I used to feel sorry for people suffering from chronic pain — then I became one of them.
It’s 4:00am, and I’m sitting next to my father in a dead-quiet hospital waiting room.
We’ve been here for about 30 minutes now, and there isn’t another soul in sight.
We exchange small talk in between persistent yawning spells.
Eventually, the lab assistant arrives.
I fill out the necessary paperwork, dress into a hospital gown, wait some more, and then head into the MRI room.
I’ve already had an MRI on my brain; the results for that test came back normal.
This MRI is for my mid-spine, lower back, and pelvis.
I make it through the 35 minutes of endless banging that the machine produces, change back into my regular clothes, and leave with my father.
He drops me off at home and then drives away — either to go back home himself or to head to work, surely picking up a coffee on the way whichever is true.
A few weeks later I see my doctor to get the results of the MRI.
They come back normal:
“A little curvature of the spine and a couple of other minor issues, but nothing out of the ordinary, really.”
Not that I want to be told there’s something seriously wrong with my body.
What I do want, however, is an explanation for why this is happening to me, and I’m still not getting one.
“Where do I go from here?” I ask myself as I drive home.
No answer comes.
Pain, Depression, and Shame at 23 Years Old
There was no single event — no precipitating injury or accident — that caused my chronic pain to emerge.
It just gradually appeared by the time I was about 23 years old, and it wouldn’t go away.
I would experience pain in my pelvis and lower body whenever I sat for more than a few minutes at a time, worked in a hot environment, or felt deeply anxious about something. Some parts of my body would ache constantly throughout the day; some areas of my arms, legs, and stomach would burn from the slightest touch or contact.
Many nights it was impossible for me to sleep, as the warm blankets made my skin feel like it was on fire.
Summers, which I usually spent partying with friends at nightclubs or outdoors music festivals, weren’t much fun for me at this time — too hot, too uncomfortable, too many reminders of other people’s good fortune.
Feeling like life was passing me by, like I was being unfairly ‘punished’ for something, depression took hold.
I became increasingly unwell from an emotional/psychological standpoint.
I felt angry, bitter, hopeless, and powerless to change my circumstances.
I became ever-more convinced that things wouldn’t go back to the way they once were, and this possibility broke my heart.
So I took on the role of a recluse.
I didn’t want to be around other people: the thought of seeing others enjoying life whilst I suffered was unbearable.
My cousin once visited my house around 8:00pm on a Friday.
I was in bed at the time eating junk food and watching a movie.
She knocked on the door, entered the room, and said to me:
“This is how you’re spending your Friday night?!”
I made up some excuse about why I was staying home, feeling increasingly anxious the longer she engaged me in conversation.
She finally left, and I felt ashamed.
I hated my life at the time, and I couldn’t help feeling sorry for myself.
Medical Tests and Doctors Visits
Over a span of several years, I underwent dozens of medical tests and saw more doctors and specialists than I could ever count (including leading pain specialists in my home city).
Virtually every diagnostic test — from EKGs and X-Rays to ultrasounds and MRIs — came back showing normal results.
I never received a formal diagnosis from the established medical profession.
I was prescribed tons of different medications, from first- to fourth-line treatments (everything from topical creams and anticonvulsants to opioid painkillers and tricyclics).
At best, one or two meds helped alleviate my discomfort, but only marginally.
At worst, I could barely function.
I suffered from insomnia, horrible night terrors, extreme fatigue, lack of focus, and a tendency to react to minor surprises (such as a loud voice) as if the whole world were collapsing around me.
After about two years of being in pain, I started seeing a physiotherapist on a weekly schedule.
My physiotherapist, a pelvic health specialist, did wonders for my pain — not in one or two treatments, but gradually over many months.
She would manually manipulate/stimulate my muscles, encouraging the tissues to relax.
She taught me how to become consciously aware of parts of my body that I couldn’t previously sense or feel.
