or a pain specialist.
At Chronicillness.co Site, the pain management specialists know that managing the day-to-day symptoms of fibromyalgia can be exhausting and troublesome. Sometimes medication just isn’t enough. This is where alternative treatments, such as supplements and herbs, come in.
Because many people—not just those with fibromyalgia—are now using alternative therapies, Congress has formed the National Center for Complementary and Alternative Medicine (NCCAM). It is part of the National Institutes of Health (NIH), and it helps appraise alternative treatments, including supplements, and define their effectiveness. This organization is now creating safe guidelines to help people choose appropriate alternative therapies that may help their symptoms without making them ill.
Some preliminary studies indicate that some medicinal herbs and natural supplements may help treat symptoms of fibromyalgia. Other studies of herbs and natural supplements, however, are less positive. For patients who want to take a natural approach to treat fibromyalgia, it’s important to learn as much as possible about the therapies to consider. The herbs and natural supplements described in this article are just some of the alternative therapies that may have an impact on fibromyalgia.
5-HTP (5-Hydroxytryptophan) is a building block of serotonin. Serotonin is a powerful brain chemical, and serotonin levels play a significant role in fibromyalgia pain. Serotonin levels are also associated with depression and sleep.
For those with fibromyalgia, 5-HTP may help to increase deep sleep and reduce pain. In one study published in the Alternative Medicine Review, researchers reported that supplementation with 5-HTP may improve symptoms of depression, anxiety, insomnia, and fibromyalgia pains. However, there are some contradictory studies that show no benefit of 5-HTP.
5-HTP is usually well tolerated. But in the late 1980s, the supplement was associated with a serious condition called eosinophilia–myalgia syndrome. It’s thought that a contaminant in 5-HTP led to the condition, which causes flu-like symptoms, severe muscle pain, and burning rashes.
Melatonin is a natural hormone that’s available as an over-the-counter supplement. It is sometimes used to induce drowsiness and improve sleep patterns. Some preliminary findings show that melatonin may be effective in treating fibromyalgia pain. Most patients with fibromyalgia have sleep problems and fatigue, and it’s thought that melatonin may help relieve these symptoms.
Melatonin is generally regarded as safe with few to no side effects. Due to the risk of daytime sleepiness, though, anyone taking melatonin should use caution when driving until they know how it affects them.
There’s no specific evidence that St. John’s wort is helpful in treating fibromyalgia. However, this herb is often used in treating depression, and depression is commonly associated with fibromyalgia.
There are several studies that show St. John’s wort is more effective than a placebo and as effective as older antidepressants called tricyclics in the short-term treatment of mild or moderate depression. Other studies show St. John’s wort is as effective as selective SSRI antidepressants such as Prozac or Zoloft in treating depression.
St John’s wort is usually well tolerated. The most common side effects are stomach upset, skin reactions, and fatigue. St. John’s wort should not be mixed with antidepressants as can cause interactions with many types of drugs.
It’s not known exactly how SAM-e works in the body, but some feel this natural supplement increases levels of serotonin and dopamine, two brain neurotransmitters. Although some researchers believe that SAM-e may alter mood and increase restful sleep, current studies do not appear to show any benefit of SAM-e over placebo in reducing the number of tender points or in alleviating depression with fibromyalgia. Additional study is needed to confirm these findings.
While the studies are limited, it’s thought that L-carnitine may give some pain relief and treat other symptoms in people with fibromyalgia. In one study, researchers evaluated the effectiveness of L-carnitine in 102 patients with fibromyalgia. Results showed significantly greater symptom improvements in the group that took L-carnitine than in the group that took a placebo. The researchers concluded that while more studies are warranted, L-carnitine may provide pain relief and improvement in the general and mental health of patients with fibromyalgia.
Before taking any herb or supplement for fibromyalgia, talk to your pain management doctor at Chronicillness.co Site or pharmacist about possible side effects or herb-drug interactions. Herbal therapies are not recommended for pregnant women, children, the elderly, or those with weakened immune systems. In addition, some herbs have a sedative or blood-thinning qualities, which may dangerously interact with anti-inflammatory painkillers or other pain medications. Others may cause stomach upset if taken in large doses.
It’s not uncommon for those with Fibromyalgia pain to feel defeated following a doctors visit, as over the years pain has been somewhat of a blind spot for doctors, with most having a difficult time treating even the most common types of pain. In one study looking into this very topic, it was found that 82% of graduates lacked basic competency in this area, if you also factor Fibromyalgia pain into this equation, then it’s likely to get even more complicated.
