Do I have to stop medical interventions for my neuroplastic pain?
By the time a person with chronic pain comes to me for coaching or psychotherapy, they’ve usually tried numerous medically-oriented interventions to treat their pain. These commonly include medications (both over-the-counter and prescription), chiropractic care, acupuncture, physical therapy, surgeries, and/or injections.
People seek out these medical interventions for logical reasons. They’ve been told that there is something wrong with their body and that the corresponding treatment is to correct whatever that deficit is through physical manipulations and interventions.
I almost never see the people for whom these interventions are successful. Instead, I work with the people who have NOT benefited from purely body-based approaches (or not benefitted as much as they would like). Over time, many of these people come to recognize that there may be more to their pain than their physiological makeup.
Once people realize that there may be a psychological or learned component to their pain (commonly called neuroplastic pain), they want to jump in full force to psychological interventions. And understandably, they don’t want anything to interfere with the success of these interventions. At some point, many people ask the question: “Should I stop using medical interventions for my pain?”
Why do people think they should stop medical interventions for pain?
I tend to think of combatting pain as an all-hands-on-deck, whatever works, not black-and-white endeavor, especially when you are first learning to get out of pain. However, there are others in the field who take a firmer stance against using medical interventions for neuroplastic pain.
The argument against using medical interventions for neuroplastic pain is that they can interfere with the unlearning process. By using a medical intervention (e.g., taking pain medication, getting an injection), you send a message to yourself that “There is something wrong with my body, over which I have no direct control, and I need an external solution for it.”
The argument is that the longer you “rely” on these ways of feeling better (or at least attempting to feel better), the longer it takes to teach yourself that there’s nothing to fear, that your body is not in danger, and that the solution to your pain lies in changing your relationship to pain, your body, and your mind.
It’s not an unreasonable argument and if it works for you to follow this advice, wonderful! However, here’s why I don’t recommend it for everyone, particularly at early stages in the pain recovery process.
Why this approach isn’t for everyone (and doesn’t have to be)
I have found that when people ask the question “Should I stop using medical interventions for my pain?” they’re usually feeling pretty freaked out about the idea.
In fact, they’re feeling pretty nervous about a lot of things related to their pain. They may have a sense that there is an ideal way for them to be treating their pain and if they stray too far from that ideal, there will be no hope for them. They might believe that if they don’t do this perfectly, they’ll mess it up and won’t be able to come back from it.
At the same time, they also have a repertoire of medical/physical approaches to their pain that they’ve been using for a while. And while these approaches may not be working as well as they would like, they are familiar and follow logically from the individual’s belief about why they have pain (which is usually a physiological/structural/disease model explanation).
This combination of fear/anxiety/worry and medical treatment strategies that are at least semi-effective can set people up for a “failure” experience if they take away the treatment strategies too quickly.
That’s because taking away the treatment strategy will almost inevitably lead to an increase in fear, at least in the short-term.
And when pain is neuroplastic, more fear usually translates into more pain.
When pain increases, and without their usual coping (treatment) strategies to rely on, the natural conclusion is “This didn’t work.” In other words, the individual concludes that they DO, in fact, need to use physical methods to control their pain (even if those never worked well enough in the first place), and that this idea about psychologically-generated pain is stupid/bogus/not applicable to them.
That is the opposite of the learning process that we are hoping for! That’s what I mean by a “failure” experience. “Failure” in this case is the idea that this experience would take a person farther away from feeling safe in their body, further cementing a belief in a purely physiological explanation for pain.
So what should you do?
Start by exploring why you're asking whether you should stop using medical interventions for your pain.
Is it because someone said you should stop?
Did you read a book or an article that took an all-or-nothing, mind vs. body approach to pain?
Have you heard that the only way to recover fully from pain is to convince yourself it’s “all in your head”?
If the answer to any of these questions is “Yes,” this may not be the best starting point from which to explore the possibility of stopping medical interventions. That’s because YOU are the person who needs to be convinced of the safety and efficacy of taking away treatment methods that you may have been relying on for years, not anyone else.
On the other hand, if you answered “Yes” to the questions above, but qualified your answer with “I have a solid understanding of the fear-pain cycle and I am prepared to manage a short-term increase in my pain using psychological methods,” it might make sense for you to try this.
Before you make any decisions about how you “should” treat your pain, however, it can be helpful to get a better understanding about what your pain is and how it operates. You’ll want to understand both the structural/physiological side AND the psychological side. Why? Because for most people with chronic pain, both are contributing to pain.
Here are some resources to get you started:
Ready to transform your relationship to pain? Check out my coaching program for chronic pain and request to join today.
The content shared here is for informational purposes only and is not intended as a substitute for professional medical advice, diagnoses, or treatment. Always seek advice from your physician or other qualified healthcare provider before making changes to your health regimen.
