Write your way out of chronic pain

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Beating chronic pain without surgery

Chronic pain affects about 116 million Americans and between back pain, arthritis, TMJ and migraine headaches, it can take over your life. Dr. Manny talks to Dr. David Hanscom, author of “Back in Control: A Spine Surgeon’s Roadmap Out of Chronic Pain,” about ways to beat the pain

Chronic pain is at an epidemic level, affecting about a third of the adult population. In adolescents, the number of in-patient admissions rose 831 percent over a seven-year period. The reason? Many of these patients are treated for acute pain, when they are really suffering from Mind Body Syndrome (MBS). MBS requires a different treatment plan, and it’s one that may surprise you—writing.

Chronic pain is stressful both physically and emotionally, and causes your body to secrete stress hormones, such as cortisol and adrenaline. MBS is a constellation of symptoms that occur after these hormones run rampant in your system. Over time, each organ system will either respond or shut down, resulting in disruptive physical symptoms.

Researchers see physical evidence of MBS when they look at functional brain MRI scans. In a study published in 2013, researchers looked at scans of patients who had acute back pain—pain for less than three months—and compared them to patients who had suffered chronic pain—for ten years or longer. The scans demonstrated that within 12 months of the onset of pain, the “driver” of the pain sensation switched from the acute pain center of the brain to the emotional center of the brain.

Writing Separates You From Your Thoughts

Treatments that target acute pain only address the physical aspect, so they aren’t effective for someone with MBS. Patients with MBS have permanently imbedded pain pathways that need to be “disrupted” and “relearned.” They cannot be unlearned—it would be similar to trying to unlearn riding a bicycle.

Fortunately, if you follow the sequence below, you can creating alternate pathways:

1. Awareness: Become aware of the effects that these disruptive pathways have on your body and nervous system.
2. Detachment: Create a space between these stimuli and the automatic responses. You have to let go in order to move forward.
3. Reprogramming: The essence of cognitive behavioral therapy, reprogramming creates space between you and your thoughts, which is quite effective at treating chronic pain and its associated anxiety.

And this is where writing comes in.

Writing separates you from your disturbing thoughts, so it can be used to help you let go. We are not our thoughts! When you create space between you and your thoughts, you can become connected to a bigger vision for your life—you are more than the pain you feel. Writing helps to reprogram the nervous system, so you can respond more appropriately to pain.

The first step is engaging in what I term “negative writing,” and it’s an essential step in the process. It simply involves writing down your negative thoughts on a piece of paper and then destroying it. You destroy your text as a way to give you complete freedom to write whatever is on your mind. The more specific you can be, the more effective the writing process will be for you.

I have seen many patients heal just by doing a version of this basic exercise. It was the first tool that I used to pulled myself out of a 15-year tailspin of chronic pain, so I know it works. The effects of expressive writing have also been well documented in the medical literature.

There are no guidelines as to how often or long you should write. My general recommendation is once or twice a day for five to thirty minutes. I view it as similar to brushing my teeth.

I have been writing like this for over 15 years. For many years, I wrote daily and now I write three or four times a week. Whenever I have stopped expressing my thoughts on paper, my symptoms recurred with two to three weeks.

Expressive writing is a remarkably effective tool, especially considering how simple it is. Try it and begin your healing.

Dr. David Hanscom is a top orthopedic spine surgeon in Seattle. He developed a structured approach to treating chronic pain that has helped hundreds of patients become pain free without surgery. He is the author of Back In Control: A Spine Surgeon's Roadmap Out of Chronic Pain.