In this hopeful episode of, Amy Toth, a seasoned physical therapist, sheds light on effective strategies for chronic pain management. She introduces the Chronic Pain Recovery Method, a two-step approach addressing nervous system regulation and brain retraining, demonstrating its applicability to various chronic pain conditions.
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Transcript
Hi and welcome to the You
::World Order Showcase podcast. Today we have with us. Amy Toth. Amy is here to tell us the truth about chronic pain strategies that work for chronic pain even when nothing else does. I'm so excited to have you here, Amy.
::We had a little bit of a struggle getting.
::Started, but now we're.
::We can see you and.
::Yeah, it's just great. I have to say like.
::Technology is clearly not my zone of genius.
::Can so relate to that but.
::I also have, I've.
::I'm glad that you made it.
::Yes, thank you. I'm very, very excited to be here. The more the more times I can share, the better.
::Yeah. And you
::Have such an important topic to talk about, but how did you get started? Do you suffer from chronic
::Pain yourself.
::Actually no, but I am. I've been a physical therapist for over 20 years.
::And you know, I've just, I've worked with a lot of people who are in, you know, chronic and persistent pain. And I think it kind of.
::It's kind of come out of a combination of being very stubborn and also still being like a little bit of a of a nerd. You know, I came out of school, I was all excited because, you know, I've wanted to be a physical therapist since I was like.
::In 7th grade.
::And so, you know, I was going to go out and heal the world. I know it's. Yeah, I was helping a lot of.
::People, but there was.
::This this certain kind of group of people.
::That even though I did all the stuff I learned in school, like it wasn't helping. And oftentimes it seemed to make things worse. And me being stubborn like I refused to accept that there was nothing I could do.
::To help these, you know, help these people that have the chronic and persistent pain. So that's when I went back into like.
::You know, kind of nerd mode and really just dug into the science and the research and all of that. And then that is all kind of.
::Morphed into where I'm at today.
::And that is.
::Oh, I'm still a physical therapist, so I still practice in the clinic, but I have also developed a the chronic pain recovery method, which is an online program that helps people move out of persistent pain and start feeling like themselves again.
::Wow, that's pretty powerful. How does that work?
::It works by - and the way this is different than a lot of other programs and to be honestly like main mainstream medicine - is we're hitting more of the underlying kind of more of the root causes of persistent pain. Because when you've had.
::Paying for more than six months or so.
::It's really no longer just the structure, so it's not just the joint or the muscle or the spine that is the primary source of pain. You have changes that have occurred in how your nervous system is processing messages and responding to messages that are.
::Keeping this kind of heightened sensitivity, this pain or pain cycle going. So my program addresses those kind of underlying nervous system changes that are really kind of the root behind kind of what keeps you in pain.
::Really interesting. So how does that work?
::It's fascinating. It's there is, there's kind of two steps to it. So there is what I call the nervous system regulation piece, which addresses more of a kind of some of the foundational, I guess you could call them skills that you kind of need to have to kind of, you know, everyone's kind of heard of the fight or flight state.
::Like you know, if you're if a bear is suddenly in front of you, you have to decide you're gonna stay there. Or are you gonna go when you're in a chronic pain? Your nervous system is kind of stuck in that fight or flight. So we use some of the regulation techniques.
::To help move it out of that fight or flight state and calm things down. So like sleep kind of focusing on sleep quality.
::Is a huge one working on movement but not like you know. Let's go to an step aerobics class movement. But like a you just you just need to move your body, but you need to move it in a way that isn't too intense and isn't going.
::To flare up all of your.
::Them and then I think the one thing that I incorporate that isn't necessarily very often incorporated is play like you need to have.
::Fun you need to reconnect to the things that make you, you, and the bonus of that is doing those things releases hormones.
::Into your system that calm your nervous system down and kind of help move you out of that fight or flight stage.
::Then there is the.
::More of like the retraining or reprogramming aspect of it. And then I use. There's one group that has developed an app to kind of basically it's kind of like brain games, but with the with the more really much more specific purpose that looks at basically retraining.
::How your brain and your body are communicating, because when you've had persistent pain, that kind of communication, communication channel just kind of kind of gets messed up.
::The science.
::No, this is this is like so novel to me.
::But yes, the science behind it. I mean one, it's fascinating and it's, yeah, it's it is it's and and I would say the science has been out for.
::d. I graduated from school in:::And there's been kind of an explosion on the research of now really understanding kind of what's going on. The challenge now is translating that knowledge into treatments that are useful and effective and that can be, you know, and.
::And also the biggest challenge right now is.
::Getting the message out, I heard I read somewhere and I can't remember where that it takes an average of like 17 years for like new.
