How to treat Chronic Pain in the Brain, Body, and Nervous System

00:00 Intro
00:35 What Is Chronic Pain
01:29 What Causes Chronic Pain
05:15 Pain Serves A Function
05:50 Acute Pain
06:41 Suppressing Pain
10:38 Optical Illusions
12:44 Alarm System
13:26 Exercise
24:25 Insula Retraining
26:20 Central Sensitization
29:37 Other Treatments
30:46 Pain Neuroscience Education
37:42 Lifestyle Changes
39:47 Medication
51:37 Breathing Exercise

Click the link below to access the transcript:

Therapy in a Nutshell and the information provided by Emma McAdam are solely intended for informational and entertainment purposes and are not a substitute for advice, diagnosis, or treatment regarding medical or mental health conditions. Although Emma McAdam is a licensed marriage and family therapist, the views expressed on this site or any related content should not be taken for medical or psychiatric advice. Always consult your physician before making any decisions related to your physical or mental health.
In therapy I use a combination of Acceptance and Commitment Therapy, Systems Theory, positive psychology, and a bio-psycho-social approach to treating mental illness and other challenges we all face in life. The ideas from my videos are frequently adapted from multiple sources. Many of them come from Acceptance and Commitment Therapy, especially the work of Steven Hayes, Jason Luoma, and Russ Harris. The sections on stress and the mind-body connection derive from the work of Stephen Porges (the Polyvagal theory), Peter Levine (Somatic Experiencing) Francine Shapiro (EMDR), and Bessel Van Der Kolk. I also rely heavily on the work of the Arbinger institute for my overall understanding of our ability to choose our life's direction.

Copyright Therapy in a Nutshell, LLC

[Louiseclaire]

30 years of chronic pain and 3 years of nervous system burnout gone in almost a week. I first researched how to desensitize central sensitization and how to support gaba production in my brain, and the neuroscienceof chronic pain. I also started doing weight training 3 times a week and yoga 3-5 times a week ( no gentle start), mindfullness, gratitude, breathwork, journaling, and learning how to speak safety to my nervous system/inner child. It's all absolutely life changing. It was easy to incorporate all of these strategies into my day and Is absolutely worth it. ❤

[lptherapygroup]

This goes to show that people without pain just don't understand people with pain. We as a society are still at our medical infancy on understanding pain.

[slcpunk_]

I have fibromyalgia, Ehlers Danlos Syndrome, Interstitial Cystitis, IBS and Hashimoto’s. I have always been very open to the theory regarding chronic pain that is talked about here. I’ve had chronic pain for 8 years. I’ve tried all of the treatments mentioned here, and I’ve only had minor success. I am not in any way obsessed with imaging. I don’t think there is anything wrong in my MRIs or X-rays. I don’t have fear of movement. I am a very objective person. I’m very ambitious. I have a full time job as an IT manager. I always commit to things. I think the healthcare system needs to be more open to studying other treatment options and stop being condescending, as I feel the doctor here was. Lidocaine infusions have helped. I think we just don’t know enough, and the palliative care approach in the US is a joke. Love your channel but felt this one wasn’t very helpful (not on you). There are people who talk about similar stuff in videos that I feel are more accessible.

[MsBrowniepuff]

Sending love to all my fellow chronic pain warriors 💕

[suzy]

Can't thank you enough for addressing chronic pain on your channel. ❤

[frankducett]

I got to the 20 minute point of this video and realized I needed to pay better attention, so I started it from the beginning.
Really amazing, thank you.

[KathleenRenninger]

Wow! I now have some hope for the chronic pain which has diminished the quality of my life of for so long! Thank you Emma, for bringing Dr Furlan's work here, and for your input as well. Your channel has been of so much help to me. May God bless you always.

[chloeferguson]

Thank you so much for this video. I’m not even to minute 4 yet and I burst into tears because I have been walking the tightrope between dealing with real pain and also telling myself I’m not crazy for almost 10 years now. It doesn’t get better, but I’ve learned better coping mechanisms. Thanks again and can’t wait to listen to the rest of this interview. ❤

[jeremyandkhana]

I have had chronic pain my whole life, even as a small child and it has become very severe in the 10 last years.
I just wanna say that your comment in the beggining "can you imagine that?" Sent me into tears. I wish everyone had that kind of empathy.
Being gaslight, ignored, neglected and even violented is possibly the worst part of this hell.
Honestly I don't even know how I survive, I find it hard to comprehend the amount of pain and suffering I love thru even myself so I understand that people have a hard time comprehending it. I just wish they would trust me. You don't need to understand, you just need to trust me.

