Mind Blown: Pain and the Brain

Yesterday I drove for the first time since my right hip replacement seven weeks ago. Despite being hypervigilant, it felt freeing, if unfamiliar, and I gradually settled in as I drove to my physical therapist.

This past week I also began PRP injections for my left hip and shoulder, areas where I have chronic pain. The doctor said that the pain in my left hip is not coming from the deterioration of the joint and bone spurs, but rather the surrounding soft tissues. Once those tissues heal I’ll likely be pain-free, since the joint is not the cause of the pain I experience when I walk. It’s a total reversal of how I’ve understood what’s happening in my hips and it means that I may be able to avoid having to replace the left hip for a long time!

I’ve been in pain most of my life. I remember being a dancer in high school and being constantly sore, as I was throughout my twenties doing Ashtanga yoga and being a bodyworker. By my thirties I had switched to Anusara yoga to try to heal some chronic issues. My hips began to hurt in my early forties, as I did HIIT and intense strength workouts and got in the best shape of my life. But by my mid-forties I largely stopped exercising and have had a couple of years since in which I barely even walked.

I told my PT yesterday, pain is how I know where I am in space. We talked about how you have to change the brain in order to change chronic pain states. We think pain is located in the tissues that are hurting, but that’s not accurate. The tissues send danger messages to the brain, which sends back the sensation of pain, largely to protect the area so it can heal. We treat the pain locally with massage, acupuncture, surgery, etc., but these treatments don’t cover the whole picture when dealing with pathways grooved into the nervous system by chronic pain.

I’ve noticed that my brain has recreated the sensation of pain in a particular location in my right hip that, before surgery, I thought was associated with the deteriorated joint. But now the joint works fine and that sharp zing has returned. That says to my PT and me that the brain hasn’t caught up to what’s now true for my hip. To retrain my brain, she is having me move my hip toward and into that zingy position for a few seconds at a time, with control, so my brain can learn that it’s safe down there and surrender a little more range.

My PT says many people who come to her don’t really want to get better, that they’re attached to their pain or to the circumstances that create the pain, and therefore are unwilling to do the work to fully allow their bodies to heal. I can relate to that, having focused for years on treating the areas that hurt, but not finding someone to work with who brought the pain issue back to the need to re-pattern my neurology. Nothing I did, whether physical, emotional, or spiritual, held very long and it was frustrating and demoralizing. I’ve resisted and accepted my pain so many times it’s been an exhausting yo-yo in here.

I think that finding the doctor who does PRP injections and says my hip joint is not the source of my pain, undoing fixed thinking that could get in the way of healing, is a sign that I’m ready to shift it now. I think that finding a PT who understands pain and brain science is a sign. I think I’m finally ready to learn a new way of moving through the world and knowing where I am in space, a way based in awareness and connection rather than pain.

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