Chronic Pain

Osteopaths are required (by our Regulator – The General Osteopathic Council) to do a certain amount of ‘Continuing Professional Development’ every year.  We tend to do far more than the minimum amount required simply because we are interested in what we do.  We are fascinated by our patients’ bodies and how they work, so we always want to know more and continuing study is part of the Osteopath’s way of life.

Last year I decided I needed to know more about Chronic Pain syndromes.  These are fascinating because the brain is normally NOT receiving pain signals!  Instead the brain interprets other signals (such as joint position information) as being pain signals and duly triggers pain sensations.  There is nothing that you can do physically to stop the pain sensations being generated because they are not being triggered by pain sensors. Instead, you have to look at the way the brain receives and processes information and that is why we have a Psychotherapist/NLP Practitioner in the practice (the very wonderful Kate Chartres who is a nurse practitioner specialising in Chronic Pain – ask her about her PhD thesis) and why I have embarked on training as an NLP Practitioner myself.

I have the great good fortune to be trained by a guy called Phil Parker.  He is also an Osteopath and the person who devised ‘The Lightening Process’.  Phil works with some of the biggest corporations on the planet, various elite athletes and A-list performers as well as homeless drug addicts.  He’s a fascinating guy and a brilliant teacher. For me it is a huge bonus that he is an Osteopath – it means we have the same basic approach to patients.  He has the same holistic mindset and is deeply rooted in the osteopathic values of empowering patients to make changes (look out for blog ‘For a Change’).

NLP is Neuro-Linguistic Programming: it looks at the way our brains process information, and how we can change unhelpful patterns of behaviour by replacing them with patterns that help us achieve things that improve our lives.  This approach has proved very powerful in helping patients overcome chronic pain by re-programming the mind’s response to the triggers that set off the chronic pain sensations.  It does this by working with the patient’s subconscious mind and using particular types of language to take advantage of neural plasticity, enabling the brain to create a new, helpful response to those triggers, by-passing the old, unhelpful (chronic pain) responses.

Within the nervous system messages are passed from one nerve cell to another by a process that uses chemicals called neurotransmitters.  An electric discharge travels down the outside of a nerve cell until it reaches the end-plate, where it triggers the release of a neurotransmitter.  This chemical travels across a gap (the synaptic gap) to the neighbouring nerve cell.  Once enough molecules of the neurotransmitter have attached to receptors on the neighbouring cell, this triggers an electric discharge that travels along the outside of this second nerve cell.  The more this connection (synapse) is used, the closer the nerve cells become and the narrower the synaptic gap between them, making it easier for the neurotransmitter to get across, making it easier, in turn, for that connection to be triggered.  This is how we acquire new skills (practicing the piano, for example) and also how we form habits, good and bad.

We develop well-used neural pathways that are easily triggered, and that is a wonderful facility when it comes to learning to play an instrument, for example, but less wonderful when the easily triggered pathway sets off a pain response.  The good news is that our brains can be re-programmed to trigger a different neural pathway and that is what NLP sets out to do. We all have the ability to do this – it is a consequence of the way our brain works.  The NLP practitioner merely helps patients access that ability within themselves, and make their own changes.

I write this on the train to London for the fifth module of the course.  This is the last of the taught modules – after that comes 4 days of assessed clinical practice working with real patients, and providing I perform to a high enough standard I will then be allowed to sit the written exams and undergo a final practical assessment.  If I pass all that I will get my Clinical NLP Practitioner Diploma and be allowed to embark on the Master Practitioner course (like I said – continuing study is part of an Osteopath’s way of life.  Maybe one of these days I’ll catch up with Kate)!