The art of batting

With the cricket season about to begin, I thought it timely to use a batting metaphor to illustrate how thinking can obstruct free flowing movement. For the cricket lover, there is great joy watching a batsman lean into his front foot, head towards the ball, eyes focused through the grill, as the bat arcs guided by fast hands, the wood kissing the leather ball in the briefest of seconds before accelerating to the rope.

Seeing an expert perform in any field has the common denominator of ease. They make it look so natural and effortless, whether playing a musical instrument, dancing or stroke play. The movements have been rehearsed and honed thousands and thousands of times before, the motor patterns in the brain grooved with the synaptic efficiency that results from hours of practice.

Most people are ‘experts’ at walking. We don’t think about it in this way necessarily but the walk is a movement pattern that has been practiced since we started, well… walking. It is only when things go wrong does the motion change. A limp for example. Walking can also change when we start thinking about it rather than naturally, unobservedly going about our business of ambulation. Note how much activity is afoot from the simple stepping action, involving the whole body, the whole person and his or her mood and the environment in which the individual resides at that moment. Of course, the perception or even attention upon the environment is affected by one’s mood — ‘how did I get here? I didn’t even notice’.

With movement and posturing being an expression of who we are and what we are thinking and feeling, there are characteristic styles that identify us to others and to self — you will recognise a friend from afar by the way he walks; and you will know that you are moving well and normally by detecting self, or rather when the self feels different. When all is well, the act of walking is not noticed, yet as I have said, this changes at the point of being conscious of how the arms swing, the legs lift and the body sways, and if heavy or light thoughts crowd into the mind.

It is well known that the batsman must concentrate on the ball until the last: ‘watch the ball onto the bat’. This happens quickly and hence any unnecessary thought can affect the end result. ‘He looks quick’, or listening to the banter from behind the stumps, and oops, it could be the long march back to the pavilion. Some high quality players have in recent years been subject to depression, which has certainly affected their ability to hit the ball. Thoughts crowding in. The art of batting then, is a mindful task whereby the mind must be quiet to allow for the free flow of movement. There is no difference between this and movement on a day to day basis.

The person suffering chronic pain moves differently. The body is protecting itself, the individual consciously protects and hence simple movements, once take for granted, are now anticipated, planned and executed in a timid and fearful way. This pattern is encoded and passed back into the sensorimotor system to plan the next movement and other possible actions that the brain predicts may happen. Where this does not match the normal pattern, a threat value is created, evoking activity in the salient network that detects when something is physiologically amiss. Part of this network’s role is to trigger responses that motivate behaviours and attention to the relevant areas of the body. Once satisfied that all is well, protection is lifted and wellness ensues.

Movement is fundamental to health and feeling normal. We can tell when someone is not well in many cases by the way they move and hold themselves. To restore flow and ease of movement often requires that we target fears and anxieties that are caused by thoughts that can obscure. Much as the batsman needs clarity, so does the person overcoming pain. And whilst sometimes we need to think about the way we move, most times we just desire natural, unconscious and purposeful action that results in a reward.

In rehabilitation and in overcoming chronic pain, just like batting, we need a clear mind so that we can focus upon the job in hand. Thoughts come and go, but if we let them interfere with the action rather than letting them pass, there will not be the same result. Practicing mindful movements where you learn the skill of focused attention allows for the right kind of concentration and attention, eradicating the effects of fear and anxiety that can so commonly be associated with normal movements and activities. Understanding pain is another key element of reducing these fears and their potent effects.

To set up the right conditions for recovery, we must consider beliefs, thoughts and fears as well as the environment and the vision of where the person wants to be. From here we can create an individualised programme that addresses all dimensions of the pain experience: the physical, the cognitive and the emotional; and how theses dimensions interact. This is the complete and whole person approach to pain that is necessary and indicated by modern pain neuroscience.

For informationPain Coach Programme or to book onto the Pain Coach Programme, please call us on 07518 445493



Pain Coach

Change and pain

Change is happening all the time. Every moment is new and unique as we pass along our own timeline, being moulded by each new experience. Where we are right now has been determined by every thought, action and exposure to date. It has taken me 41 years to write this blog!

Change and pain — learn to change and overcome your pain on the Pain Coach Programme

Change is something that we are expert at, and it is something that we cannot prevent. Apart from death, change is the only certainty in life. So if we are always changing, why does pain persist and seem to be the same for the many people suffering chronic symptoms? The answer to this question is that the symptoms are not the same, but we just don’t realise.

Our memories are notoriously unreliable, yet we think that they give us an accurate recall of events. What did you have for lunch three weeks ago last Tuesday? If it was a particularly important lunch date, you may remember. Otherwise, it is a guess or there is no memory at all. And why should you remember anyway? How useful would it be to remember it unless food was hard to come by, in which case you may recall the location so that you can go back there to search again (evolutionary biology at play).

