SUMMARY of Lorimer Moseley's "four cornerstones" of understanding / managing chronic pain (from around 18:30 to 37:00 in this video): *1. Pain protects us and promotes healing.* Patients need to understand that pain is always protective (i.e. prevents the mechanical forces or temperature changes from exceeding that tissue's strength e.g. a broken bone hurts to prevent us from moving the bone so it can heal). *2. Persisting pain (i.e. chronic pain) overprotects us and prevents recovery.* Hints that you have persisting pain: your pain moves around to different positions, or used to be in one spot but has spread to other areas. Or things that used to hurt a bit now hurt a lot. For tissues to return to normal, they need movement and weight-bearing exercises, but persisting pain strongly encourages us to *not* do these exercises (thus discouraging recovery). *3. Many factors influence every pain.* There is no such thing as a pain that has a single cause. E.g. arm pain can be either from tissue damage and/or the brain's evaluation of your entire situation. In other words, life stress, relationship troubles, difficult emotions, fears, etc can influence the amount of physical pain you feel. *4. There are many things we can do to retrain our pain system so that it overreacts less and less.* We need to keep pushing/challenging ourselves enough to trigger healing/adaptation, but not so much that we trigger a disabling/distressing chronic pain flare-up. These challenges can be to (A) our tissues, (B) our thoughts, (C) our beliefs, (D) our behaviors, (E) our relationships, (F) visiting locations that cause us distress, and so on. If you do overdo it and your pain flares up, know that it's very unlikely that you have damaged any tissue. All in all, patients need to do the hard work of truly learning the above concepts (steps 1-4) "deep in their belly" and of retraining their pain system (step 4). This is rarely quick and usually takes time. They collected data on 1500 people who attended Lorimer's various pain workshops over 10 years. Around 50% of them truly learn the concepts deeply, and have excellent outcomes at the 12-month mark, with their average pain dropping from 6/10 to 1/10. The other 50% don't see much or any improvement, possibly from not putting in the required time and effort. "I haven't met anyone in chronic pain for whom their pain is not an overreaction of a system that is outside of (their) control" i.e. Nobody is choosing their chronic pain, so there is nothing to be ashamed of having chronic pain. And the excessive pain is generated in the mind, it is not a sign of excessive tissue damage. 👍🏻
To remain curious and open and patient when learning a)pain protects us and promotes healing, b)persistent pain over protects us and c) there are many causes of pain and d) many ways to work at reprogramming our minds and bodies to deal with pain so that we can overcome the overprotective factor. We need movement and weight bearing. The Goldilocks principle finding the sweet spot changes us. Deliver a challenge to yourself to trigger change and adaptation but not a flare up. Gradual increase of movement and weight bearing promotes healing. It will work and it may be a small amount that you can do but when you trigger a flare up you at least know to do a little less next time and don’t give up persist take your time and allow you body to be bioplastic and to tend towards health. When you can’t change you exposure to a danger do it gradually plan it so you are not overloaded emotionally or physically. Humans are infinitely adaptable we live everywhere in the planet. Take you time and find someone who has the knowledge to help you in this journey.
This is EXTREMELY helpful and hopeful. I’ve watched and read many things about this process but this shines a light brighter than the others. Thank you thank you thank you.
It's t a lk and talk and avoiding shame ...and it's real to ME..sometimes, like this afternoon it is so intense I DO think of ending my life just to stop it once and for all and beyond depression...just CANT think about facing it again if I felt it coming on on like that ....like a kidney stone I had once but all over my back hips and down into legs. And so scared it WILL come back like that...completely helpless....
I’ve just found your channel. Thank you for this great interview and all the information about persistent pain in your videos, I will watch them all. Greetings from Argentina.
