Pain Management

Trauma and the Physical Body

Dr Melanie Salmon Pain, Chronic Conditions, healthy body, Pain Management, Trauma , , , , , 2 Comments
Trauma And Physical Pain. Why Chronic Pain Can Be our Physical Response To A Traumatic Event

Trauma and the Physical Body by Dr Melanie Salmon

Chronic pain is not always the result of physical injury, it may be the body’s response to a traumatic event

Not only damaging to our mental health, trauma can also have an incredible impact on our physical body. Some chronic pain complaints, for example, can be attributed to residual trauma, our body responding to past events through muscle tensing.

So, what is chronic pain? What types of chronic pain are psychological? And how can past trauma affect our current physical state? 

What is chronic pain?

In the UK, around 28 million adults are affected by some type of chronic pain (42% of the population) and globally, more than 1.5 billion (American Academy of Pain Medicine). That’s 18% of the world’s population. 

Chronic pain is defined as pain that lasts for at least 12 weeks, although it may in fact last for several years. It can limit your mobility and reduce your flexibility, strength, and endurance, making it challenging to get through daily tasks and activities. 

 

Collectively, we can categorise chronic pain as somatogenic pain (the cause is found within the structure of the body, the ‘soma’) and psychogenic pain, with the most common types of pain (across both categories) including headache; post-physical trauma pain; lower back pain; arthritis pain; neurogenic pain (pain caused by nerve damage); and psychogenic pain. The latter describes pain that isn’t caused by disease or nerve damage, the cause is thought to be in the mind. 

Trauma and the physical body: psychogenic pain

Psychogenic pain is chronic, disabling pain that is primarily caused by psychological factors. Factors such as beliefs, emotions, fears, or mental illness – like depression or anxiety – can trigger, exacerbate, or maintain pain that started in an innocuous way, such as an accident or fall.

Dr Robert Scaer (amongst others) has shown that chronic stress and trauma has a profound impact on the entire mind-body system, resulting in disease, sometimes decades later. 

Scaer studied the ‘diseases of the freeze’ – those diseases originating from a dysregulated autonomic nervous system – as a result of trauma. This includes chronic psychogenic pain. 

He showed that the majority of what we consider to be ‘arthritis’ of the neck and back is in fact myofascial pain associated with stress and trauma. An MRI scan shows no relationship with pathology. 

Trauma and The Physical Body by Dr Melanie Salmon. Trauma and the Physical Body by Dr Melanie Salmon Chronic pain is not always the result of physical injury, it may be the body’s response to a traumatic event Not only damaging to our mental health, trauma can also have an incredible impact on our physical body. Some chronic pain complaints, for example, can be attributed to residual trauma, our body responding to past events through muscle tensing. So, what is chronic pain? What types of chronic pain are psychological? And how can past trauma affect our current physical state? 

Trauma and the physical body: myofascial pain syndrome 

Myofascial pain syndrome (MPS) is a description of muscle pain: pain and inflammation in the body’s soft tissues. A chronic condition that affects the fascia (connective tissue that covers the muscles), it may involve either a single muscle or a muscle group. 

Myofascial and related chronic pain is often traceable to complex childhood trauma and is always distributed through the back. This can be explained by understanding the back’s role in protecting us from physical trauma or threat.

When threatened with violence, the back will step in to protect the body; the muscles of the core are intensely activated, pulling the body into a contracted foetal position for self-defence. 

Picture a five-year-old child who waits for her father to come home. A bully, her father often threatens to beat the children when they’re naughty and walks through the door shouting. Immediately her body reacts by moving into a defensive position. 

If she’s safe enough to do so, she’ll curl up into a foetal position to get the best protection she can. However, if she is unable, she will form an incomplete foetal position. Her body will still want to contract but can’t. This incomplete foetal position will be stored in her muscle memory: tense and trying to contract without being able to. 

The emotional memory of this event is stored in the muscle groups involved in the defence forever afterwards; the emotional memory of trying to defend. The neural pathways are set, and in later life when the body experiences chronic stress – any stress – all these muscles will contract as they always did before, pulling tight into the same type of protective response. Instead of pulling the body into a foetal position, however, the muscles of the back and neck ache with widespread myofascial pain. 

