21 Mar Rethinking Pain from the Neck Up
When I speak publicly about my experience with chronic pain I often begin my talk by saying, “Everything I know about pain I learned by accident.” It’s true.
“The Accident” left me strapped into the wreckage of my totaled vehicle with an incomplete C4 spinal cord injury, unable to move from the neck down. “You don’t want me like this,” I told my husband, “just let me go.”
He looked at me with fear in his eyes but calmed me by saying, “I love you from the neck up. Keep breathing!”
I did, and I survived through surgery, ICU, and physical rehab as I regained movement and learning to walk again. But then two years later, pain began to take over my life. It began as pins and needles and tingling immediately after my injury but gradually progressed into neck-down burning nerve pain that I could feel inside and out. Pain that had been lurking in the background for quite a while slowly began to consume my life.
Part of why my pain became worse was because of neuroplasticity. The science of neuroplasticity tells us that even into adulthood, our brains are able to adapt, increasing neuronal connections to develop pathways that help us learn new things and develop new skills like learning a language or playing an instrument. But neuroplasticity has a dark side as well. Especially when it comes to pain.
Acute pain is an important warning signal. It alerts us to injury and protects us from further injury. Pain gets our attention, and often our attention helps to solve the problem. Like pulling a thorn from our foot, for example.
But not so with chronic pain. With chronic pain, there is no “thorn” to remove, and no way to fix the pain. As we focus on the pain, the nine areas of the brain that process pain form new connections, and as they do, the pain experience gets worse. This means that most pain patients are actually making their pain worse by focusing on it.
Diagnostic questions like, “Rate your pain on a scale from 1 to 10” also force a patient to hone in on their pain and in the process experience it more. This may be a great tool for assessing and treating acute pain, but focusing on it over and over and assigning it a number can actually make chronic pain worse!
Once I realized that focusing on my pain made it worse I made a powerful personal decision. I chose to reframe my experience by changing my focus. In my case my pain was severe; my whole body burned from the neck down. What could I do? As I thought about it I remembered the conversation we had at the scene of “The Accident.” Now trapped in the wreckage of my own pain the problem was glaringly clear: “I have pain from the neck down and I don’t want to be this way.” And in that moment I found the strength to say to myself, “I love you from the neck up, keep breathing!” From that moment on “neck-up thinking” became the solution to finding a genuine way of escape from the prison of chronic pain.
I look forward to sharing more with you about what I’ve learned in the process of managing my chronic pain. In the meantime, read this interesting article recently shared by friend and fellow industry speaker Mark Pew: Marcus Aurelius, Stoism and Pain.