We do not remember events as well as we think we do. The same is for pain. Pain is experiential. We experience pain now. Not in the past or the future because the past and future only exist in our heads whereas pain exists in our body (space) in the now. In fact, this is the same for any experience. It can only really happen now, otherwise it is being created by our mind. This is the case even if we think about something unpleasant or dangerous that triggers a pain response; that pain response is now (some readers will be aware that imaging movement or watching someone else move can evoke pain in someone who is sensitive to that particular movement).

So, although we can recall that last Wednesday we had pain, we cannot recall the pain itself with any accuracy, but we can remember that it was a difficult day. Thinking about the day and things that we did may evoke a pain response, but you are feeling that now, and not then. What you feel now cannot be said to be the same as what you felt then. We also have further history to add to our timeline between the time we are trying to recall and the time that we are doing the recalling. We are thereby not accounting for the changes that have occurred between times.

We are masters of change. How do you want to be? Who do you want to be? What is your vision for you next week, next month, next year? To create that person, you need to take action now. Because now is the only real moment. Sculpting who you will be has to start in the present moment. In terms of overcoming pain, you work at a realistic vision of who you want to be and what you want to be doing, and the begin training and rehabilitation. This always begins with a thought based upon a belief, which drives big action. All of our thinking emerges from our belief system that has been grooved by all our experiences to date. This is why understanding pain is so important for overcoming the problems.

We create many habits around persisting pain, many of which are protective in nature in both thought and action, and are not actually taking us in the direction of changing pain for the better. Rather they are taking us down a path of change towards further protection. This gets us into trouble because it can look like there is no way out. Often this line of thought has been influenced by what you have been told and now believe. In essence though, consider all the change that has brought you to where you are now, and that is you have changed to get there, you can create conditions for change to go in another direction. Pain has come (a change in state), so why can pain not go (a change in state)?

Change in the direction that you want takes time. Change in the direction that you want takes hard work and dedication. But there’s nothing wrong with hard work and dedication to a better life full of meaning and a sense of wellbeing.

Pain Coach

Call us now to book your first step to overcoming pain with the Pain Coach programme: 07518 445493

Clinics in Harley Street, Chelsea and New Malden.


My tips for healthy revision

Easter holidays are here! Bunnies, chocolate eggs, Easter bonnets, spring and…..revision. Chatting to my younger patients, they all tell me that this holiday will be dominated by revision. So it is not so much a holiday but instead, 2-3 weeks of homework. Perhaps Easter Sunday will be a day off.

This appears to be the way of school life in the modern world. The demands increase, the pressures increase, the stress and anxiety increase, and the pains increase. Is this right? 1:5 children reporting chronic pain. Chronic pain is the number one global health burden and depression is at number two — and frequently they come as a pair.

Body systems are on alert. They are working hard for survival instead of orchestrating the biology of health. In adults we used to call the effects ‘burn out’. These systems that protect us can only function at that level for a finite period of time.

Of course there is nothing wrong with hard, conscientious work. But, we need to regularly put the heavy bags down and take a break.

If you or your kids are entering the revision season, here are some handy tips for them to reduce the risk of ill-health, persisting stress responses, and flare-ups of existing aches and pains. We not only need to be physically fit, we also need to be emotionally fit. The two are not exclusive but instead come together to form the whole person. The whole person is not in isolation to their environment, beliefs or what has been before. Dwelling on negative events in the past and anticipating an unpleasant future both create suffering, until you realise that both are in our minds. The problem is that we play these out in our body, e.g. tension, pain, anxiety. It is not the situation that is important, but rather how we respond.

There is nothing either good or bad, but thinking makes it so. Shakespeare (Hamlet)

My Tips for Healthy Revision

  1. Make a timetable that incorporates your best time of day for learning, chunks of 40 minutes, exercise, movement.
  2. Motion is lotion: change your posture every 15-20 minutes; stand up and move around every 40 minutes
  3. Take 3 breaths every 20-30 minutes (when you breathe out, muscle tension naturally relaxes, which you will notice if you pay attention). The breaths can be slightly deeper than normal. Of course you can do this for longer and more often if you wish. Focusing on breathing anchors you to the present moment which means that you are putting down the heavy bags of ‘past’ and ‘future’. The bonus is clarity of thought and hence performance, memory and learning can improve as you become more efficient.
  4. Exercise before you start working; e.g. a walk, a jog. And a little more later as well; 20-30 minutes is good.
  5. Test yourself on the material you are learning — many people tell me that they copy their notes out again and again. You will have a nice pile of notes, but how much do you know?

** BONUS tip 1: set up the right environment – your desk space, the lighting, odours (don’t under-estimate the effects of smell; e.g./ use an infuser for a fresh ambience).