She showed me how to ‘map’ them to my mind, and how to actively release the tension they contained.
After about a year’s worth of weekly treatments, she said to me:
“Your tissues are normal — they’re healthy. Yes, you have some tightness, but there’s nothing fundamentally wrong with you. Physically, everything is fine. I think you need to start approaching this from an emotional or psychological perspective as well. Deep breathing, meditation, cognitive behavioural therapy, yoga — this is the missing piece in your recovery.”
I resisted this idea for months.
I refused to believe that my pain was (also) ‘in my head’.
I convinced myself that another few months of physiotherapy would finally make me pain-free — either that or else a steroid injection or something like it.
Surely, my ‘problem’ was entirely physiological — not psychological.
My specialist, however, insisted that physiotherapy was only part of the healing process.
She told me, again and again, that I needed to start doing work on my own every day in order to ‘calm’, ‘relax’, and ‘de-sensitize’ my nervous system and to reduce my anxiety.
She knew I was stressed out and obsessive—somebody who always worried about the future, overthought things, and tried to be perfect at everything.
She could tell this was the case because my tissues told her as much:
I had been carrying around years’ worth of anger and anxiety inside my body, which is why my muscles had become so tight and sensitized.
My pelvic floor muscles, hip flexors, leg muscles, and other areas were all incredibly tense.
Over time, my physiotherapist helped me realize I had been squeezing certain of my muscles — literally squeezing them from the inside-out — all day, every day for years.
I knew I was ‘emotionally intense’, a workaholic, and an obsessive perfectionist.
What I hadn’t realized, however, was that I had taught my body that its natural state was to be constantly ‘on guard’, engaged in a kind of fight or flight response every waking moment.
The truth was:
After years of ‘living inside my head’, ignoring my body, and forcing myself to do physically unhealthy things all the time — like sit for five straight hours studying without standing up once — my body had become ‘naturally’ tight. That, combined with constant stress about school and work, led to the onset of persistent pain.
‘Woo Woo’ Treatments
After a few more months of heartfelt ‘badgering’ from my physiotherapist, I finally gave in:
I figured it couldn’t hurt to try meditation or cognitive behavioural therapy (CBT) or something along those lines.
After all, I had already tried virtually everything mainstream medicine had to offer, from diagnostic tests to treatments.
Feeling like I was out of options on the ‘hard science’ front, I decided to give some ‘woo woo’ therapy a shot.
I started with ‘ancient remedies’ like acupuncture and osteopathic interventions, but neither one did me any good.
I then ventured into yoga, silent meditation, CBT, and a couple of daily appreciation exercises.
I actually really enjoyed the appreciation exercises.
One consisted of taking ‘mental snapshots’ each time I did something really fun or meaningful.
The goal was to consciously create a mental impression of how lucky I was to be experiencing such a moment.
For instance, if I was on a date with a woman I liked and we were both having a great time, I’d purposely take a few seconds to think to myself:
“It’s Saturday night, and I’m on a date with a beautiful girl. I’m in a nice restaurant drinking wine and eating delicious food. We’re getting along great, and I can tell she likes me. There’s nowhere else I’d rather be right now. I’m grateful for this.”
Doing this helped me to live in the moment and to remain cognizant of how fortunate I was to be creating such memories, regardless of whether I was in pain.
A second appreciation exercise consisted of writing down, every morning, five to eight things for which I was grateful.
They could be mundane and routine:
- “I’m grateful that I have a fridge full of food”;
- “I’m grateful for the fresh snow”; or
- “I’m grateful for yesterday’s phone call with [name]”…
…or more significant and meaningful:
- “I’m grateful that my family has a new dog”;
- “I’m grateful that I got into grad school”; or
- “I’m grateful for [name’s] constant support”.
Taking mental snapshots and creating appreciation lists served to remind me of the positive things in my life at the time, despite the difficulties with which I was dealing.
