Here are some recent comments that we have received from our patients:
‘Since starting the course I have been able to look at my pain in a different light. Learnt different coping strategies which I have been using at home such as exercise and breathing.’
‘Instructors are very informative explained everything so you could understand the process of pain and how you can manage pain. It has helped me to manage problems in a more positive way. I would recommend this course to anyone suffering with persistent pain.’
‘Good Relaxation techniques, supervised exercise, staff talking to you as an individual rather than talking from the front of a class.’
An email received from Mark in November 2017:
I just wanted to update you all there with some pretty important information –
You may recall I ‘boldly’ set myself a goal of cycling from London to Brighton – the week before we discussed the boom or bust I think!!
Well, I did it. I have raised over £1000 for the Perthes Society by covering 55 (mostly up hill) miles on Sunday.
I did it in 4hours and 46 minutes which I am very pleased with!
Had I not had the opportunity to join the programme I would still be sitting somewhere ignoring my pain as best as I could and struggling! As it is I am still losing the weight – slowly now – exercising much more and stretching the aches and pains away.
So whilst I am still not pain free and doubt I ever will be I have used all of the tools you guys presented to me to make a much better way of life for myself.
Thank you all.
On bad days there was a tremor in my hands that was so strong I could barely function, I had numbness down one side of my body, and my senses were all over the place – tastes were vile, smells too strong and my vision blurred. I had to stop riding my motorbike (something I used to love) and the poor dog’s walks got shorter and shorter. I was convinced there was something really very badly wrong with my back, but two separate MRI scans showed up absolutely nothing: bar a little wear and tear, my spine was completely healthy.
The pain had come on very gradually but was getting progressively worse.
Without an identifiable problem there was no treatment and I was left unable to work or walk or properly function. The stress of not being able to pay the mortgage or cover any bills was tremendous. So I begged my GP for help. I was expecting him to give me even stronger painkillers or painful exercises but he refered me for pain management. I didn’t even know such a thing existed.
But that’s how I ended up at the Royal Orthopaedic Hospital in Birmingham on a four-week course (three hours per week in two group sessions) under the care of physiotherapist, David Rogers and Dr Grahame Brown.
The first hour changed my life. Like me, everyone in the room had been in debilitating pain for months, and not one had a satisfactory diagnosis. But we were taught about the ‘biopsychosocial approach’ and the fact that stress, tension, anxiety and fear could be making our pain so much worse. I’d worked in mental health for many years as a nursing assistant so I knew a bit about the power of the mind. It gradually became clear to me that my years as an ambulance driver, carrying adults up and down flights of stairs had clearly put a strain on my back. It hadn’t been a problem. But when a simple shoulder injury at work (I wrenched it carrying a patient)in 2014 refused to heal I could no longer do my job. I got very stressed and my back started to play up. I’d never been out of work since the age of 13, but suddenly I couldn’t pay the bills. The sessions made me realize that my anxiety and anger was as much a part of my pain problem as my back. It was a revelation.
In that first session we were taught some simple breathing exercises and stretches. I remember being asked to get up from my seat without using my hands or arms. I could only manage 18 lifts in two minutes. But by the second week I was off the painkillers and by the third week I was no longer taking anti-depressants either. The swift improvement proved to me that mine was more of a brain issue than a back issue. By the end of the course I could easily do 50 rises from the chair.
Now I’d say I’m pretty much pain free. I do various breathing and stretching exercises every day. The dog gets a proper 1 ½ hour walk and I work as a freelance artist, help in a local picture frame shop and I’m registered as a film and TV extra. I even helped a friend lay a vinyl floor – that’s not something I ever thought I’d be able to do.
The course has been life-changing for me.
I’ve been suffering from back spasms for about 15 years now. Gradually, I’ve gone from being a very fit (road running several times a week plus a couple of cardio classes) to someone who’s so afraid of damaging her back, that I hardly took any exercise. I’ve been relying on pain medications, time off work and hoping that the spasms don’t occur too often. My social life has also been impacted as I’d got into the habit of saying things like ‘I’ll try and come to the meal but if my back’s bad that day, I’ll have to drop out’ and also not feeling confident to book holidays in case my back ‘goes.’
After the worst bout of my back pain ever earlier this year, I decided I’d had enough and needed to find another way rather than just relying on pain medications and making myself inhabit a very small world. I was on a book website and saw David and Grahame’s book, bought it and read it from cover to cover within a couple of days. Everything in it just resonated with me and I realised that the last two bouts of extreme pain I’d had, had probably been due to having to have a totally unexpected major operation on my stomach last year. I’d gone from trusting my own body to being someone who was doubting every ache and pain and constantly on the watch for them too.
I found the course inspiring and the team totally supportive and encouraging. Like many back pain sufferers I’ve had physio before and also seen my GP but in both instances, I’ve always felt that they were never really aware of what an impact the fear of this pain was having on me. Nor could anyone explain why it was happening more and more often and becoming more severe each time.
