My journey as a Physiotherapist began in 1983, although I have to say that the past 5 years have been the most rewarding. The main reason for this is that now I see so many life-changing results with people whose lives have been severely affected by chronic pain. So how did a Physiotherapist like me come to specialise in a non-hands on approach that caused a 180⁰ turnaround in my understanding and treatment of chronic pain?
Quite by chance, I started off specialising in Respiratory Care, becoming a Superintendent Physiotherapist within 6 years and managing the Physiotherapy Respiratory services within a large city hospital. When I had my first child I decided I didn’t want to work fulltime, and took a 6 month position covering for someone on sabbatical, but ended up staying for 15 years! The role expanded over the years, exposing me to a variety of conditions, patients and treatment approaches.
Around the year 2000, I had become frustrated with how limited we were in how we could treat pain. At this time I personally developed severe pain in both thumbs and index fingers for no apparent reason, which not surprisingly caused me problems as a Physiotherapist. My GP and I were both concerned it might be Rheumatoid Arthritis (RA). Having seen and treated people with severe RA, this was a very frightening prospect. However, a colleague treated me with Acupuncture and within two treatments the pain went and I had no further problems with my hands. I was so impressed with my own results that I decided I would train in Acupuncture. Looking back now, I realise I was going through a very stressful time in my own life and my recovery coincided with a Rheumatologist informing me that I had Osteoarthritis, not RA, which was a massive relief.
Pieces of the Puzzle
I then completed training in Reflexology and Adapted Reflex Therapy (AdRT), and due to exciting new results with the AdRT approach, my NHS Trust asked me to run a pilot study. This was then the start of another major change in my career as I decided to focus more on helping people resolve their pain. I therefore set up my own private clinic in 2005 and interestingly even then I wasn’t prepared to just ‘manage’ pain and called my clinic the Pain Relief Centre. I also trained in a type of Bowen Therapy, called Neurostructural Integration Technique (NST), which, alongside AdRT became my most successful treatments.
Throughout the years of using these complementary approaches I was becoming more and more aware of how important it was to treat the whole person, not just the part of the body that was hurting. I had also realised that my results were improving as my treatments became gentler and recognised that the time I was now able to spend with my patients, therefore improving the relationship and trust, played a large part. I was also perplexed by the fact that occasionally a patient would burst into tears after a treatment and they were often considerably better the next time they came!
I was becoming increasingly unsettled by the medical model’s explanation for the symptoms my patients presented with. Things just weren’t adding up and all too often there were inconsistencies between a patient’s symptoms and their diagnosis. Most patients could not recall any injury and had often just woken with pain. On top of this, symptoms very often didn’t match the physical diagnosis, for example the symptoms blamed on a prolapsed disc compressing a nerve on one side would often cause symptoms involving numerous nerves and often even swapped sides.
I was also beginning to wonder why, if core stability is so important in preventing and resolving back pain, I was seeing so many people who had often already worked for months on programmes for core stability, yet they then came to me for pain relief. Other times symptoms would move around the body, bearing no relation to any physical ‘abnormality’ that might have been found on MRI. There were also frequent occasions over the years when patients would become completely pain free, despite still having the severe degeneration that had been attributed to the pain.
As well as observing my patient’s anomalies I myself developed severe sciatica soon after leaving the NHS to set up my own clinic, yet I had had no injury. It soon became clear to me that this was completely related to the stress I was feeling due to setting up my own business and not having a monthly salary any more.
In 2007, after years of searching for an answer, I received an email from Amazon recommending a book by John E Sarno MD. I often don’t even look at these, but something made me click on the link and then read the reviews. I remember thinking it all sounded too good to be true, but by this point I was so open-minded I decided to buy the book anyway and see what it was all about. This was the beginning of another major change in direction for me, yet I might not have been open to it if I had read it 10 years earlier.
As it was, it answered all the questions I had about my own pain and that of so many of my patients. Briefly, Dr Sarno is a Rehabilitation Specialist in New York and has been pioneering his work since the 1970’s with the condition he called Tension Myositis Syndrome (TMS). Briefly, his theory is that repressed emotions can trigger the unconscious part of the nervous system to create pain, just as emotions such as fear trigger an automatic reaction in the body. In other words, as we go through life we tend to cope, but we often bottle up how we really feel. These can build up and often during, or soon after, a stressful period the emerging emotions require an escape mechanism and the emotional brain reacts by creating pain, or another symptom, via the nervous system. These symptoms, and often our fears related to them, often end up becoming the focus of our attention and become a distraction from the actual underlying cause.
Interestingly, while I was reading the book, I woke up one morning with severe neck pain. I was immediately able to work out what inner turmoil was causing it, although unfortunately I hadn’t reached the point in the book which told me what to do! I remained in pain for 3 days because I was unable to continue with the book, yet once the issue resolved my pain disappeared within an hour.
This was powerful enough for me to really take on board all Dr Sarno was saying in his book and I recognised that there didn’t even have to be an obviously stressful past or current ‘trauma’ to trigger a symptom. However happy our upbringing, there are always going to be situations when our ‘buttons are pressed’ and personality plays a huge part in how we react to what’s happening around us, which then effects how much inner turmoil we might feel. We are also so used to the pace of lives these days that we often don’t even recognise how ‘stressed’ we are feeling because it has become the ‘norm’ as we continue to ‘cope’ with what’s happening in our lives.
Over the next few weeks and months, I came to understand just how many of my own recurring health problems were actually stress induced and was able to resolve them all. It became very interesting looking at a timeline of when I had symptoms and what was going on in my life at the time. This in itself reinforced to me the potential for this approach and I went from going for treatment for various recurring problems every three months or so, especially since setting up my own business, to none at all since that time, yet being fitter than ever.
During my research I came across numerous studies from the 1970’s to recent years which demonstrated that spinal degeneration found on MRI scans is often coincidental and that it is just as common in people with or without back pain (http://bit.ly/mriback). Studies like this, plus what I was observing with my patients and my own health, reinforced to me the importance of this work and that it wasn’t just a placebo effect.
As I couldn’t find anyone in Europe using this approach, I arranged to spend time with Dr Sarno in November 2007. On my return and with Dr Sarno’s blessing, I set up my own TMS Recovery Programme (http://www.sirpauk.com). Over the past few years, I have developed a specialism in this field by returning to the States twice more and building relationships and peer support links with the main specialists over there. There is a strong movement now to raise the profile of this concept and millions of dollars of funding have been granted for further research. I now also train other Practitioners to integrate this approach into their own work.
Although I now focus my whole work on this non-hands-on approach to chronic pain, I accept that as we are pushing boundaries and long held beliefs about the cause of chronic pain, there will continue to be resistance for a long time yet. However, just as something as simple as washing hands could reduce mortality in babies and their Mothers was initially ridiculed, I have no doubt that in time this concept will also become widely accepted.
I cannot ignore the fact that since I changed my whole understanding about the cause and treatment of chronic pain, I am not only healthier than I have ever been, but I am now able to help so many people not just manage, but resolve, their pain. I also love the fact that it is all about education and self-empowerment once an individual accepts the possibility that this might be an answer to their own symptoms, which therefore also has massive cost saving benefits.