Listen to why the over protective factor prevents recovery: 2145-22.50 you can’t recover if you can’t give your system the very things it needs to recover
*I had a crushed disc in my spine that required two surgeries because the doctors refused to provide the proper treatment from the start.* The only pain medication for over 16 years was ibuprofen. As I suffered the most extreme pain in my life at times and paralysis. *After the surgeries I was prescribed morphine and tylenol 5 for pain.* UP JUMPS THE TYLENOL POISON CONSPIRACY! *Then They Said PATIENTS WAS OVERDOSING ON TYLENOL Because We Don't Know If We've Taken Too Much. ?? we don't? *Tylenol was eliminated from V.A. Facities.* Then *THEY ACCUSED CHRONIC PAIN PATIENTS OF BEING DRUG DEALERS AND DRUG ADDICTS.* If we wanted our medications *WE HAD TO SUBMIT TO DRUG TEST!* ? Without any evidence of being addicted or arrested for drugs. BUT THERE WAS A LOT MORE TO JUST DRUG TEST. We had to sign a PAIN MANAGEMENT CONTRACT, With A Multitude Of Must Do's And YOU DON'T HAVE THE LIBERTY AND RIGHTS TO DO ANYMORE. *MUST GET PERMISSION BEFORE ANY PAIN MEDICATIONS DISPENSED BY ANOTHER DOCTOR. CAN'T DRINK ANY ALCOHOL. Even though there's no alcohol problem. MUST SEE THE PSYCHIATRIST, AND PSYCHOLOGIST, MUST TAKE PHYSICAL THERAPY, ACUPUNCTURE, SEE THE CHIROPRACTOR. ATTEND THREE OR FOUR DIFFERENT CLASSES A WEEK AT THE V.A. *All Of A Sudden WE HAVE AN OPIOID CRISIS!* *ALL OPIOID PAIN MEDICATIONS CEASED FROM DISPENSARY FROM THE V.A.* Vets coming home with severe injuries and all pain medication stopped. *THIS CLOWN IS THE BULLSHIT THEY TRIED OVER AND OVER BEFORE, Why I was ordered to see the psychiatrist and psychologist several times over 25 years. (16 actually. After doing all listed three times over and over I said no.) Still tried it. Doing it now. *THIS IS A WHITE NATIONALIST FUNDAMENTALIST CHRISTIAN RACIST NAZI CONSPIRACY TO END MILITARY VETERAN'S BENEFITS!* No actual evidence of a PRESCRIPTION DRUG CRISIS In The Streets. *ALL SAID THEY'RE DOING HEROIN, COCAINE, METH, CRACK, MOLLY, And other drugs.* But they all got addicted after being prescribed pain medication. *WHY AREN'T THERE MILLIONS MORE ADDICTED IF TRUE?* I was prescribed morphine. *YOU CAN'T GET HIGH OFF MORPHINE!* I DON'T KNOW WHY THEY KEEP TELLING THAT LIE! *If You Take Too Much Morphine, YOUR BREATHING BECOMES SUFFOCATING, AND YOU'RE VERY VERY NAUSEOUS!* *that's just a simple overdose.* Any more and you stop breathing. *NEVER GETTING HIGH!* You can't get high off morphine. BUT! MORPHINE WASN'T ONE OF THE DRUGS THEY HAD PROBLEMS WITH! *FENTANYL AND OXYCONTIN FULL STRENGTH.* (Tylenol 5 was Tylenol and Oxycontin mixed.) What happened to it? THEY SAID IT WAS DESTROYING OUR LIVERS AND KIDNEYS FROM OVERDOSE AND ELIMINATED IT. *How did it become a problem ?* THEY COULDN'T SAY TYLENOL IN THEIR CONSPIRACY, SO THEY USED AN INGREDIENT. *Now they're paying this fool to say OUR 100% PHYSICAL PAINS FROM INJURIES ARE ONLY IN OUR MINDS!* The Same Used On Me Until I Got Highly Upset. Allowed conservatives to go wild after all they don't like in society. So they can try to create the White Nationalist Fundamentalist Nazi Christian religious fantasy country of their dreams.
*I forgot this in the first comments.* *IF THE DOCTOR, OR PHARMACIST SUSPECTS WE'VE TAKEN MORE DRUGS THAN PRESCRIBED?* They could send police to our homes and *Police Could Arrest Us For Any Criminal Activity They See Or Find.* In the "pain management contract." When I was taking the drug test, EACH AND EVERY DOCTOR I SAW WANTED ME TO TAKE ANOTHER DRUG TEST. ONE WANTED TO TAKE BLOOD BECAUSE THEY FOUND NOTHING. Even though I just taken the drug test. *I REFUSED TO DO IT. CALL THE POLICE. *This is what they do to people on criminal probation.* "THEY'RE GOING TO HAVE TO TAKE ASPIRIN". Jeff Sessions. Sounds like someone looking for drug crimes or going after pain patients period?
I totally agree. I am fan of Lorimer but also a filmmaker and blogger. It is fully 5 mins before he even speaks. All the chat about time zones and admin is deep frustrating and many will simply leave. Please just edit out the first 5 mins so there is a crisp relevant start to the material.
On topic of “shame” I have experienced resentment from people around me when I am having an episode. Even though sympathetic at the beginning loved ones can become fatigued by watching someone in pain.This may be a basis of “shame”.
Hi Madeleine, you are doing amazing work, a suggestion for more improvement in your podcast, could you please stop interrupting the guest until he/she completes his point of view. As I really got disturbed and couldn't focus on Lorimer points during the whole podcast. I hope you will take this as a positive gestures.
I would argue that pain can persist because you can’t create over a creation that is already there. You have to discreate the “pain” creation in order to create “My body is filled with welbeing”. AS long as “I’m in pain” is operating, you’ll never create well being>. AvatarEPC teaches how to do this. It works.