I had a spasm earlier this week but didn’t automatically go to the catastrophising thoughts I did previously. I’ve been following the Headspace meditation programme so carried on with that, and also have been doing Abbie’s clenched fist stress reliever. Knowing now how there are triggers to the bouts of pain has also made me reflect on what could have triggered this spasm. I’d volunteered to do something I didn’t really want to do and was stressing about it. I wouldn’t previously have connected that with getting a back spasm. So far, I haven’t had to take any pain medication, am just using the meditation, the stress reliever, stretching and today, I went for a gentle walk.
I can honestly say that going on the course has, if not completely given me the old ‘me’ back, has shown me that I can get back to that person in the future. My fear of moving has decreased considerably and I’m now setting myself new goals rather than just accepting that my life has to be restricted because of the possibility that my back might ‘go.’ I’ve signed up for Pilates classes (something I used to do but had given up), am booking a holiday for next year and am trying to incorporate all the lessons I learnt on the course. The bottom line for me is that good as doctors, physios and pain medications are, at the end of the day, you can’t hand off this problem to someone else; the solution has to come from you but when you’re in such a dark place with pain and fear, you need great people to point that out to you. Thankfully the team at the FRP did that for me.
When I first met you all I “knew” I needed some advice and instruction to improve my ‘physical-ness’ and also give me permission to go back to training more in a vain with how I had been before the original injury last year.
My initial impressions were very good with the staff though the very wide range of abilities in the room coupled with my ‘acute’ (6 months old) injury compared with people who had been in ‘pain’ for 4 years felt disheartening. Was I in the same boat as these people? They described pain in a very different way, something I would consider a normal part of being active, muscle pain, left them incapable of movement for days?
My original targets were set in a what I believed were a somewhat realistic manner but also as a way to challenge the course, would I be told to slow down would I be told these are aspirations. My most recent scan clearly showed there was still damage (a bulge) which would reduce the spinal column’s volume, and that coupled with the normal body reactions to injury (swelling) had clearly affected me in January this year. But you took that in your stride, asking me more details about my normal levels of flexibility strength etc. and though I was warned not to ‘boom and bust’ I was given the encouragement I needed to try at least.
So after a rocky first week, I realised a couple of things. I wasn’t going to get a ‘magic treatment’ or even ‘permission’ to go out and ‘get back on the horse’. And that the message Grahame was giving the others about starting to move and starting to attempt normal activity again (which seemed like it didn’t apply to me) was the same he would give me one-to-one. It was my own lack of understanding about this and in my case fear of a repeat injury that was stopping me from taking the next step, just the same as everyone else.
The talks on psychology of pain, how your body reacts to situations, and how external factors can effect or heighten these inputs really helped me. They rang true and allowed me to identify contributing factors that no doubt allowed me to become fixated on the injury and the effects of it, dwelling on the pain. It also helped me quantify the effects of my setback in January. It was a realistic reaction but it didn’t necessarily mean the injury was worse or had even been significantly affected by the exercise I had done.
So where am I now…
Very happy, confident that though the spinal disk will always be weaker, as will they all, (no doubt an inherited weakness, all my brothers have diagnosed injuries of one form or another as did my dad). I’m also aware at some point in the future I will push too far and possibly re-aggravate the original injury or do something else. But I’m not scared. It’s part of growing older and doing things. I will pick up injuries, and I will heal at one level or another.
I’m confident I have the tools to copepsychologically with the injury and I havea plan I can take when things go bad. I also know that the biggest thing stopping me from recovery and normal activity are my own worries and fears.
The course help me realise the last 6 months had affected me mentally far more than I had given them credit, the realisation of this and the support I was given helped me work out what I needed to do recover. As a person who has played team sports for most of their life this is the first time I have faced an injury like this without the support of a several coaches, a couple of physios and two teams of friends and peers who could give support encouragement and ‘essentially the kick up the arse’ I needed to move on.
I do not want to give the impression I will go gung ho and ignore the calm and measured advice I was given, just the opposite. I have taken that all on bored and it will become part of my normal routine. But more than any other aspect the understanding of my own weaknesses both on going and those specific to the time of the original injury has helped me to reassess how I deal with these situations and given me the confidence to carry on.
So in summary, Many many thanks for all the course has helped me to achieve in such a short time, it would have taken me immeasurably longer on my own and I possibly would not have reached the same levels without the help and support given. To those embarking on this program Grahame’s advice might seem strange at first and even unproductive but if you are willing to give the course a fair chance and put in the effort required it will help you. Be willing to listen to the stories of others and share and I’m sure you will find common themes and issues that can’t be wholly ignored.
All the best for the future to all those involved, but special thanks to Grahame - for being patient with me, Sam – great to have someone in the room who could understand the rigors and stresses of contact sports and the desire to play these even when you might injure yourself and Chris - who listened to me ramble on about sports in general.