This type of pain is uniquely stress-related.

Neglect and the physical body: example case study

Trauma may lead to a life of low-grade sustained vigilance, sensitive to environmental as well as internal triggers. 

If you can imagine a child that was repeatedly bullied from the age of six years old, while trying to find their place in the world and connect with society, they are rejected and lack social bonding. At home, parents are absent because they work all the time and therefore don’t offer sufficient care-giver support.

The child grows up with low self-esteem, feeling unworthy and unsafe in the world; trust in them and others is diminished. They may develop an inability to express themselves and repress their emotions for fear of punishment, judgement, or rejection. 

When confronted with a difficult situation, they bottle their emotions and feel internal anguish, repeatedly releasing toxic stress chemicals into the body. 

Their immune system is compromised, making them more susceptible to illness. Over time, they develop chronic pain. 

 

Healing trauma: body and mind

What has emerged from pioneers in the field of epigenetics and neuroscience, is an understanding of the importance of healing past trauma – and doing so by working with the subconscious mind.

While we cannot go back in time and ‘un-experience’ a traumatic event, our history is imprinted within us, crystallizing as our core beliefs or “truths”. To effectively heal from our past we must bypass the rational mind and access the source of our belief systems. 

 

Using the QEC method, we are able to change the belief systems and conditioning that no longer serve us. The neuroplasticity of the brain allows us to ‘rewire’ our neural pathways, freeing us from the limitations of our past.

In this way, we can fundamentally change the way we feel about ourselves and the world around us.

Most commonly used for working with trauma, depression, grief and loss, stress, health and relationships, you can learn more about QEC here. 

 

Living With Hyperacusis – Noise Sensitivity

Eileen Burns Pain Management, Chronic Conditions, health , , , , 0 Comment
The Challenges Of Living With Hyperacusis - Noise Sensitivity Pain In Ears by Eileen Burns

The Challenges Of Living With Hyperacusis ( Noise Sensitivity)

The Challenges Of Living With Hyperacusis. What is Hyperacusis?  And why is hyperacusis such a misunderstood and extremely challenging condition?

So What Is Hyperacusis?

Hyperacusis is an abnormal sensitivity to sound. For those suffering from severe hyperacusis, especially very painful hypersensitivity, it can be an extremely debilitating hearing condition that doesn’t just cause discomfort but for someone like myself at times horrendous pain. Now sadly some people confuse Hyperacusis with Misophonia which is a dislike to particular sounds. There is also a perception that the person is experiencing just sensitivity and uncomfortableness but for some of us the pain can be literally so painful it can feel like someone is stabbing you in the ear.

My Own Story Living With Hyperacusis

I was always slightly more aware of sounds than my siblings I would wake up with noises that other people would sleep through. But noise sensitivity only started to become a life-changing condition over 8 years ago after I ended up in ICU with sepsis. Caused by a dental complication that led me to have nerve damage, lockjaw, and osteomyelitis. Now I had previous weakness in this area, previous nerve damage, and trauma from an injury, and a rare medical condition that left me quite vulnerable to temporomandibular issues.

My Own Story Living With Hyperacusis  I was always slightly more aware of sounds than my siblings I would wake up with noises that other people would sleep through. But noise sensitivity only started to become a life-changing condition over 8 years ago after I ended up in ICU with sepsis. Caused by a dental complication that led me to have nerve damage, lockjaw, and osteomyelitis. Now I had previous weakness in this area, previous nerve damage, and trauma from an injury, and a rare medical condition that left me quite vulnerable to temporomandibular issues. But anyway after recovering from sepsis, which left me with a lot of weakness, and nerve damage down the right side of my face, neck, and body. I developed a lot of problems with certain levels, and types of sounds to my right ear, that would literally cause me to lose my balance. I also had developed a complex movement disorder and what is regarded as non-epileptic seizures which all seem to be seriously triggered by vibration and noise.

But anyway after recovering from sepsis, which left me with a lot of weakness, and nerve damage down the right side of my face, neck, and body. I developed a lot of problems with certain levels, and types of sounds to my right ear, that would literally cause me to lose my balance. I also had developed a complex movement disorder and what is regarded as non-epileptic seizures which all seem to be seriously triggered by vibration and noise.

