ESSAY:
Where does pain come from?
I hurt my back over the weekend. It was not that dramatic (those who heard me complain about it at the time likely disagree, hah) and it is mostly healed, but it raised this question: where does pain come from?
On Friday, I traveled to Delaware County, one of my favorite corners of the Catskills, for a wedding. It is a long drive from Brooklyn. When I arrived at my Airbnb (an adorable cottage made of straw bale), I climbed the ladder and crawled into the tiny loft bedroom to check it out. Coming down, I realized I had “tweaked” my back. It hurt a lot, I couldn’t really bend, and later that night I tossed and turned unable to find a comfortable position to sleep. I am who I am, so in the morning I drove to the health food store (shout out Good Cheap Food in Delhi) and bought Arnica tablets and Tiger Balm. I stretched in the sun, beside the goldenrod field at the cottage. By the time I was heading home on Sunday, my pain was down ~60%. I honestly chalked up the experience to a long drive coupled with “aging” (I am in my 30s?) but then I remembered something that happened the week prior.
A friend recently encouraged me to try a pretty high-intensity fitness class, which is admittedly out of character for me, but I signed up for a trial week to try it out. The instructor came over and asked if I had had an injury on my left side- he was noticing a strong favoring of my right. I mentioned a foot fracture 2 years ago and he said yes, that is it and be careful because what often comes next is back pain. I thought yes okay I will heed this warning and did a quick scan of my back — feels good, as it almost always does, it’s never really been an issue for me. The next day, I mentioned this exchange to my practitioner Damian, who was basically like .. sure .. but what is more likely to cause back pain is someone telling you you’re going to have back pain.
A week later, I had completely forgotten about all of this happening when “my back went out”. But it makes me wonder - was it the drive? An unengaged core? The ominous warning from the instructor? Some sort of vague age-related decline? Or the narrative we have been repeatedly taught, and maybe repeat to our friends and to ourselves, that aging somehow inherently causes pain?
And what healed it? The sweet sweet burn of tiger balm coupled with the seat-heat of my volkswagon was GOOD. The chiropractic visit I scheduled upon arriving back in Brooklyn left me feeling 2 inches taller. The pain seems less after each dose of Arnica. And I tell myself repeatedly that I am not a victim of back pain and that this will heal (it has).
It is a fact that the extent of pain is not correlated with extent of injury. In my practice, focused on gut health and hormones, I am often working with more visceral types of pain. I have seen patients with ZERO period pain find out they have stage 4 (the most severe) endometriosis- incidentally! I have seen patients with near-perfect stool analyses report daily stomachaches (IBS is literally defined by its visceral hypersensitivity.) In practice, I’ve seen chronic constipation cured by a job change and disordered eating habits stop by falling in love with the right person. And of course, I also see dietary changes, movement, herbs and medications change people’s lives every single day.
So back to the questions- what causes pain, what heals it? I believe it is all of the above. The root cause can be muscle strain AND the power of suggestion. The cure can be medications, healing touch, herbal medicine AND a change of perspective. Our bodies are dynamic and should be treated accordingly.
— Dr. Lauren