Complicated Pain Recovery™

Fight or flight is an amazing and marvelous survival mechanism that has allowed human beings to flourish since we first walked the earth. It was designed to activate in the presence of physical threats. The sympathetic nervous system releases chemicals into the body that make us run our fastest and fight our strongest in the face of physical threats. Ages ago it might have been a saber toothed tiger wandering into the encampment or the attack of a neighboring tribe. In modern life it would be activated when camping and hearing the rustling of a grizzly bear outside your tent. Or in town while walking across the street you hear the footsteps of an unwelcome stranger. Perhaps you have heard the story of the mother who lifted up a car to release her young child pinned under a tire. Where did that superhuman strength come from? The activated sympathetic nervous system.

The fight or flight response was designed to activate for brief periods of time to ensure we survive a physical threat. After the five, ten or fifteen minutes expended running or fighting, hopefully we have escaped the life threatening situation and once again the parasympathetic nervous system predominates as we return to the “rest and digest” activities of everyday life.

Now here is the problem we face in modern life – most of the “threats” we experience are not physical, and yet we remain wired to activate the fight or flight response. Money worries, relationship conflicts, job dissatisfaction, even traffic jams – all activate this sympathetic fight or flight mode. Most of us have this system activated throughout the day. And this over activity of the sympathetic nervous system is the first and most common complicating factor contributing to complicated pain. This over activity you will better know as anxiety, tension, stress, worry, panic and insomnia.

Remember, sympathetic activation releases chemicals that prime the body to run or fight. These chemicals by their very nature induce muscle tension. When you are sympathetically activated – stressed or anxious – some muscle in your body is tense. Depending on your predisposition, you are clenching your jaw, furrowing your brow, hiking your shoulders, gripping your fists, squeezing your butt cheeks, pressing your toes to the floor, shaking your leg or shifting back and forth. Now, if you already have an area of your body that is stressed or injured and you are tensing muscles around it, you are creating or worsening pain. Even in a perfectly healthy part of your body, if you tense the muscles long enough you will create pain. Just try clenching your fist hard and see how long it takes before your hand hurts. Many headaches, neck and back aches are caused, worsened or lengthened in duration by the muscle tension induced by sympathetic over activity.

There are very effective ways to calm the sympathetic drive and restore balance which become an integral part of the pain recovery process.

I have had the pleasure of explaining and teaching the tenets of complicated pain to many hundreds of professionals as patients. It can often take hours or days to grasp the totality of the model. Below is a bullet point “Cliff’s Notes” version to help to quickly get the basics.

Core principles:

• The natural course of painful conditions is to resolve or recede.
• When a painful condition resolves or recedes with appropriate care over an expected timeframe this is considered “simple pain”.
• When pain fails to resolve or recede with appropriate care over an expected timeframe, it is understood that there are complicating factors interfering with natural healing.
• When pain fails to resolve or recede as expected due to complicating factors, this is considered “complicated pain”.
• Complicated pain continues to have the potential to resolve or recede if all of the complicating factors are identified and addressed concurrently.
• There are four major complicating factors which the model refer to as:
  1. bio-mechanical pain
  2. hyper-sensitization
  3. metabolic inflammation
  4. inertia
• If even one of the complicating factors remains unaddressed, this will interfere with the effectiveness of care or treatment directed at other factors.
• Treating one complicating factor while ignoring any other active factor makes good and appropriate treatment appear to be ineffective or paradoxically worsen the pain.
• The four complicating factors may be likened to a combination lock with four tumblers; all four tumblers must be addressed to “unlock” the pain. The complicating factors are often referred to as “the four tumblers” to reinforce this key metaphor.
• For those with complicated pain, the process of addressing the complicating factors must be ongoing and simultaneous, requiring active and ongoing practices and strategies on the part of the person experiencing pain. For this reason it is termed a recovery process. The model is called “Complicated Pain Recovery”™.
• Complicated Pain Recovery™ is not synonymous with pain treatment. Pain treatment is provided by licensed personnel, requiring specific training and expertise (i.e. medical doctor, chiropractor, physical therapist, psychologist, etc.).
• Complicated Pain Recovery™ is offered to individuals in pain through an educational and coaching process. This process does not involve diagnosis or treatment.
• Training and expertise to provide Complicated Pain Recovery™ educational and coaching services is provided solely through Compaire Consulting, LLC, which develops and maintains the standards and processes to designate an individual as Certified Complicated Pain Recovery™ Coach and a facility as providing a Certified Complicated Pain Recovery™ Treatment Program. Compaire Consulting, LLC has the right both to designate and rescind certification.