Relationship Status: It’s Complicated

Pain is a complex experience.  There were days when I was convinced that this – pain – would be the most intimate and demanding relationship in my life. It morphed into a pushy, unwanted and voracious companion that moved into my body. At its worst, it screamed at me with each and every move I made.

Upon my diagnosis, I researched Chemotherapy Induced Peripheral Neuropathy (CIPN). Over and over again, researchers declared the same thing: CIPN is the result of various types of chemotherapy and its impact upon the peripheral nervous system (those nerves that exist outside of your spinal chord and your brain – think limbs). When it does not heal itself naturally, patients are left with a particularly nasty and difficult type of pain – neuropathic pain. The exact mechanisms of injury are not well understood, and after getting lost in the weeds trying to decode it, I simply landed on this: it is likely that the chemotherapy had melted potholes into the highway of myelin sheathing that coats and protects your nerves as they conduct electrical impulses to the brain. Thus, these physical injuries – unlikely to mend – were the culprit. The very system designed to communicate pain? It was now generating pain.

So the misery that I was experiencing was rooted in a physical injury to my peripheral nerves. The problem was, a neuropathic injury gets real complicated, real fast, without meaningful interventions.

For a very long time, I failed to grasp a more sinister aspect of the pain: it had moved into my brain, too. My physiotherapist, thankfully, spent a good deal of time and effort helping me to understand that these injuries, while affecting my hands and feet, were actually neurological. Pain is interpreted and regulated by the brain. Relentless distress signals had put my brain under tremendous pressure. And, as I would learn in the ensuing years, the brain is “plastic” – it learns. Just as we develop new skills – music, athletics, languages, etc – through practice, our nervous system will change in response to the continual prompting of the pain, too.

With practice, the brain learns to “upregulate” pain – because it encounters pain signals so frequently, it emphasizes the input. In the end, nerve signals become “louder” – and the body responds with greater sensitivity to the alarms. Thus, my central nervous system was in a continual state of hyper vigilance. It had learned to expect pain, and lived in a constant state of anticipation – and when my brain received this input it went “Oh, there it is! There it is! This is going to hurt, guys.” My breathing changed, my muscular skeletal system braced itself, and everything tensed. Eventually, other bodily systems were sucked into this state of alarm: my shoulder blades were locked high, constantly hiked, which yanked my ribcage out of place, both aggravating the CIPN symptoms and setting off a slew of other issues. Sleep was elusive. Migraines became frequent. I struggled to digest food easily, and my appetite was often depressed.

In essence, pain becomes its own disease.

I share this information with you, because it will be helpful in understanding the next few events in my storyline. But I also wanted to address this directly, simply because I keep encountering fellow chronic pain suffers, and here’s the good news: it’s not “just in your head!” The pain is very real, and over time can unleash some physiological processes that cause your body to become more sensitized to the experience of pain. You are a living breathing example of neuroplasticity – the concept that the brain, over time, learns and changes. In the case of chronic pain, those changes are not positive – but they do not have to be so dominant.

The second bit of good news is this: it is possible to mitigate these changes. There are a variety of new approaches to pain management, and research into the relationship between our brains and chronic pain are producing hopeful new avenues. In my case, the prescription included these elements: Yoga, as developed by Mike’s Breathe into Motion system, was the first effective tool. When connected to physiotherapy, massage therapy and high CBD oil, my brain started to interpret these alarms differently.

I’m just going to put this link here, and invite you to watch what one pain expert has to say about pain and the brain. I hope you find it encouraging.

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