Nurse who suffers chronic tailbone pain

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I am a Registered Nurse who has suffered with tailbone pain for over 8 years. Like all chronic pain, it is essential that sufferers get the correct support, diagnosis and treatment appropriate for them as an individual. This blog follows my journey with chronic pain, it expresses my personal opinions and thoughts. It is not intended as a replacement for advice or treatment from your normal Healthcare Provider.

Saturday, 7 November 2015

Pain Management and brain retraining

Yesterday I had an appointment at the pain Clinic. The man I saw said he was a physiotherapist, but 'wore many different hats'. I was with him almost an hour. He took a very detailed history. It seemed like psychoanalysis almost!! He kept asking questions like 'how does the pain make you feel'? 'how do you feel that people can't see your pain'? 'how do you cope on a daily basis''?

I think my main reply was 'frustrated'. That is why I started my blog- to SHOUT OUT about COCCYDYNIA!! as no one seems to have any answers, no one talks about it, some people have never even heard of it, and I get fed up of hearing 'it's notoriously hard to treat'. As far as 'coping'- I just do. Life has to go on, and some people are so much worse off than me.

He kept reassuring me that he understood. That the pain is real- although he conceded that I already knew this!

To be fair he was lovely.

His approach was very different to other health care professionals that I have seen.

He told me that my pain is a learnt behaviour. He explained that my body is now oversensitive to pain- something I have been told before. He said that my body reacts by sending pain signals to protect my coccyx from threat of pain, even if really there is no pain. This is in theory similar to 'Central Sensitisation' which I have discussed before.

He explained how pain is generated by ones nervous system  and that by understanding that my pain is generated by my brain, not by tissue damage anymore, I can learn to over-ride the pain signals/warning system. If ones brains perceives a threat of pain, where there is perhaps none, it will still create pain, to protect us. The more pain one has experienced, or over a longer time period, the more sensitised the body is to pain, and the less stimulus it will need to cause pain. In a way it gets 'better' at warning us of a potential threat. However, the truth is that we become more sensitive to pain, and at the same time less precise. But, the fact remains that the pain is authentic. I guess a bit like phantom limb pain experienced by an amputee. Although obviously I am in NO WAY comparing my self to anyone who has gone through this traumatic experience.

I have found an excellent blog discussing the work of Dr David Butler and Prof Lorimer Moseley. It has links to a couple of videos by them both. They discuss chronic pain, and how by working with our brains we may be able to change the body's perception of pain.

Butler and Moseley

Diagram showing acute and chronic pain, courtesy of Butler and Moseley (2003).

My advice to take away, is to increase the amount of time I tolerate pain. By that I mean, the physio has suggested as soon as I start to feel discomfort and would normally change position or get up, to instead, sit through it for a minute, then gradually increase this. The idea (I think) is to retrain my brain so that it realises that what my brain perceives as a threat by producing pain, will be learnt to not be a threat- my brain will realise that actually, sitting one minute longer has not caused me more pain....and so on, until I build up the time I sit.

I can see the logic. I understand the theory. I remain to be convinced, as I know that I have damage here, and a hypermobile coccyx. Whether it is true and this is not actually painful, that is to say, the damage is not causing pain I remain to be convinced. I will try this though. What have I got to lose?

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