My Journey Through Chronic Pain: A Personal and Professional Story of Healing

It all started one spring morning in 2019. I woke up for a quick run while the rest of my family was still asleep. I was thirty-two: a young, high-energy thirty-two that could easily pass for twenty-two and is frequently carded at the supermarket checkout. I was a clinical social worker working with families coping with the aftermath of child sexual abuse, a job that was both intense and meaningful.

That morning while putting on my sneakers, I noticed that my feet felt sore; I assumed it was due to my previous morning’s run. I momentarily second-guessed my decision to exercise, but shook it off and reminded myself that I’d feel great on the other end. After my run my feet hurt even more. The pain that arrived that morning without warning, would continue and worsen for nearly three years.

I didn’t panic at first. I figured I had overdone it with the run and that the pain would go away after a few days. Wrong. Weeks later, I was in a whole lot more pain. I did not despair. I substituted yoga for running and went to physical therapy. I asked the physical therapist if the pain could be stress related and was told that it was physical, due to my body aging. "My mom is in her 60’s and runs half marathons as a hobby, how could this be happening to me?" I thought.

After seven months of excruciating pain I  saw a highly-recommended podiatrist at a prestigious hospital while visiting my family in New York. After an ultrasound and multiple appointments the podiatrist diagnosed “plantar fibroma.” He instructed me on how to treat it and assured me that if I followed through with the treatment the pain would be gone in 2-3 months. 

Over the next couple of years this podiatrist would join a list of highly regarded practitioners - three orthopedic surgeons, three acupuncturists, two physical therapists, an osteopath, a reflexologist, and two general practitioners -  who diagnosed my pain and confidently assured me that if I followed “X” treatment I would return to a pain-free life.  I was given diagnoses such as inflammation of the TP, inflammation of the FHL, and pelvic misalignment, to name just a few. I underwent MRI, ultrasounds, cortisone shots, prescription pain-killers, osteopathy, physical therapy, massage therapy, and acupuncture, all of which ultimately got me nowhere. And then, nearly three years after the pain first began, a trusted friend recommended a book that had helped her with chronic migraines. 

Finding Answers

“The Way Out” by Alan Gordon could not have a more apt title. Gordon coined the term “Neuroplastic Pain”, which is essentially pain that originates in the brain. This is in contrast to structural pain, which originates in the body. 

This is not a “it's all in your head” situation. 

The pain is real and confirmable thanks to fMRI technology that enables scientists to monitor brain activity. Here is a mind-blowing fact: physical pain in the body that is produced by our brain is identical, whether there is an actual structural injury in the body or whether the brain mistakenly believes there is a structural injury in the body. To offer an analogy, a smoke alarm that sounds because it is broken makes the exact loud and very real noise as a smoke alarm that sounds because there is smoke from an actual fire. 

Gordon explains that the neural pathways for fear and pain are linked, and sometimes pain is just the result of our brain making a mistake.  Because our brains associate fear and danger with physical injury, sometimes when a person is exposed to fear and danger, whether real or perceived, our brains may mistakenly detect injury and produce pain, even absent a structural injury. The fear of pain then further fuels the pain, and so years of chronic pain can cycle on indefinitely. This is what Gordon calls Neuroplastic Pain. 

Gordon’s understanding of neuroplastic pain is based on scientific research and clinical data. While he does not presume to diagnose anyone through his book, he explores some of the most common features of neuroplastic pain. One that stood out to me is that in contrast to structural pain, neuroplastic pain can present as symmetrical. Every practitioner I visited was baffled that my foot pain was bilateral, because structural injuries do not tend to be symmetrical. 

