Whiplash, Pain, and the Brain.

Earlier this week it snowed a lot. Then it melted, and froze overnight. And when I took my dog out for her morning walk, well, you can probably guess what happened. I didn’t make it 20 feet from my door before my feet slid out from under me on a patch of ice and I landed hard on my butt, with my head being painfully snapped back. I was, of course, a little stunned and went back to my house to survey the damage. No broken bones, just some bruises. Over the next few days I monitored myself for signs of concussion, which , thankfully, there were none, but what I did have was a painful stiffness and ache in my neck when I tried to move my head. “Oh great,” I thought. Whiplash.

An Icy Morning.

When I first walked into my house after slipping on the ice, these were the thoughts in my head, “oh no, you have a delicate neck. This is going to be so bad. You are going to be dealing with this for months. What if you have another concussion? That’s going to really mess you up…” and on and on.

Luckily, I had the knowledge and training to know that these thoughts would be the most significant factor in my speed and completeness of my recovery. Even though it was hard, I started to change my self talk. I said to myself, “this is not that bad. You’ll get over it soon with a couple days for your strained muscles to heal. You didn’t hit your head, and there are no signs that anything is seriously wrong. You’re going to be ok.”

At first, I didn’t believe these words I told myself, but I kept up with it. And, over the course of the day, I started believing a little bit of it. But more importantly, my body felt less tense and guarded. Now, three days later, my neck pain is almost completely gone. I didn’t have to go to a chiropractor or have needles stuck in my neck. I didn’t have to do any special exercises except some breathing to calm my nervous system. I didn’t even have to change my daily activities and still did what I would usually do, including exercise.

Of course, it’s not always that easy, and it has not always been the case for me to get over neck pain that quickly. I have had many neck injuries of varying severity, and the pain of them has plagued me for many years of my life. I tried everything, acupuncture, chiropractic, and of course several physical therapists. Those all helped, but my neck pain never really went away until I changed the way I thought about my pain. I know, I know, it sounds like I’m saying, “it’s all in your head.” Which is just not true. But, it is true that a lot of it is in how your head and your body talk to each other.

Pain and the Brain

You see, the brain determines levels of threat, and sends signals to our body on what to do accordingly. When your brain perceives high threat, it starts emitting neurotransmitters that tell your body to tense, to breathe more shallowly, and halt healing processes.

This is actually really good. For example, let’s say you’re a wild human and you get attacked by a tiger. You find yourself bleeding and injured, and your brain knows that it needs to get your muscles tensed and ready to go so that you can hoof it back to your village before you die in the middle of the prairie. (Do tiger’s even live on prairies? Anyway, you get the idea). Your brain, in that moment, is not worried about healing. Healing occurs when you get back to the village and your wounds can be tended, you are safe.

But what if you never get to the village? What if the stress of getting attacked by a tiger is replaced with the stress and worry that’s associated with chronic neck pain, the fear that you will never get better, the threat of having to deal with a stiff neck on top of all the other things you are having to deal with in your life right now?

In this scenario, your body never gets a signal to relax, to soften your tensed muscles, to release a cascade of neurochemical transmitters that promote healing. You become caught in a troublesome feedback loop: your muscles get’s tense, which causes your brain to percieve threat. As a result of that percieved threat, your body get’s more tense. And on and on, until you find yourself dealing with months to years of pain with no one able to explain to you why it won’t go away.

Getting out of the Cycle of Pain

I have been there, in that loop. I have a tendency to go back there, maybe it’s just how I’m wired. I have to actively, consciously, change the way I think about my body and pain in order to subvert that loop. And it works. I also use relaxation techniques and mindfulness meditation practices to assist me in this process. But what has been so fascinating to me is that this is the missing link in healing from chronic pain, and, perhaps more importantly, preventing it in the first place.

This is not news to the medical community; there have been plenty of studies linking a patient’s outlook on recovery to how well they actually recover. This mind body connection is starting to become more popular in pain management, but in most cases it is not emphasized or even acknowledged in our healthcare system. Certainly, there are appropriate times to seek invasive modalities or even surgery, but shouldn’t we start with an intervention that is very low risk and potentially very high reward in regards to resolution of symptoms?

I have created some resources to help you manage your pain and to prevent yourself from developing chronic pain syndromes. It starts with being able to sense and feel your body, in a non-threatening way. This will allow your brain and body to get out of the cycle of threat and pain and back into fluid, alternating, reciprocating motion.

Getting Back in Your Body

A great place to start getting back in your body is with this simple 5 minute Guided Body Awareness Technique. (You should try it, it’s really relaxing!)

Five Minute Body Awareness Exercise.

Remember, pain is not just in your body, and it’s not just in your brain. Whoever says that mind and body are two separate things is just wrong. You can’t treat one and not the other and expect to change the patterns that we live in. If you find yourself in chronic pain, be kind and gentle with yourself. Reconnecting with the sensations in your body is the first step to letting go of these stuck patterns.

May you find ease in your body.

– Dr. Derya

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