The majority of the people I work with have been spat out of the medical system for having clusters of symptoms that don't fit traditional diagnoses.
A bunch of them have gone to doctors, got images taken of their painful body part, little showed up, and the pain doc just sorta shrugged and said, “I don't know, maybe try therapy?”
Which isn't half wrong but doesn't provide a clear path forward.
When you have pain but don't have an identifiable cause in your imaging (or sometimes even if you do, but that's another post), why do you still hurt?
People often ask me, “is it in my head?” and my response is always, “no, but it's in your brain.”
Pain in NOT in your painful body segment but in how your brain perceives what's happening there and how problematic it is.
To understand this better, think of the brain like a prediction machine. It learns based on your experiences and its job is to keep you safe. But the problem is the prediction software isn't perfect, and it can get reprogrammed in unhelpful ways by our experiences.
Chronic pain is one of the ways the prediction software gets hacked and is now protecting us from normal everyday things. It's gotten too sensitive.
So the goal of rehab then is to help the brain come to more accurate conclusions about what's dangerous and what's not by sensing its environment more clearly.
Well-done corrective exercise allows the brain to sense the body and how it moves/controls itself more clearly.
Needles and manual therapy help the brain sense an area more clearly.
Somatic therapy helps the nervous system sense its internal and external environment more clearly.
We take whatever combination of these approaches and stack them together in a way that helps your brain figure out how to change its predictive processing errors and ease up on setting off the pain alarms when it doesn't need to.
It's a little different for everyone, but the process of good therapy and rehab is systematically applying and carefully listening to what's helping your system write new, helpful software that suits how you want to live.