::Like information or techniques or like procedures to kind of trickle from. We've learned about it. We now know how it works to more kind of mainstream treatments and medicine. So I'm hoping we're kind of starting to get towards the tail end of that trickle down. But that's kind of part of my, my purpose. And my mission is to kind of.
::Start spreading, spreading the word.
::Because, I mean, there's no test that you can do necessarily to like assess, you know this part of the nervous system, a lot of providers don't know about it. But I truly believe that it is kind of like the missing links to really start getting a handle on this problem.
::Does it work for all?
::Kinds of chronic pain like.
::If you have chronic fatigue syndrome, it.
::That's like one thing, but if you have.
::Arthritis. Is it something else or are?
::They all.
::Good, good question. The more they do for most part right now, we think it it's pretty much good.
::For almost all types.
::Because they do more and more, definitely. I think you know, if there's pain involved with the chronic fatigue, but definitely with conditions like fibromyalgia, complex regional pain syndrome, even with like some hypermobility conditions like or stand lows, you know, definitely just with any old.
::Kind of like.
::Regular, so to speak, arthritis. You know, back pain neck pain, joint pain. There's been multiple studies that look at it in multiple joints, whether it's shoulder, whether it's knee has been found to be effective.
::And they're even finding it more like in conditions like rheumatoid arthritis, where they it's traditionally thought that really that is more of kind of an inflammatory process. And that's where the pain comes.
::This room there have actually been some recent studies that are showing that the, that, that that's not necessarily coming from inflammation, that there's a completely separate kind of pathway in which this pain process is going that would also be affected by using some of these techniques.
::You're amazing me.
::It is it. Is it like it's. It's like, it's fascinating and it's mind blowing, but it's also.
::Our you know, Healthcare is, so we're really good at treating symptoms like you come to me and your shoulder hurts. I can take an X-ray. I can tell you whether you have arthritis and historically we have kind of made.
::You know your whatever your imaging is, whether it's an X-ray or an MRI has kind of been like if it shows this, then we know that that you're going to have pain and This is why it hurts.
::Because they're kind of equating the structure or the nanny or the tissue as being the primary source of the pain. And what we're really starting to find out is at around the six month mark of having had pain pretty consistently is when your nervous system starts to make these adaptations.
::And that's the point at which you know whatever is going on in your joint for the most part has probably healed or has been, you know, the symptoms have been treated. And it's really these underlying changes in the nervous system that are, you know, perpetuating the pain continuously.
::And then if you start, if you kind of come from the back end and start addressing some of those changes, then we start seeing the pain change.
::So it's kind of like.
::A much better alternative to like pain medications that people get on and.
::Have all kinds of other problems.
::Yeah. Because then again, you know, those are treating the symptom, but they're not really getting at. Why do you still have that pain to begin with? So yes.
::Right.
::It seems like that.
::If you take a pain medication, it is.
::It's not retraining your brain necessarily, but it is. In some ways it's retraining your brain because it's blocking signals and.
::And that's I think maybe where that addiction?
::Part comes in.
::Yeah, it's been falling here and it's like.
::And I think.
::Yeah. And I think the other thing and I haven't looked into the research behind it, but I know like if you look at depression, there's been some talk of like.
::You know, do like. Yes, the medications are helpful because they block.
::Good luck. Whenever receptors that keeps like the serotine, so the serotonin keeps floating in your system. But the caveat being if you have all this floating in your system.
::Then your body's not going to think it needs to produce anymore, so it's actually gonna like, does it actually long term create its own problem. And I know with some pain medications it's well known that.
::Prolonged use can actually increase your sensitivity to pain.
::So it's helping, but sometimes it also kind of creates a little bit of its own problem. And I mean another thing, I mean I.
::Don't think, but I also have a little bit of the soapbox of.
::You know the opioid? Yes, there was the opioid crisis.
::Which was not a good thing, but we have gone so far the other direction that we now have providers scared to do anything.
::So they've kind of just abandoned this whole group of people where for many people at this point in time, like the medication is their lifeline, like good or bad like it is what it is. And I think we're doing so many of these.
::Right.
::People a disservice.
::In general, but also in specifically by just all of a sudden saying these medications are bad for you. So you.
::Need to quit taking them.
::What are you gonna replace it with? Like you gotta, you know. But I've heard of lots of people just kind of being cut off cold Turkey and I just like, it's just horrible.
::That is really horrible, but it's encouraging that you have a system that can take people that are in chronic pain and actually fix the root problem, which is brain chemistry and.
::Yeah, Yep. Yep. And kind of how the it's literally like at the like cellular level of how of like.
