A 77 years old woman, who I will refer to as V, came to see me recently looking for
relief from chronic neuropathic pain. The severe pain, radiating from under her right
arm towards her right breast, started after surgery to remove two lobes of her right
cancerous lung and she had been experiencing it continuously over the last 18
months.
According to Cancer Research UK, ‘some people find they have pain that lasts for a
long time after lung surgery. The pain is from damage to nerves during the operation.
The pain often runs along the operation scar. For most people it gradually reduces
over a couple of years as the nerves repair themselves. But for some people it may
continue for longer’ (cancerresearchuk.org).
Nerve pain can be difficult to get under control. Because of their structure and
function, nerves do not heal as quickly as some body parts do. Nerves regenerate at
approximately 1 millimetre per day, which means that full recovery can take a
number of months and sometimes years, and in some cases may never come back
completely. Nerve damage, aside from
being painful, can also affect movement
range. As a consequence, lack of movement contributes to tissues rigidity,
vasoconstriction and the compression of more nerves in the affected area.
Another aspect of chronic pain following surgery is adhesions, more commonly
known as scar tissue. The scar we see on the surface of the skin is only the tip of the
iceberg. Adhesions are abnormal attachments between body tissues that can go
quite deep into the various structures of the body, including organs, and prevent
them from functioning properly eventually causing pain. Fascial adhesions can
restrict blood supply and damage nerves, leaving you with chronic pain and
dysfunction. Adhesions restrict movement and cause damage to the surrounding
area triggering more inflammation. The increase in inflammation tells the body to
send in more collagen links, resulting in even more adhesions development. Over
time as movement of the area becomes more restricted the adhesions harden and
solidify.
With long-term pain the mind also plays a significant part in creating further barriers
to recovery and in worsening the intensity of pain. Fear, anxiety, depression,
catastrophising around one’s own ability to cope and live a ‘normal’ life, all contribute
to intensify the pain loop. The person feels stuck and unable to heal and move
forward. This is why long-term pain can be very difficult to eradicate.
When V came to her first appointment she was distressed, having been in severe
pain for over a year. She states:
‘My operation was on the 6th April 2021 which left me with chronic neuropathic pain. Have had 2 different types of opiate tablets which I was intolerant to with hallucinations and giddiness which I already have but made it worse and tinnitus which again I suffer with and it made it much worse. So, I struggled along with constant everyday ibuprofen and paracetamol as I did not want to try anymore tablets with opiates. I have had 4 treatments of Bowen Technique and am thrilled with the results. In the last 3 weeks I have only had to take 10 tablets whereas before I was on 16 tablets a day.’
Since this testimonial, I have seen V for other 3 appointments. During this time, she
had reduced her tablets from 16 in 3 weeks (during this period she had a flare up
due to a sudden lifting movement carrying a heavy bottle) to 2 tablets in two weeks
and finally on her last appointment she reported she hasn’t taken any tablets at all in
two weeks! In brief, having regular appointments for 3 months, initially weekly then fortnightly, V has gone from 16 tablets a day to none at all. We are now testing the consistency of her healing with further appointments every 3 weeks and eventually leaving longer periods between sessions. She feels regular appointments keep her on track of her
healing process.
When I first met V, although she was very concerned about her ability to carrying on
with the severity of the pain and the high intake of painkillers, it was also clear that
she was a strong, resilient and optimistic woman. She had been through other health
challenges since very young age (she lost her hearing at 4 years old because of
measles and has had many operations to one of her ears since then and suffering
from frequent dizziness and tinnitus as a consequence of this). I firmly believe that
her optimistic mindset was one of the contributory factors to her successful healing
process.
Keeping a record of the painkillers intake was the first step towards tracking her
improvement, giving her confidence and facilitate the positive mindset. I have also
advised her to resist the urge to take the painkillers as soon as the pain starts,
unless absolutely necessary, to build up a resilience to the sensations of pain and
broader her pain threshold. She found this advice very helpful and said that although
most days now she hasn’t got pain, when she does, because it is much more
bearable, she tries to avoid the tablets and the pain dissolves completely on its own
after about half an hour.
Anti-inflammatory medications may negatively affect long-term tissue healing. Optimal soft tissue regeneration is supported by the various phases of the inflammatory process and making use of medications to inhibit the inflammatory process could impair healing
(of course, sometimes the pain is too intense and debilitating and we do need to use
medication).
What Bowen procedures have I used to treat V? I started with the BRMs relaxation
procedures and then used the Respiratory, Hamstrings, Kidney, Chest, Sternal and
Thoracic procedures on different sessions. She reported a sensation of warmth on
the right side of her chest during one of these appointments. In the last three
sessions I have used myofascial release techniques to soften and restore gliding of
the tissues around her scar.
To conclude, light, intentional and directional touch and pressure, have an incredible
potential to heal tissues and communicate safety and compassion, also necessary ingredients for successful healing. A mindful approach to anti-inflammatory
medications and a positive mindset are indeed crucial when dealing with long-term
pain. Throughout the process utilising the Bowen Technique to gently assist healing.
Article published on Bowen News, Issue 86