But Why?? Why do my pains keep coming back? Why do I have chronic illness & persistent pain?
Often patients present with an injury/pain/illness that keeps recurring, for example they continually get a pain in their buttock or piriformis and treatment including stretches, needles or trigger points etc is temporary. Often they can be focused on the area of symptoms and previous diagnoses e.g. piriformis syndrome etc…while these treatments and diagnoses are often correct, if a problem keeps recurring I begin to ask ‘but why….’…’but why do you keep getting this condition?’.
Often I find a couple of different answers depending on the condition and the individual. Sometimes the area of symptoms is not the cause of the problem and thus the treatment is only addressing the problem temporarily and missing the source.
My patients often ask me why I am asking about all their medical history, including medical conditions, past fractures or surgeries etc as they do not understand how this is relevant to their problem….sometimes it isn’t but if a problem keeps recurring or someone has multiple areas of issues and or many medical conditions it very well might.
I look at the whole person and their medical history to get a sense of how their connective tissue/fascia (or other physical structures) may be influencing their presenting problem. As Fascia is around every cell (and sends microfibers into the cell) it can connect any part of the body to a more remote area i.e. so your foot problem can be connected to your head issue etc…as fascia is also around our organs too therefore medical conditions can create tensions and blocks in the fascia which is not good as our physical & organ movements depend on the fascia to transmit the forces around the body. A block in organ or soft tissue fascia in one area can create an abnormal tension elsewhere and contribute to a musculo-skeletal problem or a pathology forming…knowing the history gives clues to where these blocks may be hiding.
Fascial Manipulation is a great technique that allows these distant areas to be linked and treated. I have had patient’s reports sensations in their plantar fascia- the presenting problem- while treating points in their upper scapula area. Or thoracic imbalance can create abnormal movement patterns in the hip creating hip or buttock issues.
The other reason I am very interested in a person’s medical history is that optimal health is a balanced nervous system. Most chronic illnesses including chronic pain are often an imbalance in the nervous system resulting in us living in a state of flight/flight/freeze more than in the optimal healthy state. For short periods this is ok and has a purpose for example, when we need to escape from scary situations or muster great strength to help someone trapped under a car etc… but to live in this state is toxic to our cells and our health. If our cells are exposed to fight/flight/freeze conditions long term then we have cortisol going around our blood stream (so it affects EVERY cell in the body- the weak point is where the injury or illness manifests) and cortisol makes muscles tense and get strong- short term good- long term this over contracting creates issues- exercise can then possibly cause injury as the muscles cannot relax enough and stay tensed and or we can possibly end up with a chronic illness e.g. blood pressure issues, tachycardia, recurrent infections, autoimmune diseases, cancer, anxiety, depression, gut issues and many more- the type of problem is individual to each patient depending on their life’s conditions and environment.
If a patient has chronic cortisol in their system from living in overwhelm or fight/fight/freeze, then local physical treatment is likely to be temporary, as the tissue tense up quickly again after treatment from the continued cortisol action. So what is to be done? Any technique that teaches the body to move from fight/flight/freeze to rest & digest(healing state) will help. How do we do this?
Anything that makes us feel happy, joyful, light, grateful, compassionate, caring, loving helps and should be encouraged to be done as much as possible. Laughing and being in nature are also very healing…. Meditation, Breathwork, Heartmath techniques and some manual techniques like Fascial Manipulation or massage also help to make the transition to the healing state.
While it sounds simple to do practicing these techniques can be challenging for some, as often we are not aware of the patterns we have that make these healing practices difficult. These healing techniques require self discipline and practice just as any excises requires practice. You don’t think you are Arnold Schwartzenegger after one gym session….so it takes time to cultivate new neurobioplastic (patterns) pathways to install these healing practices and the healing state as your body’s norm.
Sometimes these techniques can increase a person’s symptoms etc especially at the beginning and this is quite normal but sometimes people can have underlying traumas that are not conscious and then doing these techniques may allow these unresolved symptoms to bubble up…as this can be a bit disconcerting having a therapist or trauma therapist to guide you in the process would be a safe way to help these people integrate the unresolved issues so they too can learn to live in a more balanced state of health and enjoy life more…..living in this more harmonious state may resolve chronic conditions or may assist current therapies to work better….either way it is a better life for the patient.
*Jo no longer works for Live Well, however you can learn more about her work here
