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Chronic Pain & the Nervous System

By Kali Foster
from Kallista Chinese Medicine

Acute pain is usually caused by an injury to our body, and should resolve once healing has occurred. However, sometimes pain persists. When pain continues with no apparent physical reason for it, this indicates that there is no longer just a problem with the body, but there may also be a problem with the nervous system.

Types of Chronic Pain:

  1. Pain that persists after an injury
  2. Ongoing tension pain such as in the back, hip or neck
  3. Ongoing pain due to physical problems. For example: arthritis, degeneration, tumour growth and nerve impingement

All types of chronic pain involve changes in the nervous system. If pain persists, nerves get used to being excited, become more easily activated, releasing more pain chemicals and can sensitise an area so that pain is experienced more easily, even when there is only light touch or small movement, or an increase in stress. (Pearson, 2014)

Pain is a signal that something is dangerous to the body, and its purpose is to stop you doing whatever it is that you are doing. Pain is a strong deterrent, but pain can be disproportionate to an injury or damage and can recur when there is no longer a danger or injury. It’s important to consult with your health practitioner to ensure that there’s nothing wrong in your body that requires immediate attention. If you’ve been given the go ahead you can then explore alternative ways to manage or resolve this pain.

Acupuncture is an excellent treatment for pain – acute and chronic, as is massage and all modalities of bodywork. Bodywork practices help to release tight muscles, help the client connect to their bodies the present moment, and free up the movement of qi and blood.

My Clinical Experience Treating Pain

For 15 years I have seen clients present with different types of enduring pain like sciatica, back or neck pain, and have found that they respond well to shiatsu, cupping and acupuncture. However, often their symptoms return in a week or two. At first, I didn’t understand this. Week after week, year after year I was treating their symptoms, yet I became aware that I wasn’t making a permanent difference. Intuitively I sensed that I was just working on their physical issues, and that their tension patterns were the result of their emotional state, posture, and childhood experiences.

Similarly, I found my own chronic hip pain getting worse with stress which I believe was related to my childhood – the terrible fighting with my brother that had gone on for so many years. As a result of this my body had become chronically braced in a fight response, ready to defend myself. This tension started in the psoas muscle on the right, then pulled my pelvis into a twist, resulting in sacroiliac pain. Osteopathy and other therapies could realign my pelvis, even temporarily release the psoas, but within a few days it’d all be back again.

Trauma – Often an Underlying Cause of Chronic Pain

Chronic pain is more likely to occur when there is significant prolonged stress or a history of trauma. Both pain and trauma affect the nervous system and the brain as both are responsible for our experience of pain. Therefore, in order to resolve chronic pain, we need to address this level of our being.

Trauma can be understood as an experience where we felt threatened, or our life is at risk, and we could not overcome the threat. For example, a child who is bullied by a parent or a gang of kids at school. The threat is too big for them to cope with and the SNS (fight/flight-action response) is engaged but cannot be completed (cannot fight or flee the threat). This triggers the nervous system into overwhelm (freeze response) and the charge is suppressed but held in the body to be dealt with at a later time, when it is safe. But that safe time may not happen. We have also been conditioned to “get on with it” and “get over it” and so do not give ourselves the time and space needed to address and release a stressful experience.

We have all experienced feelings of overwhelmed in our lives, and they can add up creating low grade stress under the surface. If we don’t allow our body to release these “charges” under the surface we may find ourselves chronically stressed, anxious or depressed as it takes a lot of energy to hold these in. This also makes us more likely to experience chronic pain, as well as other illnesses.

The Pain Cycle

One of the most important factors in chronic muscular pain is the unresolved fight/flight/freeze (trauma) reaction. The unreleased muscle tensing leads to pain, which in turn leads to fear and more bracing, which leads to more pain. (Levine & Phillips, 2012)

So, how do we begin to let go of trauma from our body and nervous system?

Firstly, it is important to understand how the nervous system works. This needs more than a few sentences to explain properly but there are many books and articles that explore this in depth. Please refer to resources list at the end of this article.

Tools and Techniques to Reset and Rewire the Nervous System:

  1. Body Awareness exercises – these include mindfulness meditations, yoga, Pilates, conscious dance, walking or gentle movement with awareness, noticing the pain but focusing more on any pleasure or good feelings in the body
  2. Calm Breathing – there are many exercises available online, but the emphasis should be on gradually taking longer breaths, then making them smoother and softer. (Neil Pearson 2014)
  3. Vagus Nerve Exercises – my favourite is sounding “Ahhh” at the heart centre for at least three repetitions and then noticing the body. Do you feel calmer or more activated? Then sounding “Ooooh” at the belly – just below the navel. Again, notice the sensations in the body after three or more sounds. Complete by resting one palm over the heart and the other over the belly. Tell yourself you are there for you, right now.
  4. TRE® (Tension and Trauma Releasing Exercises) may be appropriate for you. Also seeing a somatic-focused counsellor, or craniosacral therapist may help.

I used all of the above tools and techniques in my recovery from chronic hip pain.

If you are suffering with chronic pain, I recommend you address it from three levels – the body, the mental/emotional, and the nervous system. Try and find a therapist who has some awareness of how the nervous system affects pain. You need to find someone you feel safe with and heard by, so your nervous system can relax, which is half the work. There will also be many daily self-practices which may be challenging but rewarding.

Perhaps the pain you experience can be seen as an opportunity to bring you more into the present and into your body, and closer to your feelings. You may resolve old emotional traumas, improve existing relationships and grow as a human being.

More about the author

Kali Foster
Kali Foster
– Kallista Chinese Medicine

Kali is the founder of Kallista Chinese Medicine and has been practicing from the clinic since 2006. Kali is an Acupuncturist, Chinese Herbalist and Body-oriented trauma therapist. She has trained in TRE® (Tension & Trauma Release Exercises), and Somatic Experiencing® (3 year training in Trauma therapy). This has given her a deeper understanding of how the nervous system & body work together, often manifesting in the symptoms clients present with.

Kali has a special interest in stress, anxiety & nervous system disorders, resolving short or long-term trauma held in the body, chronic pain, women’s health & pregnancy care, as well as general practice TCM.

Kali provides gentle acupuncture, or acupressure/ laser if preferred, and herbal medicine consultations. TRE/ Trauma therapy is also offered as a stand-alone session (1hr) or can be combined with Acupuncture in 1.5hr sessions.


Recommended Resources:

Freedom from Pain (2012), by Peter Levine and Maggie Phillips – an excellent book, especially helpful for unresolved emotional trauma

Life Is Now Pain Care – online resources from Neil Pearson:

The Body Keeps the Score (2014), Mind, Brain and Body in the Transformation of Trauma, by Bessel Vander Kolk

The Tapping Solution for Pain Relief (2015), self-help book by Nick Ortner

Overcoming Trauma Through Yoga (2011), by David Emerson and Elizabeth Hopper

The Pocket Guide to The Polyvagal Theory (2017), by Stephen Porges – pioneering neurophysiology for those who want the science about safety and social engagement in healing trauma

The Psoas Book (1981, 1997, 2012) & Core Awareness (2012) books by Liz Koch.

Liz explores the role of the Psoas muscle in fight/flight and shares many practical approaches to embodiment & release of tension in this muscle. A great resource for physical therapists too.