Trauma and The Brain

Another common feature of neuroplastic pain is that it often begins during particularly stressful periods. I tried to think about whether or not my stress levels were higher than usual when my pain began.  Like an investigator, I looked through my old journals and there it was, right under my nose, a sentence written when my pain first began that could have been taken straight from Gordon’s book: “I feel like I have an overactive amygdala.” The amygdala is located in the midbrain, is the seat of ‘big emotions’, and is known for its role as the body’s “alarm-system”. Back when my pain first began I had actually written in my journal about how my alarm switch was in a permanent “on'' position. 

What kind of strange person journals about her amygdala? The kind that’s a therapist treating traumatized children. I had been working for years with cases of child abuse, while simultaneously carrying and birthing babies myself. We are not immune to the stories we hear.  They are absorbed into our thoughts, emotions, bodies, and, as I have come to learn firsthand, can create actual neurological changes orienting us towards fear, worry, and hyper-vigilance.  After a decade of working with traumatic material, my brain was understandably oriented towards danger and fear. 

Finally, Relief Arrives

Lucky for me, Gordon’s book offers “a way out.” Once you understand that your pain is the brain mistakenly interpreting a neutral sensation as painful, the antidote is re-educating your brain that the sensation is in fact safe. This process, called Pain Reprocessing Therapy, or “PRT”, involves simple exercises aimed at rewiring your brain so that it understands that you are in fact safe¹.  Amazingly, just knowing that my pain was neuroplastic (before even starting any of the exercises) substantially reduced my pain overnight. 

The primary treatment for neuroplastic pain is called “somatic tracking,” which involves mindfulness (gently paying attention to the pain sensation without judging it), safety reappraisal (reminding your brain that there is nothing structurally wrong with the body and that the painful sensation is safe and not an indication of injury), and positive affect induction (basically, cracking jokes). Somatic tracking can be done on one’s own or with a trained professional, depending on the person's needs.

Putting The Pieces Together 

I believe one reason PRT was effective for me in such a short span of time is because PRT echoes important tools for working with trauma that I studied and practiced for years. For example, a primary symptom of PTSD is hyper-vigilance. In treatment, a traumatized person learns that while hyper-vigilance was adaptive during the time of the trauma, once the danger is no longer present it becomes maladaptive, and therapy helps a person to understand it is now safe to let go of the hyper-vigilance. 

I had also trained in Somatic Experience, which echoes PRT in having people locate emotions as sensations in their body and track the sensation. I wish that during my years of training I had been explicitly taught to proactively turn these tools inward to build my resilience as a clinician so that I could be better equipped to hold my client’s stories. Sure, I was trained to practice self-care and to use mindfulness, but there was a critical missing link: safety. If we’re dancing with trauma for a living, explicitly and proactively orienting our brains towards safety must be part of the job. Now that I understand this, I am not only living a life without chronic pain but I am a better equipped professional.

Looking back, my journey with foot pain was winding, scary, and sometimes dark. After almost three years of pain and unsuccessful treatments, it’s hard to believe two months of PRT has left me nearly pain free and fascinated by the concept of Neuroplastic Pain. 

So much so, that I recently completed professional training in Pain Reprocessing Therapy. Over Zoom I studied with therapists from Gordon’s California-based Pain Psychology Clinic, and connected with psychotherapists, pharmacologists, and physical therapists from around the world. I feel fortunate to have found this treatment after just a few years of pain, as I now understand that neuroplastic pain can plague people for decades. It’s probably not by chance that it took me a few years to discover PRT, as the treatment is part of a new and promising paradigm shift in the world of chronic pain that could bring permanent relief to millions of people². Ultimately my journey through pain has come to serve me both personally and professionally. I am excited to begin incorporating PRT into my therapy practice, paying it forward to others experiencing chronic pain. 

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¹ To be clear, neuroplastic pain does not account for all chronic pain. Some chronic pain is structurally caused and there are physicians trained to make this distinction.

² Just recently, The Boulder Back Pain Study was published, a study out of the University of Boulder that scientifically validated PRT as an effective treatment for chronic pain: https://jamanetwork.com/journals/jamapsychiatry/fullarticle/2784694