Now the level of noise sensitivity and pain in my right ear became so unbearably painful that I couldn’t handle so many everyday sounds. My ear and jaw would become very warm and at times the muscles in my jaw would twitch. The horrendous pain was one thing the effect on my conscious and my functioning was something else. It would be like this weird surge of electrical energy in my bring that would like short circuit.  I would end up in pain for days. But despite this level of disability, no Doctor would send me to get my ear checked or tested.

Now initially there was more focus on the cause of other issues, I had the complex movement disorder, non-epileptic seizures, and other neurological issues I had, fine motor skill issues I had. But no one could give me any answers. From the beginning, I believed the pain inside my ear alongside the amount of muscle weakness and the nerve damage I had was creating a vicious circle. But I was simply told there was nothing we can do for you, you just have to live with your conditions. Issues which made me housebound because I would have no control over my body. My body would go into constant violent jerking and spasms so I wouldn’t be able to walk outside etc. And the pain in my ear would be so painful as Tom Maholchic in the video Hyperacusis with Pain describes the sound “explodes in my head” and as another person says in this video is “like an ice pick in my ear”

My Diagnosis Of Hyperacusis

Now to get a proper diagnosis of hyperacusis one of the tests you need to get is a ULL uncomfortable loudness level test. But in many areas sadly this is not readily available from the NHS and well even more challenging is that many doctors don’t even realise that Hyperacusis is an actual real condition, my G.P. didn’t. So despite noise sensitivity for years, increasing levels of pain, and seizures, and doing everything I possibly could to help myself I still hadn’t been seen by an audiologist.

It was only when I discovered I could get a private hearing testing at home which would include a ULL test that things changed. The audiologist was very surprised at what the ULL test showed in relation even to the decibels that correlate with normal speech. For this reason, the audiologist sent a letter to my GP recommending further testing. But even when I finally saw an ENT specialist and the audiologist couldn’t complete the test because of the harm it was having on me. The Dr had no interest in trying to help me,  he was extremely dismissive.

I was then sent to a Tinnitus Clinic, given information sheets and recommendations to treat tinnitus, with only a tiny paragraph that mentioned a bit about hyperacusis. At least in this clinic the practitioner actually asked me a lot of questions especially around my underlying medical conditions, the injury I had, and she was also very interested in the research that I had done. She was honest that the clinic didn’t really treat hyperacusis, she commented they knew nothing about Lyme Disease which is known to cause hyperacusis and other neurological issues and my particular issues were very rare. So I had to find my own solutions in how to live with hyperacusis, how to reduce and treat my sound sensitivity/

The Difficulties Of Living With Hyperacusis

The biggest problem I believe living with hyperacusis for many is that firstly many Doctors and medical professionals don’t actually realise that is a real condition one that can be extremely disabling. A seriously under-researched condition, and as MD Timothy Hain suggests one most in audiology appears to have very outdated views.

Many sufferers living with Hyperacusis are neglected and discriminated against because of myths around sound sensitivity. Some people might find some noises annoying, uncomfortable while others suffer tremendous pain like me. Those few hyperacusis with pain rarely get any help, support, or treatment. Although there is a lot more types of treatment available in the United States.

The facts are sound sensitivity is not something that is well researched or something that many neurologists or audiologists actually study. And then even worse some confuse hyperacusis with misophonia ( fear of loud sounds). Now I also have Parry Romberg’s Disease and I have also have had more than a few diagnoses of different conditions some that are including in my list of different causes of hyperacusis.  I have a lot of underlying complex challenges other than injury actually known to be linked with Hyperacusis so it was very surprising that I had to wait so many years to get a diagnosis.