I also tried yoga, but I really disliked it — I still dislike it today.
There’s just not enough action in it for me.
I’d do it for several months at a time but then eventually give up on it entirely — this happened again and again.
Silent meditation was tolerable for a while.
I would do at night before bed.
On the one hand, I enjoyed the quiet and the need to focus on my breathing.
On the other, though, I always got lost in my thoughts, and this became frustrating over time.
Some of the CBT strategies proved to be very useful.
This was especially true regarding the techniques I learned for managing catastrophization.
My physiotherapist would point out to me whenever I was catastrophizing, and she would help me re-frame the situation so I could see things more reasonably.
Certain books, like The Anxiety and Phobia Workbook, also really helped me recognize and ‘dial down’ my catastrophic thoughts.
As much as I disliked yoga, I began engaging in a twice-daily stretching routine.
Every morning and evening I’d take 30 minutes to try to stretch and lengthen my muscles, particularly my back and leg muscles.
I’d use a foam roller and elastic bands/wraps where necessary.
(Ironically, I’d do a number of yoga poses during my stretching routine, such as cat/cow and happy baby. I think it’s having to hold poses for so long that makes me dislike yoga as such so much…)
The most effective exercise, however, was also the easiest of all to do, i.e., deep breathing meditation — specifically in the form of legs-up-the-wall.
Diaphragmatic Breathing + Legs-Up-The-Wall
Here are a couple of photos of the pose:
I started doing this pose at least twice (often three to four times) per day, for 20 minutes each session.
After swinging my legs against the wall and situating myself, I would focus on 1) taking long, slow inhales that pushed my diaphragm (not my chest!) towards the ceiling and 2) releasing the breaths with even longer and slower exhales. On each exhale, I would 3) try to ‘actively release’ the muscles in my pelvis, i.e., I would consciously let these muscles fall to the floor by letting go of all the tension (squeezing) in this part of my body.
(I’ve been told that, anatomically, it makes more sense to try to actively release the muscles on the inhale rather than the exhale, but that never felt right to me.)
I’d usually listen to a guided meditation whilst performing this exercise — either one for pelvic pain in particular or for general wellness and relaxation.
Every time I did the LUTW yoga pose, I tried to:
- Consciously release muscular tension (i.e., feel the ‘tightness’ in my body relax);
- Let go of my worries for the duration of the session; and
- Feel physically and emotionally grounded (i.e., ‘sunk’ into the Earth and judgment-free).
Once the 20 minutes had expired, I always felt calmer, less anxious/‘revved up’, and more capable of dealing with the rest of the day — even if I was still experiencing discomfort.
Scientifically, this makes sense.
Experts have shown that deep, diaphragmatic breathing leads to:
- A slower heart beat;
- Decreased blood pressure;
- Increased oxygen intake; and
- The release/activation of neurotransmitters in the brain that promote feelings of wellness and tranquility (1, 2, 3, 4, 5).
You certainly don’t have to suffer from chronic pain in order to benefit from LUTW meditation.
It’s a wonderfully relaxing ‘time-out’ that can help virtually every one of us feel more ‘centred’ and at ease in our day-to-day lives.
If you’re just starting out with LUTW, I suggest:
- Placing a thick pillow under your hips and one under head — your back/bum and/or head might hurt without pillows;
- Beginning with 10-minute sessions as you get used to the exercise;
- Bending your knees as necessary, particularly if you feel like your legs are starting to fall asleep; and
- Maintaining 1–1.5 feet of distance between your feet rather than sticking them together if the latter proves uncomfortable.
Two Life-Changing Books, and a ‘Whacky’ Pain Management Technique
In addition to the LUTW and stretching exercises, I began reading two hugely important books for my recovery:
- John E. Sarno’s The Mindbody Prescription; and
- Howard Schubiner and Michael Betzold’s Unlearn Your Pain.