::What? What channels are there in the cell membrane and which ones are opening and allowing certain things to happen? And it is? It's kind of crazy how doing so. Yeah, kind of coming at it from a, you know, kind of trying to sneak in kind of under the radar, so to speak, just kind of has this like trickle down effect.
::And also I mean it is.
::It is very challenging because with one of the you know people who are in pain.
::Have been through a lot. They have seen a lot of people. They have seen a lot of providers. They have tried a lot of pills. They have tried a lot of.
::Procedures many of.
::Which at best were not helpful. You know, at worst made things worse, a lot of providers don't always treat people in persistent pain.
::The best. So one of my biggest challenges is.
::Kind of fostering the hope.
::That there, you know there is, there is something that works and also gaining trust because so many people have just not had good experiences with people in the healthcare field. And while I am.
::Well, I have been in the clinic for 20 some years. Right now they're just seeing me online. So like who you know who? Why are you trusting this person that you saw, you know, online kind of a thing? So that has been has been. My has been my, my, my greatest opportunity, we'll call it that.
::Wow. And you have something that you offer people and you also have.
::A workshop that you do.
::So tell us a little bit about those things.
::Yes. One thing I have.
::And my work with people is, you know who have persistent pain, like life is hard. It can be hard to get out of bed and just like, take care of yourself and the basic things you need to do in any given day. So it can be really hard to stay consistent with any kind of either self-care or workout routine.
::Or anything. So I've created a guide.
::It is 3 things that you can do basically to kind of ease what hurts or to help your pain even on days that you don't want to get out of bed. So these are things that you can do literally laying in bed, but have research has shown will release hormones or cause other processes.
::To go on the help, calm, soothe the nervous system and decrease pain.
::And then I do run at least once a month.
::Then it goes over this concept of the nervous system as kind of being an underlying cause in more detail, so that it and in a in a way that like it's easy to understand. I'm not using like you know, big words. I'm kind of using a noun. There's a thing. So it kind of really you can really kind of start to wrap your mind.
::Around it because it really is like a mindset shift.
::From there is something wrong like with my joints, there's something wrong with my body, it is broken. It's not going to get better versus.
::Well, actually a lot of this is just my nervous system is a little bit sensitive and like and that.
::Like I can work with that.
::Yeah, it's so fascinating. How much? How much?
::Your brain chemistry.
::Dictates how you feel, what you think about how your joints react.
::It just like.
::Your mind is so powerful and it really can.
::Heal you of.
::You know once.
::Its goal is to keep you.
::Going and that's it's kind of the irony because, you know, your brains. Its whole purpose is.
::Yes, it's.
::To keep you safe.
::And somehow it thinks that these changes that it makes when you've been in persistent pain, it's doing.
::In the under the like it believes it's keeping you safe and we're just trying to kind of teach it and remind it that actually, no, this hasn't been working out so well.
::For us, so we.
::We're not gonna try. Gonna try a new way. And I, you know, and promising like you're still going to be safe, but we just need to think about this kind of a little bit different way.
::Yeah, yeah. So people can get in touch with you to, to take your master classes and what kind of people would want to? I assume that, you know somebody that's in chronic pain, but.
::Yeah. I mean pretty much any kind of persistent, you know it could be arthritis, you know it could be you know, neck pain, back pain, you know, fibromyalgia, you know, could be something that just hasn't even been, you know, necessarily diagnosed.
::But you have it has.
::Like, unfortunately, pretty consistent not, you know, discomfort or pain for probably six months. Ish is kind of like the initial cut off, but some other things that you can that you know that you can kind of tell that.
::The nervous system is probably part of your problem, like if you if your pain level changes when you're more stressed or if your pain is going to start in one area but is really kind of starting to spread to other.
::Areas or it just it kind of changes one day it might bother you and your hip. The next day it might bother you in your knee. Those are all kind of some signs that there's probably a nervous system component to kind of what is going on with your pain level. Yes, I just, I just think it's fascinating and interesting. So even if you don't have.
::Thing you should listen to it because it's pretty. It is pretty interesting and like there's a new.
::Like either you or someone you know, like they will unfortunately experience this cause I believe it's one in four to one in five people in the world will experience chronic or persistent pain. And in the United States specifically.
::New cases of chronic pain out now outnumber new cases of depression. New cases of diabetes or new cases of high blood pressure. So it's a problem.
::That there are, yeah.
::That's a big.
::Problem because those other three that you just mentioned are like.
::The numbers are astronomical.
::Yes, yes. And that unlike the other ones, there's really no good protocol or treatment necessary plan for us. I think they found at least 2/3 of those.
::New cases are still dealing with the issue. You know a year later, so.