** BONUS tip 2: dress for work and sit for work – this will put you in the right mindset. We respond to our body language as much as our body language communicates how we are feeling. Keep moving (motion is lotion) but concentrate and engage more by sitting up.

** BONUS tip 3: make sure you have enough sleep — minimum 8 hours, and if you are tired, have a power nap between 1pm and 3pm for 20-30 minutes. You need to refresh and renew and you need sleep to learn.

Pain CoachFor more information about Pain Coach programmes and wellbeing programmes for health and performance, call us today 07518 445493


I used thirst to help someone understand pain

I used thirst to help someone understand pain. He had been given the structural explanation for recurring low back pain (trapped nerve that runs all the way to the toes), which naturally leads to a tissue based focus on ways to get better. Whilst this is a common way to describe pain, it is wrong. Pain is a protective response to a perceived threat.

Yes, if a nerve is sensitised by inflammation or injury, it will transmit danger signals to the spinal cord and then the brain. All the while, signals are being sent down from the brain to mingle with these ascending signals, the sum of which will be scrutinised by brain networks to determine whether a threat exists. If there is a threat deemed tangible, then the body will protect itself with pain, altered movement, altered thinking and altered behaviours:

  • it hurts in a location
  • you limp or limit how far you move the painful area
  • you consider how bad it is and whether you can go to the party, game, work etc
  • you don’t go to the party, the game, work etc

This is all very useful at the outset, but becomes less so as time goes on and the body is healing.

Often there is a kindling or priming effect. The first acute painful episode calms down but then recurring bouts of pain become more intense and with less and less time between–familiar? In the first instance, the systems that protect do so effectively, slowing you down and enforcing action to allow healing. This would usually be in response to inflammation, and is all entirely normal whilst being an unpleasant experience. Not nice, but nothing to worry about. Of course, you would be wise to take heed and do everything that you can to fully recover, which means that the tissues heal and the protective systems switch back to normal modus operandi. There is a chance that you will need some guidance.

It appears that there are some people who maybe vulnerable to developing on-going pain, which is on-going protection. There is likely to be a genetic aspect to this, and certainly a prior experience that may have primed the systems so that they kick in more vigorously, or simply do not turn off when they need to. An over-protect or sensitivity. The priming event(s) may happen much earlier in life so that when the body perceives a threat some years later, there is recognition of the need to protect based upon what has been learned before. Detecting this potential vulnerability is really important in the assessment so that the right action can be taken to counter on-going pain.

Back to thirst.

Where do you feel thirst? Think about it for a minute. Where in your body is thirst? It is not a dry mouth; so it is not your mouth (a dry mouth is a dry mouth and that is all). Is it in your stomach or chest? We have a sense of discomfort that can include a dry mouth, and when we note that sense we give it a meaning. That meaning is “I am thirsty’. The point of this is to motivate us to take action and seek water to quench the thirst.

The same happens in pain. We have a feeling or sensation in our body that grabs our attention. This sensation is given a meaning: this hurts, and then we look for a cause, why does this hurt? What have I done? What is going on? What are the implications, now and in the future? Naturally this happens very quickly, in a split second. The pain then motivates us to take action, like thirst. We rub, cry out, seek help.

In both thirst and pain it is the meaning that defines the experience, and whilst we feel things in certain places, it is how we think about them that gives the richness and implication. We therefore have these experiences with our whole body and self. We feel and experience thirst with our whole body, the sensation not distinct from how we then think and act. The same in pain. To se the whole creates marvellous opportunity for change, growth and moving forward. In most cases thirst is easily overcome, chronic pain being far more challenging.

Chronic pain is about on-going perception of threat as body systems adapt, we adapt and the world around us adapts. We are on a continuous timeline of development that we can influence by our knowledge, understanding and use of skills. Understanding your pain is the first step, creating a foundation for overcoming pain.

Pain Coach

Pain Coach courses for clinicians and therapists: a practical way to coach chronic pain sufferers how to overcome their pain; small group learning and 1:1 mentoring. Call us on 07518 445493


Pain and trauma 

Pain and trauma — The smell of freshly mown grass would be enough to trigger feelings of panic and pain in Clive. He didn’t know that this normally innocuous odour was a cue for protection and re-ignition of memories of a car accident that occurred several years before. This is a classic example of the co-existence of pain and trauma.

Equally in others the cue could be a piece of music, a particular place, a person or a taste. We are multisensory and at the time of a trauma, the context creates a multisensory (molecular) memory that has high emotional valency due to the unpleasantness of the situation. At the time of an incident we may cope but afterwards there can be a trauma response that is when the coping fails and the person becomes ridden with anxiety. The physical dimension of anxiety commonly manifests as tension, discomfort, feelings of unease and pain that can gradually become increasingly widespread. Initially localised to where an injury may have been sustained, often it does not take long for the sensitivity to increase and the pain map widen.