Collectively, these books radically changed my outlook on, and my understanding of, the mind-body connection in general and of the emotional/psychological components of chronic pain in particular.
Specifically, Sarno, Schubiner, and Betzold’s insights ‘allowed me’ to accept that there is real, objective science showing that:
- Emotional trauma can cause and/or amplify chronic pain, irrespective of whether structural abnormalities are present in the body;
- Emotional pain and physical pain are extremely similar, particularly in terms of how they each affect the brain;
- What we tell ourselves (self-talk) and what we say to others can significantly influence our physical and emotional states, and they both have the power to disrupt or facilitate our recovery; and
- We’re far more able to affect our day-to-day happiness than we often believe.
Sarno’s book details his reflections on a lifetime of treating patients with back pain issues, many of whom reported either experiencing pain despite not having structural abnormalities (like a bulging disk) or not experiencing pain despite having structural abnormalities.
Schubiner and Betzold’s book comprises two main components:
- A review of scientific studies into the nature of the mind-body connection; and
- A practical healing program (a workbook) for dealing with chronic pain, which is based on identifying, writing about, and ‘working through’ traumatic experiences.
(Note: I’m not suggesting that every one of Sarno’s or Schubiner and Betzold’s claims is accurate or incontrovertible — some of the assertions in these two books are undoubtedly controversial. I simply wish to point out that these two books played a tremendous role in my recovery.)
The Mindbody Problem and Unlearn Your Pain convinced me to start using a certain pain-management technique every time I experienced physical discomfort:
Whenever my pelvis or legs would bother me, I’d say the following to myself, often out-loud: “Cut it out brain! There’s nothing wrong with me! I’m safe, I’m healthy, I’m strong! There’s no reason for me to be in pain right now! My tissues are normal and healthy! I don’t have to be scared!” Then, I’d get on with whatever I was doing at the time, and the pain would subside.
From a neurological perspective, this empowering self-talk can effectively reduce the sensation of pain because it activates the dorsolateral prefrontal cortex (DLPFC) in the brain.
The DLPFC de-activates the pain-exacerbating effects of the anterior cingulate cortex (Unlearn Your Pain, pp. 24–33.)
If the pain wouldn’t subside despite using this self-talk approach, I’d do 15–20 minutes of deep relaxation.
If I was still in pain at that point, I’d remind myself that the sensation wouldn’t last forever and that I could do more relaxation later if necessary, and I’d carry on.
Weightlifting + My New Self-Talk Strategy
The more I practiced deep breathing LUTW and my self-talk pain management technique, the more I developed the courage to believe that:
- I was healthy and strong; and
- I could engage in physical activities, like working out at the gym, safely and without injuring myself.
And even if I pushed things too far at times, e.g., by trying to lift a bit too much weight whilst squatting, I’d simply take a few days or a week off from the gym, do lots of LUTW relaxation, use a bunch of positive self-talk, and return to training when I felt well enough to do so.
As a preventive measure, I made it a habit to say the following to myself before each workout session:
“I’m healthy, I’m strong, I’m safe. I can do this. There’s no reason I can’t work out. There’s nothing wrong my body. This is going to be great.”
Over time, I learned to avoid certain exercises, e.g., leg press and pull-ups, because they tended to give me more trouble than others.
What I didn’t do, however, is stop working out completely, or begin believing that my body was somehow broken.
(Remember, I had the results of many X-rays, MRIs, ultrasounds, and other tests confirming that my body was just fine.)
As the months went by and I added a bit of muscle to my frame, my confidence and sense of hope for the future both began to increase.
Confronting Years’ Worth of Emotional Trauma
The other major ‘adventure’ I went on during my mid-20s was working through the Unlearn Your Pain program I mentioned earlier.