Let me start by saying that pain is a very real experience, it destroys lives and it certainly doesn’t discriminate who it chooses. However, much like what I just wrote, we tend to anthropomorphize pain. We assign negative human qualities to it, as at times it feels like it’s malicious in its very nature. I know that at the moment it may feel like it’s you versus your fibromyalgia pain, battling every day with this omnipotent foe, but the pain isn’t malicious. Pain is your brain trying to keep you safe, it doesn’t mean your body is damaged or that you are ready for a knackers yard, as some of my favorite clients have put it.
In the studio, we often find that one of the most prevalent fears around Fibromyalgia pain is that most believe it means they are damaged. However, if the last few years of research into pain has taught us anything, it’s that this statement is simply not true. In fact, most people with Fibromyalgia can attest to this, as after countless imagining and other tests, there is nothing seemingly wrong with their nerves, bones, or muscle.
It is understandable as to why people can feel like pain does mean damage though, after all, pain is one of our most primal protective responses, and if it didn’t instil fear and force us to worry then it wouldn’t be of much use.
Those with Fibromyalgia are subjected to multitudes of tests, including, blood tests, imaging, and nerve conduction test. However, as is often the case, those individuals are given a clean bill of health once those test results come back normal, despite still being in pain. As I mentioned before, after a plethora of tests to find the reason for your pain come back normal. it can easily leave people a little deflated. I can personally testify to this.
After being diagnosed with Fibromyalgia, having tests conducted, and being told nothing is wrong, it leaves people wondering just what the hell is actually going on.
Pain is defined as: An unpleasant sensory and emotional experience associated with, or resembling that associated with, actual or potential tissue damage.
The definition of pain has remained untouched for many years, but was finally updated in 2020 to add in “resembling that associated with”. Even after all these years we still seemingly struggle to define pain, and rightly so. Pain is ridiculously complex, and we will never truly understand it in its entirety, at least not until we can fully explain consciousness. And even then, we are most likely still going to struggle.
The science of pain has come a long way since we first started to try to understand pain. So, before we get into this, let’s take a little history lesson on pain and see where we have come from, and where we are going.
Aristotle (384 BC – 322 BC) pushed that pain was caused by evil spirits entering the body during injury, and because he was considered a fairly smart guy during his lifetime, his theories seemingly stuck around, for a very long time.
Rene Descartes (1596 – 1650) introduced and eventually solidified the Cartesian Model of Pain (CMP) into history and ultimately medical science. The CMP explained pain as being created in the tissues that would send pain signals to the brain. Even in 2022, a plethora of medical treatments are still being used based on the CMP where people receive nerve blocks, have nerves burnt or are given cortisone injections in an attempt to relieve their pain. However, we now know this model, like many before, has pieces missing, yet is still largely practiced. Keep in mind also, that this theory was created back in a time we were burning people at the stake because we thought they were witches, so there’s always that.
The Gate Control Theory (GCT) by Melzack and Wall was the next kid on the block. This theory explained how the spinal cord acted as a gatekeeper, choosing what dangerous and non-dangerous messages were sent to the brain. Even after some of the greatest minds had come together to help explain pain, the GCT could still not explain how people could be in pain without any messages being sent to the brain. Think of when amputees still feel pain in the limbs that they no longer have(which we are going to look at a little bit later), or in our case much closer to home, when we feel pain despite the lack of tissue damage. If the GCT is to be believed, the pain we feel in these cases is not possible and we all know that’s not true.
We then had the Neuromatrix Model of Pain, followed and updated by the Cortical Body Matrix, which was heavily supported by evidence and built upon the principles of the formation of neurotags. But, alas, even in these later theories of pain, pieces were still missing.
Most recently, we have moved towards the Biopsychosocial (BPS) model of pain. This was first put forth by Dr George Engel in the 1970s. The Biopsychosocial model of pain considers all the biological, psychological and social factors which can influence pain. The Biopsychosocial model explains how pain is created and modulated by the brain, how pain can be influenced by tissue damage or created in the absence of tissue damage. It describes how pain is a multifactorial, personal experience. It is ultimately the BPS model of pain that helped me understand my own personal pain experience and help me ground my method in solid, evidence-based science.
Despite having imagining showing no damage to tissue, bone, or nerves, it can still be hard for individuals to truly believe they are not damaged. After all, it’s hard not to when your muscles and bones ache to such an extent it limits what you can do every day. So, to help hammer home this point of pain not meaning damage, I managed to find some brilliant examples to help show you how pain can exist with or without damage. One such example is that of people around the world who don’t even feel pain!
This is known as “congenital analgesia” and for those with this rare medical condition, their life expectancy is drastically reduced. After all, how would you know if your appendix was about to burst if you couldn’t feel pain? Or how would you know if you were walking on a fractured leg? Well, the truth is you wouldn’t.
There’s a reason we experience pain and it’s not about damage, it’s about protection. In fact, we don’t even need a body to feel pain. There’s no shortage of people with pain in legs and arms that were amputated decades ago, suffering what is commonly referred to as phantom pain syndrome.