Post-traumatic stress disorder (PTSD) is a relatively well known term and describes how a person continues to experience  the trauma despite that fact that it has passed. They continue to replay the tape and suffer the consequences: pain, tension, anxiety. The simple fact is that when we think about something, if we are embroiled with that thought, we live it out through our entire self: that is the physical feeling, the emotions and the thoughts all emerging as the one experience. The different dimensions are not in isolation to each other but rather integrated into the reality of that moment.

The problem appears to lie with the attempts to numb and avoid the trauma whilst repeatedly re-experiencing the event. This struggle causes great suffering whilst the body pain continues and often amplifies, vigilance to bodily sensations increase and other symptoms can begin to emerge: digestive problems, abdominal pain, headaches, disrupted sleep and concentration.

In essence the body is in protect and survive mode. All resources are being diverted to survival and hence the motor system is on alert ready to fight an opponent/wild animal or to run away (muscle tension, overactive muscles), the immune system is primed for healing initially but then drops off, digestion falters and vigilance is high for threat. With continuous feelings of anxiety, it seems like all life presents to you is dangerous.

Pain associated with PTSD is a good example of the need to think about the whole person and all the inter-related dimensions of pain: physical, emotional and cognitive. It is always about the individual as much as the condition, and the environment in which they reside. For pain to get better, the person must get better.  There are a number of newer approaches based on top-down mechanisms (brain focused), however my belief is that we have an embodied mind. In other words, our (physical) bodies are as much the experience as the thought itself and therefore we must consider this in any treatment programme. Promising techniques may exist in reprogramming memories or learning how to re-interpret thoughts, but where do we feel the sensations? In the body.

Example programme


  • understand pain and symptoms—the biology of pain and stress, what influences pain and stress, what triggers pain and stress, how thoughts and feelings are part of the pain experience, other influences such as tiredness, the environment, beliefs, gender and prior experiences. Setting the scene with modern pain science reduces fear and anxiety as the patient starts to see all the opportunities for change.
  • re-training body sense and normal movement that is commonly affected in pain and PTSD.
  • learn skills to ease muscles tension and over-activity, how to switch from sympathetic to parasympathetic to create the conditions for change, easing out of survival and into well-being in both thought and action.
  • create the vision of where the patient wants to be and plan how that will happen
  • check patient’s language (verbal, body and the ‘internal voice’) and change if necessary

From the foundation the above skills are developed alongside motivation and resilience training, focused attention training for clarity of thought. The patient must be able to problem solve moment to moment and use their skills and techniques independently whilst being fully supported and progressed along, always Molina at moving forward. There may be a need to plan a return to work, return to sports or increasing other limited activities gradually.

Clearly any programme must be individualised and monitored closely alongside treatment given for the purposes of pain relief. I commonly use my hands to desensitise and reduce pain, often teaching the patient how to do this themselves or how to involve their partner.  The notion that hands on therapy does not have a role in dealing with pain is wrong in my view. We need touch for normal healthy development and it plays an important social role. Judicious use of touch therapies can help to develop trust between care giver and recipient and change the processing of signals from the body, also having a top-down effect when explained.

We are complex, pain is complex, pain relief is complex; however this creates many opportunities for change. And our role is to facilitate change, to focus on our own natural ability to create health and wellbeing. We must acknowledge and validate pain, teach patients about their pain but then we must focus on moving on, so the less attention on pain the better. Let’s think about what we can do — the CAN mentality and start changing the largest global health burden. Because we can.

Pain CoachContact us for details about the treatment, training and coaching programmes for pain sufferers and for clinicians wanting to become a Pain Coach (small group training and 1:1 mentoring): call 07518 445493


Pain Coach

Overcoming pain – key skills (1)

Pain CoachOvercoming pain requires us to understand it and have a range of skills that we use moment to moment to change the direction in which we are going. To be able to change gears once we are aware what is happening is vital. Cultivating awareness is the first step, followed by adopting a new behaviour and subsequent change for the better. ABC.

3 steps: 

  • A- Awareness
  • B – Behaviours
  • C – Change

I like ‘threes’, and the ABC above is one that I use to guide individuals from where they are when they arrive to where they want to be. Each encounter (session) that we have will be unique and designed with specific aims using ABC.

We are continuously adapting to our situation, internally and externally. Much of this happens without us really knowing about it in the form of habits. When we have suffered pain for some time, there are a number of protective habits that have been created and whilst these maybe useful with a new injury, they prohibit recovery in time. Identifying these habits and then working hard to create new healthy ones is a key skill.