::And if you're.
::Not suffering somebody you know probably is.
::Yes. And again, the various you can kind of understand, you know they're not being lazy and it's often called like the invisible illness because people will look just fine. But.
::You have no.
::Idea kind of what's underneath all of that.
::Yeah, I have a really good friend who she suffered from a neck injury and she looks fine, but she struggles like every single day just to do the basic things. And another friend who had back pain and same deal in fact.
::She had patches, pain patches that.
::Caused her to lose a large portion of her Intestines.
::And almost died because she'd been on them for so long, and doctors don't monitor you. It's really.
::Up to you to.
::Stay in touch with them even though they're prescribing these incredibly powerful drugs to you.
::Yeah, yeah.
::To me that seems a little.
::Yeah, the system is, yeah, I say the system is not does not serve.
::You're fine.
::People with pain. Well, and I am a majority of it, is not out of any.
::Malice that I don't think. I think it's more out of. I don't really want to say ignorance, but.
::Lack of like doing what they know and that doesn't work. Not sure what to do next other than if we can give this to you so you feel a little bit.
::Better, we'll just kind.
::Of see how that goes for a while.
::I struggled with neck pain when I was much younger and it was before chiropracty.
::Really started gaining momentum in the United States. I'd fallen on my neck and I still suffer from problems with that. When I'm under stress, my neck will just like it's it gives me a headache. It's just excruciating, but.
::Oh yeah.
::But I would go to the doctors and I went to the doctor the first time and they like, slapped me down on the board with the head thing. And because they were afraid I'd broken my neck and I hadn't. But it didn't mean that there wasn't an injury there. So they just gave me, you know, opiates.
::Oh yeah.
::And sent me on my way and.
::And you can't live on that stuff.
::And it doesn't.
::Really help.
::Well, as I say, I mean opiates have their time in place like in your instance, acute injury for a couple of weeks to really help manage the symptoms. So that you can do the movement, do the stretches, do the exercises that you need to restore things.
::You know, that's what they're, you know.
::After you have a.
::Total knee surgery after.
::You have a total hip like. That's what they're intended for. Unfortunately it went.
::Haywire. And now they're kind of going really too far the other way. It's. Yeah, there's a time and a place. And if we would just kind of respect.
::That time.
::And place.
::Then they do what they're supposed to do.
::Yeah, I agree. Totally. And I've met, you know, my own mom. She's she had surgery for something or another. And she's like, well, I'm not going to take the.
::Pain medications like well.
::Yeah, you should take the pain medication. That's.
::It's for.
::You're not going to get addicted if you just.
::Do it for.
::A short period of time and you stay in contact with.
::Your doctor and.
::You do it.
::The way it's prescribed.
::When you start getting into trouble, is.
::When you self prescribe and you.
::Self medicate and you don't know what you're doing and.
::Then you end up.
::In all kinds of trouble.
::Yeah, I take it like my mom just had her second hip replacement a couple of months ago, and I and I'm like.
::Like take your like for the first two weeks you need to take the medication the way they tell you to, because that's what's going to help you get up and get moving and do the things you need to do to recuperate faster and like and nowadays there is usually a definite cutoff, like after two weeks you really should be transitioning, you know, on to these other lesser.
::Things like I said, you know, it's got a time and a place, and if you respect that it works great.
::Absolutely. So how can people get in
::Touch with you.
::Yes. So I am on social media, of course on and the easiest probably Instagram is The Amy Toth. So TH E AMY TOTH and then or e-mail I am Amy at amytoth dot com. So that one's pretty easy and on Instagram.
::You will find the link in my bio that links to the guide for the three things to kind of ease what hurts even when you can't get out of bed.
::Perfect. So what's the one thing you'd like to leave?
::The audience with today.
::I hope that there is, you know, for any of you who have been dealing with chronic persistent pain. There are things out there and there are there are people and providers out there who understand how this works and.
::Have techniques to help you. Unfortunately you have to search a little harder to find them there. No is there's no like national directory, but they are out there. So if you're working with a provider that is not clicking and you're not feeling heard, try somebody else. It's time to move on.
::To the next.
::Thank you so much for joining me today. This has been an incredible.
::Amount of information.
::For a group of people that struggle to be heard and.
::Just the conversation I think provides hope for.
::Yeah, and it's, it's.
::Yeah. And that's yeah, that's been one of my frustrations in general is, yeah, how so many people are. Yeah. Brushed off or yes not listened to. And that's it. Again. Part of the reason why the current system isn't working. And I could talk about this stuff for hours. It's just fascinating to me.
::Yeah. Thank you so much for joining us.
::Thank you.