[Ij-jan]

When you have chronic spinal pain, after a failed laminectomy, all the journaling, mindfulness, meditation, and anything else like that does not help. There is a reason for the pain. The nerves are damaged and nothing is going to make it better.

[accidentaltimetravelermagg]

Lived with migraines for 20 years. Best doctors, tried everything. It was when I found a community, 12 step, surrender, a personal relationship with the lord. Am not discounting what is said here, however, believe this is far to complicated, 46:27
we are not doctors.and living with pain…..🙏🏻God can do what I couldn’t, eventually began doing much of this, eating, exercising. But his love support of community seeing & hearing what a power greater us, does WORKED ! Shocking my doctors. I truly l
Found many of your videos so helpful. Keeping it simple, taking off the pressure. Hope this makes sense. Love is the most powerful medicine..

For anyone no many your beliefs or not believing, it’s just having a higher power, can be your dog. My heart goes out to all in pain.

[dee]

Thank you Emma! This is another very helpful video.All videos don't need to apply to everyone.Your knowledge, compassion, empathy and caring are so evident in all of your videos.Thank you for all that you do!

[SuenosDeLaNoche]

My journey to chronic severe pain began in 1984 while working on a military project on a remote tiny island in the Pacific.
The degenerative chronic severe pain I live with originates in my spine and affect everything attached to it.
Dealing with the depression cycle is all too often is more challenging than what is required for the pain management.
Blessed Be to All of you that live with chronic pain. May you achieve mastery over the pain. 🙏🏼

[Nick-nzif]

Please note that RICE (at 5:55) for acute pain is outdated for almost a decade now and is not longer recommended. It impairs and delays healing.

[krisshensley]

Wonderful conversation. There truly are many avenues to treating chronic pain. What I particularly like is "Empowering the Patient". The pain is real and there are ways to manage (and in many cases) reduce chronic pain. Thank you both so much for helping us.

[kainiezgoda]

Thank you Emma, I am so excited to see a respected practitioner like you spreading the word about mind-body approaches to pain! It may not be for everyone, but everyone should know it is an option for them.

[MilesMontgomery-pjxc]

Hey Emma, I love your video's! they are helpful and I love how clear you are in them. Thank you so much!

[yvonnekneeshaw]

There r several comments that view this as negative. Done CBT and I’m in ACT now & has moved me in an upward direction a few degrees. And I’ll take it! Kept me from going over the edge. The somatic part is new to me. Just to be clear we do feel pain. It that the message of pain is screwed up and needs to be interrupted and retrained. There IS value in these suggestions. If We are already at our wits end … what do we have to lose? Meds do little for my chronic pain.

[aandrus]

It is extremely hard and terrifying to listen to this. I have lived with high pain for 34 years. I've been diagnosed with Fibromyalgia, Myalgic Encepalimyalitis, Hashimoto's Thyroiditis, Long Covid and I am still recovering from viral meningitis symptoms which started 5 months ago. I've also been diagnosed with depression and anxiety. I don't even remember what it feels like to not have pain. You talk about undoing synopsis and I WANT to be fixed. I WANT to have a life finally. But I do not (as far as I'm aware) have a thing that has broken me. These illnesses can't be seen on tests. Yet, they are very real. I have seriously struggled with chonic pain for so long that I don't even remember what it feels like to not have pain. So, I can't say to myself, "My broken bone is healed now." I once DID break my shoulder and it hurt like hell, but then it healed and doesn't hurt. That pain experience was different than my chronic pain. I don't understand why and how this applies to me to fix me. But I NEED relief desperately! How can this help me!?

[PsychologyFeed]

I love how Dr. Andrea consistently stresses on the fact that "we all heal". I can almost sense how empathetic she is to people who are suffering and it is very reassuring to hear her say this. - Having said that, I also understand how people with terrible, chronic, real pain can feel devalued by this conversation. I hope that the message that "your pain is real" gets conveyed to all of them. Yes medicines work, but in a number of cases the pain may be enhanced or made chronic due to to psychological and neurological conditioning AS WELL. I'm sure their motive was not to infuriate people or trivialize their feelings.