Essentially, this program teaches you about the science behind the idea that emotionally traumatic experiences, such as:
- Child abuse;
- Sexual assault;
- Exposure to problematic substance use in the home;
- Romantic breakups;
- The death of a loved one; and
- The divorce of one’s parents…
…often ‘imprint’ themselves onto the brain in such a way that your body and mind become overly sensitized to the negative effects of stress and other difficulties in life.
With this understanding of the connections between trauma, pain, and stress, you’re then encouraged to do a sort of inventory of all the unresolved trauma you’ve accumulated throughout your lifetime.
The goal here is to consciously confront this trauma, move beyond it, and thereby give your mind and body less ‘reason’ to produce persistent pain.
This involves a lot of no-holds-barred writing exercises where you put aside any concern with the judgment of others and allow yourself to feel, and to ‘violently respond to’, all the hurt, disappointment, fear, shame, and anger you’ve been storing inside yourself for years.
For me, this meant having to face up to many difficult experiences from my childhood and teenage years but also from my life as a young adult (issues with my parents’ divorce, with being bullied at school, with failed romantic relationships, and so on).
It wasn’t easy, but it was very cathartic.
I often broke down in tears as I forced myself to ‘experience’ and ‘process’ what I had felt at the time, what I wished I had done or said differently, what I believed other people should or shouldn’t have done to/for me, and the lessons I wanted to learn going forward.
Ultimately, I produced several notebooks full of reflective writing, which I still have here with me in my office all these years later.
Putting It All Together
These numerous interventions, i.e.,
- My twice-daily stretching routine;
- My LUTW deep breathing meditation practice;
- The CBT/self-talk pain management exercises;
- The scores of visits to my physiotherapist’s office;
- Reading Sarno’s and Schubiner and Betzold’s books; and
- All the journaling I did in an effort to heal a lifetime of emotional trauma…
…eventually gave me my life back.
As time went on, I began seeing my physiotherapist only once per month.
Then it became only once every few months.
Then once or twice per year.
Eventually, I no longer required consistent treatment as I was effectively managing my pain on my own.
This was possible partly because I had discovered (and had been taught) a bunch of exercises and practices that were clearly helping me, and partly because I had finally accepted that I have the power to heal myself.
As I started to see improvements in my physical wellbeing, my emotional and psychological wellbeing got better as well.
I no longer felt I needed to take anti-depressant medication, which I had been on for about 13 months at one point.
My anxieties about the future and feelings of hopelessness gradually abated as I became more optimistic and inspired in my day-to-day life.
I began spending time with friends again and engaging in physical activities.
Ultimately, I left a job at which I wasn’t happy, began a new career in education, and moved 300 miles away to a new city.
How Am I Feeling Today?
It’s been nearly 10 years since I first began experiencing chronic pain and even longer since I first experienced the trauma and formed the bad habits that I believe gave rise to my discomfort.
I would describe myself as relatively pain-free now and as monumentally better than I was in my mid-20s.
I still swear by the LUTW yoga practice.
I do it every morning — now for 25–30 minutes at a time — and whenever else I feel like I need to ‘reset’ my mind and/or release some tension in my body.
I still engage in appreciation exercises every day.
For instance, this morning I wrote a list of eight things for which I’m grateful before finishing this article.
Just a few days ago I went for dinner with some relatives.
I purposely stopped myself for a moment in the middle of the night and thought:
“It’s March 2019, and I’m here with [so and so] having a lovely dinner. It’s been months since we were last together, and we’re all having a great time. I’m thankful for this moment. This is wonderful.”
Am I 100% pain-free every second of the day?
No, I’m not, but is anybody ever?
The skin burning sensation is virtually gone — essentially, a non-issue for me these days.
I still experience pelvic pain sometimes when I sit for too long.
That’s why I’ve been following a self-imposed rule for many years now:
I never sit for more than an hour at a time without getting up and walking around for a few minutes as a break.
Plus, I use a standing desk (of sorts) when I work long hours and don’t want to sit all day.
I play full-court basketball with guys many years younger than me, and I do a decent job of keeping up with them, thank you very much!