Different Causes Of Hyperacusis

According to Timothy Hain MD, it is considered Hyperacusis may be associated with damage to the inner ear but there is a lot of debate around that. We do know there are many different conditions and causes linked to hyperacusis these include

  • Autism Spectrum Disorders, Aspergers
  • Chronic Noise Exposure, such as a noisy working environment
  • Central Nervous System Disorders, Brain stem issues
  • Deficiencies – Magnesium
  • Disrupted attenuation reflex as seen in Bells Palsy, M.S,  Menieres Disease
  • Medication – Certain medications for example the antibiotic Ciprofloxacin, psychoactive drugs  LSD, methaqualone, phencyclidine (angel-dust)  have been associated with hyperacusis.
  • Head Injury Of Trauma
  • Late- Stage Lyme Disease
  • Nerve Damage, Facial Nerve Palsy
  • Surgery To The Ear
  • Williams Syndrome, a genetic disorder where hyperacusisis a symptom.
  • Toxicity, Oxotoxicity one reason why you should avoid the overuse of ear drops, get the right medical treatment for ear infections, and ear wax removal.

The reality is according to Haines it is time the audiology community starts realising that hyperacusis sufferers are not the cause of their disease. For a long time, Hyperacusis was viewed by some as psychologically when it is simply an area of medical science that we don’t know enough about.

Different Treatments For Hyperacusis

Although presently there is no technical standard treatment for Hyperacusis especially for those of us with severe pain. There are many who have sound sensitivity that benefit from de-sensitization programs or relaxation therapy. I personally tried de-sensitization the first few years it made things worse. In fact for me the more I removed myself from the pain, the less pain and other complications I aid. I actually have been a stress management trainer, meditation teacher, and coach for many years, and I actually teach relaxation therapy.

The Doctor who appeared to have no interest in helping, initially told me to stop using earphones or earbuds. But this was completely impractical as exposing myself to even everyday sounds caused me to lose my balance, fall, lose control of my body, have seizures, and be in horrendous pain for days. I couldn’t even walk out the door myself. I could only expose myself to certain sounds for small periods in a healthy way when the inflammation and pain in my jaw, nerves, and ear were reduced.

Now although I am still predominately housebound, I am getting better slowly. I can now listen to the TV if it’s down very low. I can handle normal speech if it’s not at a high pitch, without jerking about or feeling is if I am being stabbed in my ear.

Luckily for me, I have found a combination of things that have helped me reduce the constant high levels of pain. I still can’t go out on my own and certain sounds and pitches cause me to have all sorts of issues but I am getting there. These are a few of the things that I found helpful

  1. Dub Earbuds which reduce the decibel of sound in your ear/ears – Invaluable at the initial stages helped me be able to talk on the phone and work online.
  2. Herbal Treatment For Bacterial Co-Infections  Associated With Lyme Disease
  3. Better Denture – I have a lot of TMJ and rare teeth issues, the better the denture the better support for your mouth
  4. Mouth Guard – A well-fitting mouthguard really helped to reduce pain in the jaw and nerves
  5. Craniosacral Therapy – I found craniosacral helpful at releasing a lot of cranial pressure, nerve issues
  6. Magnesium, Vitamin B6 ( Pyridoxine) – Some suggest magnesium and B6 deficiency can be a cause of hyperacusis
  7. Muscle Therapy, Physiotherapy exercises to support the neck and head muscles.
  8. Meditation – Thank goodness I learned meditation many years ago, a life safer to cope with extremely challenging situations and of course reduces anxiety and stress.
  9. Relaxation Therapy – Helps to relax the muscles, nerves as much as I can  luckily this has been one of my areas of expertise for many years and has helped me cope
  10. Visit a Chiropractor to help solve any alignment and trauma injury to the body, this can make a huge difference to many people.

Common Recommendations For Hyperacusis

  • Use Of White Noise Machine
  • Medical Treatment For Any Ear Infection
  • Proper Ear Wax Removal- – Don’t ever use cotton buds.
  • Meditation – I am lucky to have been a meditation teacher for many years and thankfully this helped me keep sane.
  • Relaxation Therapy – I have taught Relaxation Therapy for many years and for most people with stress-induced hypersensitivity relaxation techniques can be very helpful.
  • Stress Management – Stress will increase symptoms of hyperacusis so it is important to manage your stress.
  • Trauma Therapy – There is a wide range of trauma therapies available that can be helpful to some types of noise sensitivity or sound intolerances.

Also, it should be a must that if you have any sort of ear pain that you do get it checked, that you get treated for an ear infection and that you always get ear wax removed by a professional.