The world is constantly changing, we are constantly changing and the people around us are constantly changing. We are not in isolation to others and the environment in which we are situated at any given moment, which is why both are so influential. Whilst we are subject to these influences, we can also use them to our advantage and in particular to change the social dimension of pain. One of the most significant features of the social dimension is isolation.

One becomes isolated through withdrawal and avoidance. Isolation is simply not good for health — the way you think and the behaviours that follow. And it worsens with time, so certainly a dimension of the pain problem that must be addressed. Gradual resumption of social activities, similar to gradual increase in physical activities, allows the individual to realise that they are safe to progress. We do not function in isolation to others and the world around us. I think that we define ourselves in relation to others and the environment, for who are we without another?

The moment to moment decision making has to be based upon clear thought. Clear thought emerges from awareness of self, others and the environment — the ‘econiche’ (Edelman) or the concept of emotional intelligence being utterly relevant. ABC it is. Learn these skills and see how you can move forward. The range of training methods and techniques used all base their effectiveness on the ABC.


The Pain Coach programme is available at all clinics, addressing all dimensions of pain (physical, emotional and thinking) for the complete way forward to overcome chronic pain. Call us for details: 07518 445493 — Pain Coach website coming soon


Specialist Pain Physio Clinics, London

Toast of Surrey Business Awards

At SpeToast of Surrey Awardscialist Pain Physio Clinics, we are delighted to be shortlisted for Toast of Surrey Business Awards in the Mental Health & Wellbeing category. This is great news because it creates an opportunity to tell Surrey businesses about the problem of pain — the number one global health burden — and what we can do about it.

Many businesses suffer the financial and social consequences of employees being on sick leave for painful problems; back pain, neck pain, repetitive strain injury, injuries sustained at work etc. I believe that understanding pain and communicating about it in the right way leads to return to work for many, instead of the common scenario when the employee and employer reach loggerheads. I welcome the opportunity to show businesses how to deal with these problems effectively and efficiently, which is ultimately by looking after the employee’s welfare and wellbeing from the point that they report pain or injury.

Surrey Clinic at The New Malden Diagnostic Centre. Call 07518 445493

Other clinics in Harley Street and Chelsea


Our UP | Understanding Pain campaign launch a huge success!

TeamOn Saturday we held our launch event at London Heathrow Terminal 5 with over 700 Rock Choir singers performing favourite songs. It was an incredible day as the music created a powerful voice to raise awareness for chronic pain, the number one global health burden. UP is not just about telling the world that pain is a problem though, we are passionately spreading messages about how you CAN overcome pain, even in the direst of situations. No-one illustrates this better than my co-founder, Georgie Standage, who now leads the fullest life having worked with tremendous effort to overcome complex regional pain syndrome (CRPS). Yesterday was no exception as Georgie was interviewed on BBC radio yesterday morning and then on itv news just before leading her choir at our mammoth event.

The epic centrepiece was the positioning of the choirs across the walkway creating the most amazing sound. This was also a great opportunity for me to address the 700 singers and the audience about why we were there. I simply pointed out that chronic pain is the number one global health burden, a fact that no-one knew, and that now we understand pain so that we can give the right messages to sufferers so that the right action can be taken to overcome their pain. The biggest issue is the misunderstanding of pain, which means that people are not receiving the facts about their pain and hence struggle to move forward, often becoming increasingly limited in their lives. We argue that this does not need to be the case when people understand their pain and then know how to use this knowledge practically so that they can restore a meaningful life.

UP chronic pain awareness dayPeople were so very generous and donated money that we are putting towards the next event as we build the momentum to challenge the status quo in pain, and drive our mission forwards with passion and music. We are also planning to run a series of coaching programmes so that we can make the knowledge and skills available for sufferers and their carers.

This was the most amazing way to start our campaign. But this is just the beginning. From here we will pursue our mission with increasing passion and gusto inspired by the immense support we have received — Facebook, Twitter and You Tube has been saturated with incredible messages and comments, showing how pain affects everyone somehow.

It is time to make serious changes in how people think about pain across the board. The practice in healthcare is simply too far behind what we know, and at UP we are determined to close this gap.

Please show your support by spreading the word! Tweet us @upandsing and like us on Facebook.