I work out at the gym — truthfully, I’ve been on a bit of hiatus recently, but that’s because I’ve been ‘going hard’ at work, not because I’m being held back by health-related issues.
I hike for hours in the middle of snowstorms shooting photos every winter.
I even tried waterskiing for the first time two summers ago: I couldn’t figure out how to stand up, though — perhaps because I felt like I was going to be ripped in half every time the boat took off 🤣
Physically, there’s not much I can’t or won’t do, and I’m very grateful for that.
Emotionally, I’m also doing well.
I’m medication-free, feeling inspired and excited for the future, committed to making something of my life and to helping people along the way, and less cynical in some ways than I used to be.
I certainly ‘have my moments’, like we all do from time to time.
Overall, though, the sort of depression with which I dealt in my 20s hasn’t re-surfaced since I learned how to effectively manage my pain issues.
I owe a huge debt of gratitude to my friends and family for the unwavering love and support they showed me during my darkest times, and continue to show me today.
My parents, in particular, took me to lots of medical appointments and told me dozens of times that they’d do anything they could to help me become pain-free, even if that meant somehow taking on my pain themselves.
Knowing how much they care about me gave me the extra strength I needed to ‘keep pushing’ whenever I wanted to give up.
The Takeaway: How I Finally Beat My Chronic Pain
Here are the six things I did over a period of five years or so that finally allowed me to overcome my chronic pain and depression:
- I ruled out the possibility that I was suffering from a physical disease— I was examined by many different doctors, underwent a plethora of diagnostic tests, and tried dozens of different medications — nothing suggested my body was fundamentally unwell;
- I was treated by a pelvic health specialist for two years — I underwent physiotherapy every week for most of the first year, and then every few weeks and ultimately every few months for the second year;
- I began doing appreciation exercises daily — I took ‘mental snapshots’ whenever I was lucky enough to do something really enjoyable, and every morning I listed five to eight things in my life for which I was grateful (big and small);
- I learned how to recognize and reduce my tendency to engage in catastrophization — I read The Anxiety and Phobia Workbook and practiced the CBT exercises that my physiotherapist gave me, actively seeking to change my thinking process and my self-talk, especially regarding the future;
- I practiced the legs-up-the-wall (LUTW) yoga pose multiple times per day, every day — I engaged in deep-breathing meditation with my legs resting against a wall for 20–25 minutes at a time, typically once in the morning and once at night, and whenever else I needed to actively release the tension in my pelvis and to calm my mind; and
- I read John E. Sarno’s The Mindbody Prescription and Howard Schubiner and Michael Betzold’s Unlearn Your Pain — these two books drastically changed my understanding of the mind-body connection and of the role of emotional trauma in chronic pain; I regularly used the “I’m healthy, I’m safe, I’m strong” self-talk pain management technique described above, and I completed the Unlearn Your Pain workbook program, which involved journaling about all the hurt I had accumulated since childhood.
If you’re currently facing your own chronic pain and/or mental health challenges, please know that you’re not alone.
I hope you find something of value in this article.
Best of luck ❤️
- I’m neither a doctor nor a medical professional of any kind;
- The ideas discussed in this post are not intended to function as, nor should they be interpreted as constituting, medical advice in any way;
- My health journey is mine alone — it might not reflect what you’re experiencing or what you’re medically capable of achieving; and
- I never once received a medical diagnosis suggesting my body is somehow anatomically abnormal or compromised, which is a significant reason why I felt comfortable pursuing a mind-body approach to my recovery and doing so after being treated by medical professionals for a couple of years.
(Have you spotted an error in this article? If so, feel free to leave a comment below, and I’ll happily correct the mistake. Thanks!)
How I Finally Beat Chronic Pain and Got My Life Back was originally published in The Mission on Medium, where people are continuing the conversation by highlighting and responding to this story.
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Author: Nico Ryan