What is Your Body Trying to Tell You? The Top Causes of Chronic Pain and How to Tackle Pain Head On
Apr 28, 2025
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Andrea Furlan, a scientist and physician specializing in chronic pain, emphasizes how emotional issues often fuel pain signals sent by the brain. Meanwhile, Howard Schubiner, a professor and director at a MindBody Center, discusses how adverse childhood experiences can lead to chronic pain in adulthood. Both experts challenge conventional pain treatment approaches, advocating for integrated methods that address emotional triggers. By focusing on the brain's role and lifestyle factors, they offer listeners a transformative perspective on achieving lasting relief.
Chronic pain is not a normal part of aging, as many older adults can have physical issues without experiencing pain.
Nociplastic pain arises from an over-sensitized pain system, requiring treatment that recalibrates pain responses rather than merely suppressing symptoms.
Mind-body interventions, including cognitive therapy and relaxation practices, are essential for addressing the emotional components of chronic pain.
Deep dives
Myths Surrounding Chronic Pain
One prevalent misconception is that experiencing pain is a normal part of aging, leading many to believe that age inevitably brings increased pain. However, research indicates that many older adults may have significant physical issues visible on X-rays yet feel no pain at all. For example, Dr. Andrea Furlan shares the case of her 92-year-old grandmother, whose severe neck degeneration did not cause her any discomfort. This highlights that aging does not inherently correlate with chronic pain, challenging the narrative that suffering is simply an expected consequence of growing older.
Understanding Chronic Pain Mechanisms
Chronic pain often arises from a condition known as nociplastic pain, where the pain system becomes sensitized and misinterprets signals, leading to ongoing discomfort without a clear physical cause. This condition requires different treatment strategies than acute pain, which is typically addressed through physical interventions. Dr. Furlan uses the analogy of a malfunctioning alarm system: an alarm signaling danger improperly leads to chronic pain, thus necessitating methods aimed at recalibrating the pain response rather than simply suppressing symptoms. Effective management strategies include movement, proper nutrition, and mind-body therapies, emphasizing the need for comprehensive approaches to treating chronic pain.
Impact of Stress and Lifestyle Choices
Research shows that stress plays a significant role in the transition from acute to chronic pain, reinforcing the necessity to address the brain's danger perception signals related to pain. Factors such as adverse childhood experiences and ongoing stress can exacerbate pain signaling, creating a cycle that perpetuates discomfort. Additionally, poor lifestyle choices, including lack of exercise, unhealthy diets, and insufficient sleep, can lower the body's resilience against chronic pain. Addressing these lifestyle factors is crucial as they significantly increase the likelihood of developing persistent pain conditions.
Mind-Body Approaches to Pain Management
Mind-body interventions are increasingly recognized as effective tools in addressing chronic pain, particularly by helping individuals manage their stress and change their perception of pain. Techniques such as cognitive therapy and psychotherapy can empower patients to regain control over their pain experiences by challenging negative thought patterns associated with pain. Furthermore, relaxation practices like yoga, meditation, and massage offer strategies for activating the body's parasympathetic nervous system, promoting relaxation and reducing pain. This holistic approach underscores the importance of treating the emotional and psychological components of chronic pain as much as the physical aspects.
The Broken Pain Management System
Current pain management practices are often limited by a reliance on the biomedical paradigm, which can lead to ineffective treatments focused solely on symptom suppression without addressing underlying causes. This model's failure to account for the brain's role in pain generation results in many patients receiving unwarranted imaging or unnecessary procedures, further complicating their pain experience. Recent studies suggest that a significant majority of chronic pain sufferers do not have ongoing physical injuries; rather, their pain may stem from psychological factors or previous trauma. Introducing the symptom perception model shifts the focus from managing pain to reprogramming the brain's understanding of pain, offering patients a greater potential for recovery and improved quality of life.
Chronic pain affects millions of people, yet traditional approaches often focus only on managing symptoms, without addressing the root cause. Today’s guests share a groundbreaking perspective: that pain is created by the brain as a signal of an underlying emotional issue that needs attention. By identifying and addressing these emotional triggers, lasting relief can be achieved by rewiring the brain.
Today on The Dhru Purohit Show, we’re bringing you a special compilation episode featuring Dhru’s conversations with leading experts on getting to the root cause of chronic pain.
Dr. Andrea Furlan breaks down the drivers of chronic pain and debunks common myths around treatment. She also highlights the dangers of a sedentary lifestyle in worsening pain and shares her unique, integrative approach to healing.
Next, Dr. Howard Schubiner explains why chronic pain is becoming more prevalent and how it’s closely connected to the brain. He outlines why the current model of pain management falls short and introduces Emotional Awareness and Expression Therapy—an evidence-based approach that has been shown to be more effective than traditional treatments. Dr. Schubiner also discusses how adverse childhood experiences can manifest as chronic pain later in life, and how we can retrain our brains to change our perception and experience of pain.
In this episode, Dhru and his guests dive into:
Top myths in treating chronic pain (01:05)
Tier ranking of the top drivers of chronic pain (06:40)
Corrective exercises for addressing lower back pain (12:36)
Solutions, answers, and advice for lower back pain (15:33)
Evidence-based alternative approaches for chronic lower back and shoulder pain (19:26)
Do's and don'ts to prevent abuse of the body (22:51)
Why back pain has doubled in the last twenty years (29:20)
What pain in the body actually is (32:28)
Why the current approach to pain and pain management is broken (35:43)
The Symptom Perception Model and its effectiveness (43:00)
Incentives that contribute to systemic failure (44:32)
Why MRIs don’t provide a complete picture of pain (49:11)
Adverse childhood experiences and their relationship to pain (54:45)
Understanding how the brain generates pain (59:58)
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