Visit our UP | Understanding Pain website here 


Joe’s pain story

Up LogoJoe’s pain story told by his mum Jenny as part of the UP | Understanding Pain Campaign that launches this Saturday with 700+ singers performing at Heathrow – follow us on Twitter @upandsing to show your support

It was the morning of Tuesday 27th November 2012 and the usual school morning rush was well underway when my son, aged 11, lent forward and picked up his school bag. Straight away he complained of back pain, he was unable to fully stand up straight but by no means was in agony. I explained to my son that I felt his muscles were in spasm and the best thing for him to do was to keep moving. I work in a sports injuries clinic and said that I would book him in after school for a massage. I’d only been in work 10 minutes when the school called to say that Joe had ‘got stuck’ bending down at this locker and could I come and collect him. Joe shuffled out to the car in a manner that I had seen many patients at work walk and knew he must be in a fair amount of pain. On the subject of pain I would like to point out that Joe was no stranger to pain, he’s broken bones in his foot and not even muttered anything about it until I noticed the lovely purple bruise. He’s been a keen cyclist since the age of 5 and has had crashes resulting in loss of skin and friction burns; crashing at around 30 mph dressed in lycra is always going to hurt! Thinking back over Joe’s life he had never complained of pain and he was always one of those people who would rather get on with it.

Joe’s muscles where indeed in spasm and the physio treated Joe as much as he could but he recommended further investigations at our local hospital. The local hospital listened to what had happened and sent us home with paracetamol. That evening Joe’s pain became worse. He was only comfortable lying on his side and struggled to walk, I started rotating paracetamol and ibuprofen every two hours but nothing was touching the pain. We tried every distraction technique we could think of, hoping that once Joe slept he would feel better in the morning. Joe was literally screaming with pain by midnight, we had no way of moving him to the car so we called an ambulance.

To cut a very long story short this first hospital visit was the first of many. Joe would be screaming in pain day in day out. It was the most heartbreaking thing to witness as I had no way of controlling his pain. Our local hospital had no way of controlling Joe’s pain either, they had tried everything they could think of but where unable to pinpoint why Joe was in so much pain. Our experience at the hospital soon became very stressful, we became in a loop of ambulances and ward stays. One day they sent us home and within two hours of being at home Joe started screaming, ‘blacking out’ and screaming again, it was relentless and we had no option but to call for another ambulance. Thankfully by now they were used to seeing Joe so started the morphine and we thought it would just be a matter of time before the pain was under control. Three hours later Joe was still screaming non stop and my husband and myself were at breaking point. Consultant after consultant came in to see Joe, they all did the exactly the same leg lift test and left. No one except the A&E nurses seemed to care that Joe was still screaming and that nothing was helping him. Eventually one of the nurses said she had had enough. He had enough morphine to knock out a rugby player and she was moving Joe round to adult A&E as she said they couldn’t ignore him there. Within five minutes we were surrounded by consultants who decided that Joe needed to be put under so that they could perform a lumbar puncture. The relief when he fell asleep was overwhelming. I cannot begin to describe what it feels like to see your child in so much unbearable pain. Every time Joe ‘blacked out’ for a few seconds it was a relief only for him to wake again and continue screaming.

Joe was awake when we next saw him and surprisingly in no pain. The consultant said that maybe his brain had forgotten to turn his ‘pain switch’ off and going under had ‘reset him’. At the time I didn’t care why the pain had stopped I was just so glad it had! Joe was admitted and over the next day his pain started to return. His results had come back negative so the hospital decided to refer him to Great Ormond Street Hospital (GOSH). After spending a very surreal New Year’s Eve in hospital we were transferred on New Years Day. GOSH started him on a different mix of medication that started to work within a coupe of days. Their physio’s worked with Joe several times a day with his first goal being able to sit up for 10 seconds. They re-ran loads of tests on Joe but they were also unable to come up with a definite answer. They explained that unfortunately as it was 5 weeks since the Joe had injured himself, the injury could have already healed. They felt that the best course of action was to continue with the medication, pain killers and tens machine and to go to our local hospital to continue the physiotherapy.

We returned home after a week in GOSH with Joe’s pain under control with medication and plenty of telephone help from the Pain Team. After our experience with the local hospital I felt that attending physio with them would be a waste of time. I started searching on the internet for private physio’s and Richmond Stace came up again and again. I spoke with the GOSH Pain Team and they were happy for us to attend a private physio. I contacted Richmond and briefly explained our story and asked if he could help, ‘Of course’ was his reply. I remember putting the phone down half smiling and half in shock. Had I just heard right? He knew how he could help Joe. I was so shocked as apart from the staff on Koala ward at GOSH no one, I repeat no one had any idea what was going on with and how to deal with it.

Our first meeting with Richmond was such a positive experience, he listened and understood Joe’s pain. He explained that Joe was not the first person he had seen with that level of pain and it was something he could help us with. Joe started to improve over the weeks that we saw Richmond and we started to lower his medication. He was also managing more school that ever before and I could finally see a glimpse of the future and Joe being well. Richmond has this amazing ability to calm you, take the stress and worry out of the situation and just help you focus on the here and now. We learnt that our surroundings, state of mind, belief in what is wrong etc all have such a major impact on how we perceive pain and how we deal with it. For me, as Joe’s mum, I felt in control for the first time in months and I have no doubt that the feeling of being in control rubbed off on Joe. Listening to Richmond speak to Joe made me realise there was hope. I had truly started to question whether Joe would ever be pain free, how can no one know what caused the pain? How can they not know how to stop it? If we didn’t know what caused the pain could it happen again?