Pain is 100% real, but it is also a subjective experience, which means we have no real way of knowing if everyone feels the pain the same way. As I mentioned before, If pain is made in the brain, then we don’t even need a body to feel it. A great example regarding phantom limb pain is the example is of Mark Goddard back in the late ’90s, who fell off his motorbike and began to suffer intense pain in his hand as a result. Mark had multiple x-rays, MRI’s and even nerve conduction tests, and every time, they came back fine. After a while, Mark asked the NHS to amputate his hand, as he felt that he would rather not have the hand if it meant no more pain. After a long drawn out argument with the NHS about the ethics (because he was asking them to amputate a hand with perfectly healthy tissue), they said no.
After being told no by the NHS, Mark had reached the end of his tether and decided that he would take matters into his own hands. Over the next two weeks, he built a guillotine in his shed. Mark waited until his wife went out of the house and he chopped his own hand off! He threw his hand into a bucket and set it on fire so that it could never be reattached, and after a whole year of not having his hand, Mark still had hand pain….despite not having a hand. If you want to read about marks story, you can read his press article here.
I myself have seen this in the studio over the years, as clients report that joints hurt, despite the fact they have had a full knee replacement years ago! They were feeling pain in a piece of metal, which again, is a great way to show you that you experience pain in the brain and not the tissue. Pain is complex, it needs emotion, beliefs, context, and so much more to exist.
Mark is the perfect example that pain isn’t about damage, as he had healthy tissue, but also had pain, then he had no tissue after he removed his hand, but he still had pain. Pain is for protection, it’s not just about damage. In the studio, we see clients every day who have spent decades afraid to even move, in fear they with hurt themselves.
So, if somebody can have no damage and still have pain, can somebody have damage and experience no pain? In short, absolutely!
Take for example Federico who was involved in a shark attack. Fed was out surfing one day when he was attacked and sustained a bite to the arm. After being rescued and pulled to shore, he realised he had also been bitten on the leg and he had never even felt it. You can read about Fed here.
Then there is a great story about Julia, a Russian woman who was walking home one day from work and encountered a mugger. She was unknowingly stabbed in the neck, but took over an hour to realise that the knife was still in there! You can read her story here.
I hope this short article has helped you dispel some of the myths around pain as a result of damage and has encouraged you to do more, and let your brain slowly begin to start trusting your body again.
Lower back pain is a common problem among people suffering from chronic pain, and while upper back pain is not a very common spinal disorder, it can cause significant discomfort and pain when it does occur. The most common causes of upper back pain are muscular irritation (myofascial pain) and joint dysfunction.
While there can sometimes be an injury to a disc in the upper back (such as a thoracic herniated disc or degenerated disc) that causes severe upper back pain, such injuries are usually very rare.
The reason why upper back pain is so rare is that the thoracic spine (also called upper back, middle back, or mid-back) is very different in form and function than the cervical spine (neck) or the lumbar spine (lower back). The neck and lower back are designed to provide us with mobility, but the thoracic spine is designed to be very strong and stable to allow us to stand upright and protect the vital internal organs in the chest. Because this section of the spinal column has a great deal of stability and only limited movement, there is generally little risk of injury or degeneration over time in the upper back.
Because there is little motion and a great deal of stability throughout the upper back (thoracic spine), this section of the spine does not tend to develop common spinal disorders, such as a herniated disc, spinal stenosis, degenerative disc disease, or spinal instability. These conditions can cause upper back pain but are exceedingly rare in the upper back.
Because of this stability and lack of motion, in most cases, anatomic causes of upper back pain cannot be found, and an MRI scan or CT scan will rarely image an anatomic problem that is amenable to any sort of surgical solution for the upper back pain.
Upper back pain can occur as a result of trauma or sudden injury, or it can occur through strain or poor posture over time. As an example of the latter cause, in recent years, upper back pain has become a familiar complaint from people who work at computers most of the day. Often, upper back pain occurs along with neck pain and/or shoulder pain.
The vast majority of cases of upper back pain are due to one (or both) of the following: muscular irritation (myofascial pain) and joint dysfunction.
The shoulder girdle attaches by large muscles to the scapula (the shoulder blade) and the back of the thoracic rib cage. These large upper back muscles are prone to developing irritation (myofascial pain) that can be painful and difficult to work out.
Often, muscular irritation and upper back pain are due to either de-conditioning (lack of strength) or overuse injuries (such as repetitive motions). Muscle strains, sports injuries, auto accidents, or other injuries can all result in pain from muscular irritation.
The ribs connect with the vertebrae in the thoracic spine by two joints that connect with each side of the spine, and dysfunction in these joints can result in upper back pain.