After everything that Joe had been through it had changed him. No longer was Joe my fearless boy, he was now cautious, carried himself differently and seemed different from his peers. In my opinion there is no doubt that pain changes you, makes you aware of your immortality and causes you to protect yourself when, most of the time that protection isn’t actually needed. Maybe our brains are too clever for their own good! Richmond helped Joe realise he was ok. In fact his was better than ok he was Joe again. Not Joe who screams in pain, not Joe who is fragile and unable to do much more than lie in bed but old Joe — Joe who loves school, riding his bike, playing football, going out with friends and playing his guitar. Richmond helped Joe see that and he helped him see that he can control his pain, giving Joe the belief in himself again, proving that he was not at the mercy of a painful back, destined to take painkillers and other medication for the rest of his life. The belief and the tools Richmond gave Joe changed his thought processes, enabling him to progress through his physio, lower and eventually stop his medication.

If anyone reading this is suffering with pain please, please see Richmond. Your life doesn’t have to be ruled by pain. Pain is exhausting and all consuming and it doesn’t have to be that way.


CRPS | Georgie’s Story

Georgie suffers with complex regional pain syndrome (CRPS), which is a condition that can feature the most severe and extraordinary pain and symptoms. Soon after starting to work together, Georgie told me that she wanted to raise the awareness of CRPS and chronic pain. For some months we played with ideas, culminating in ‘UP’ — Understanding Pain.

UP has a mission. This is to raise awareness that chronic pain is the largest global health burden and that one of the biggest problems is the lack of understanding of pain. This leads to poor communication about chronic pain, low expectations with regards to overcoming pain, and poor treatment of chronic pain. Our aim is to change this thinking by raising the level of understanding so that people can see that there is a way forward. All too often the label of chronic pain is associated with isolation, hopelessness, disbelief and being discarded with regards to recovery. If only healthcare at large, policy makers, private health insurers and sufferers were aware of the facts about chronic pain based on rigorous research and pain science, than we can go about changing this situation.

This is our purpose:

  • Facts about pain so that everyone understands
  • Practical and effective ways of overcoming pain and living a meaningful life.

Here is Georgie’s story:

‘I suffer from CRPS – Complex Regional Pain Syndrome. CRPS is a chronic systemic disease causing severe pain which scores 42 out of 50 on the McGill pain scale. CRPS has many symptoms including skin colour changes and temperature changes from hot to cold, burning pain, stabbing like pains, numbness, pins and needles to name but a few. It can often start in one limb following an injury or surgery, some cases with no known injury and the disease can spread to other limbs and in some cases throughout the whole body. CRPS has a major impact on day to day life, it is debilitating and has a negative impact physiologically for the patient, their family and friends around them.

My story

When I was young, I was always very athletic. I came first in sprinting, loved horse riding and I was very good at gymnastics. I also had an artistic streak, studying piano, singing and gained honors in grade 8 organ. What I didn’t realise then was that I had hypermobility. This is not necessarily a bad thing as for gymnasts/dancers and musicians/ singers this means you are more flexible, which can be an advantage. But it can sometimes trigger other underlying possible conditions. I was not aware of my hypermobility until recently and it now explains so much about my life.

Once I left school, it took me a while to know what I wanted to do, I was an office junior, a travel agent, and then I went to Australia for what was supposed to be 12 months on a working travel visa. I travelled from Perth to Sydney by bus taking plenty of stops until I got to Melbourne. One day I woke up in my hostel room and I was unable to see properly. I got myself to hospital and they just told me I wasn’t eating properly which was common in travellers. I then took a 4 day bus to Sydney during this time my sight deteriorated. I then went to hospital in Melbourne and I was told I had Bilateral Papillitis a swelling of the optic nerve and they were not sure what damage it may do to my sight. I am not sure if this is related to my condition but I am not ruling that out. I spent so many hours listening to music and this saw me through my time there, I made a huge life decision and decided to become a singer…what did I have to lose? I wanted to live life to the full. I quickly returned home after being in the hospital for 2 weeks. The cause was never found after a few MRI scans, CAT Scans, Lumber Punches. However the symptoms reduced over 6 months on their own.

I found a college and became a professional singer. Of course, this is not the easiest path but I loved every minute of it. However from around 2002 I started to fall regularly as my ankle would give way, I would recover from one fall then months later have another fall from the weakness in the joint. In 2005 I had a fall that changed my life forever. I had fractured my metatarsal bone and badly sprained my ankle. I spent 4 weeks on crutches and started to realize something was really not right at all. My foot was freezing cold, it was black and purple in color and was highly sensitive to touch. I had drop foot and could not move my foot at all. The pain was unbearable burning, stabbing, shooting pains, pins and needles, numbness. I went back to the hospital who immediately knew something wasn’t right and after some 12 weeks in physio and after more scans I was informed that I had CRPS – Complex Regional Pain Syndrome. The first thing my physio said was don’t read anything on the internet it will just scare you, it will be a long journey and there is no guarantee of a good outcome. I had some treatment in the Surrey hospital undergoing a 
Guanethidine Block under sedation. Then my treatment was moved to St Mary’s in Paddington under the care of Dr Jenner.

I had many Guanethidine Blocks every 2 weeks nearly, but these were so traumatic for me that after a year I was unable to take any more treatment – my body was too week and after the last procedure the doctors found it too difficult to wake me up. I was on a cocktail of tablets to ease the pain. But I had no life left. I couldn’t work, I was on crutches or wheelchair bound for 3 years and my life felt completely hopeless. Depression started to set in, it felt like the darkest and most lonely place. Many of my friends were unable to understand and completely unable to help me, I lost a few friends along the way. CRPS is completely isolating, its an evil disease and its not called “The Suicide disease” for nothing as many people give up the fight. If pain is all you feel what else is there? But I had so much to live for and I am a fighter. I loved music and in those times of darkness it saw me though.

One day I started to write music again I don’t even know what inspired me, I just picked up my pen and started to write. I thought I had lost all of my passion, but there it was again still inside somewhere and I’m so glad I found it again. I wrote every day and I still do to this day. The music, singing and writing kept me occupied and in some brief moments made me forget the pain as my mind was busy creating. The music gave me hope back, if I could bring back passion, what else could I achieve? So I decided I was going to work at trying to walk to my kitchen and back to the sofa – now in actual fact this is only a few steps these days, but back then it took me a really long time, shuffling and holding on to everything I could find to hold me up, hopping, but I made it there. Now all I had to do was get back to the sofa with a cup of tea, this I hadn’t quite thought through and by the time I made it back to the sofa most of the tea was on the floor. I suffered a flare up after this attempt but I decided not to give up and little by little I found a way to make this small journey. Once I had achieved this, I started to make longer journeys to the bathroom and I even attempted the stairs. Going out without crutches was really scary, after 6 months I thought now is my time to try. Every week my friend Pete would pick me up for a jazz gig. He knocked on the door and I was stood there without my crutches, he asked me “Where’s your crutches” and I said “look…” I walked myself to his car (only a few feet away) with no aids. He started to cry. He said he couldn’t believe it and he was so proud of me. Pete is such a loyal and close friend he was there for me in some of my darkest times. From there I decided I had to try more and I wanted to find more to do in music. I saw an ad for Rock Choir leaders and I went for an audition, I tried to hide my limp and I got the job! (although, now that I know the Rock Choir team, I shouldn’t have been so worried about my limp). It was one of the happiest days of my life and I have never looked back.

When I started Rock Choir 5 years ago I ran 6 choirs. Before I started the job I was never sure how my body would cope – but it did and slowly I got used to my schedule and I loved every second of it, from training to rehearsals and shows. The adrenaline for me was the best part of it as it helped cover the pain I had and the music was so uplifting it always made me happy and lifted my spirits, I had never been happier. I was writing more than ever and started my own original band The Big Bads! Then just over a year ago my CRPS spread up my leg and into my arm and hand. This was devastating as it made it so much harder to play piano and do the one thing I love so much, conducting my choirs and getting to all my rehearsals and writing. I quickly realized that I would have to give up my morning choirs so that my body could recover and so that the CRPS would not spread to other limbs. I found it so hard to adapt and I felt so very low. It felt like all that I had fought so hard to have back could just be taken from me again.
I went back to my consultant who put me in touch with Richmond Stace, a specialist pain physiotherapist, to help me overcome the spread of the condition. He explained the condition so that I understood my role and what I could achieve, and taught me techniques including mindfulness, breathing, motor imagery and specific exercises. We talk about how I will get through some of my conducting, right down to visualizing and practicing the moves before I see my choir. I use nourishing techniques and try to remember to pace myself and move every so often into a different position. We talk though the schedule I have coming up and how best to manage it and every time I start to have a flare up we nip it in the bud before it develops. This year will be the first year in 10 years that I have not had a major flare up that has lasted longer than a couple of weeks!

I can see a future now; a future that means I can deal with the condition I have and co- exist with it. I would like to help others now to regain their lives from pain. I know how hard it is, but if I told you it was possible would you try too? I don’t want people to give up. There has to be a better way and if we can help more people find their path through the pain by understanding their symptoms, using music and techniques that work such as mindfulness, imagery, graded exercise, then that would make me even happier!