• Black Sheep Diggers presentation - March 29th 7pm

    In the Crown Hotel Middlesmoor the Black Sheep Diggers are going to provide an evening presentation to locals and other cavers.

    We will be highlighting with slides and explanations the explorations we have been doing over the years and that of cave divers plus research of the fascinating world of nearby lead mines.

    Click here for more details

Caving and Chronic pain

bagpuss

Active member
Where I work we have a biannual e-newsletter and I decided to write about caving this month.

Caving and chronic pain

Caving and chronic pain is probably two phrases you probably won’t hear together very often, but here’s my story… A year or so ago I started to get a niggling pain in my back and so began my journey with chronic pain began. The back pain got worse and worse, to the extent I was often crying from the pain. I tried everything to fix the pain- physio, acupuncture, massage, medications, sorting out my home work set up. The pain eventually debilitated me to the point where I could barely walk any distance. As someone that is ‘outdoorsy’ by nature this had a huge impact on my mental health. The pain eventually spread to everywhere in my body. I had all the medical tests I could have, which showed absolutely nothing. I eventually started to read about mind/body pain (often referred to as ‘neuroplastic pain’) This condition causes real pain, it doesn’t mean that someone is making it up, in my case it’s that the brain is misfiring pain signals making me think something is wrong, therefore creating pain. I will often wake up in the morning have a blissful few minutes of no pain, until my mind wakes up and starts sending the pain signals again. Things like physio won’t fix my pain because it’s coming from my mind, rather than my body.

Trying to recover/manage pain has been a challenge, I did start to return to physical activity whilst still in pain. I would sometimes try and do too much which would massively worsen my symptoms and further debilitate me. One of the techniques to manage returning to activity is to slowly pace the return, to try and reassure the mind that activity is ‘safe’. I’ve always loved caving and that has been the hardest activity to return to, the oversensitivity my body feels to pain means that any slight knock hurts me much more than the average person and it’s quite hard to avoid banging into rocks when crawling underground! I am lucky to be in a caving club that is supportive and understanding, this has meant they’ve not gotten mad at me when I’ve dropped out of things because I’m too exhausted or because I've been more snappy due to pain (I've always apologised afterwards) They’ve been happy to do easy trips and have plenty of rest stops for me. The less I am able to think about the pain and be distracted by things I enjoy, the easier it is to manage.

I wanted to write this article to share a photo of a cave I recently visited. The cave is so highly decorated you have to have a volunteer conservation warden to take you around, it is one of the most decorated caves in the South West. I explained to our leader in advance that I had some health issues and we would need to go slowly, they kindly accommodated this throughout with lots of rest stops for conversation and photography. Sometimes I have days where I grieve who I was before the pain, but I try to remind myself that 6 months ago I wouldn’t have been able to cave at all, staring in wonder at ‘green lake chamber (see photo) I felt quite emotional at achieving something I didn’t think was possible. I think sometimes there’s the assumption that I am better because I am doing something very physically active as a hobby, but that’s largely down to adapting things to a level I can manage and doing it despite the pain.
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For anyone interested in taking up caving more information can be found here: (obviously this link was more relevant to colleagues reading this than forum members!)

https://newtocaving.com/contacts.php
 
Interesting story. You must be doing well as I cannot get into Green Lake Grotto nowadays as my chest won't compress like it used to. Some of the other caves in the quarry are less challenging so well worth considering.
 
Interesting story. You must be doing well as I cannot get into Green Lake Grotto nowadays as my chest won't compress like it used to. Some of the other caves in the quarry are less challenging so well worth considering.
I'm quite small framed so squeezes aren't a big barrier 🙂 we've visited most the caves in the quarry in previous years and will likely return in the spring when the ones closed for bats are back open as there's always something new to see in these special caves.
 
Strangely I took a visitor from Canada into Withyhill Cave yesterday. I have developed a chronic pain in my upper back and thought some caving would help it. Certainly during the trip the pain remained low key and I was able to navigate fine through the cave but it was as bad as ever when I was driving home. Very annoying as I thought a workout might help! Doctor's appt end of the week looming!
 
This is really good to hear and you make some really nice observations that I wish my other patients would.

As a physio I receive and treat A LOT of chronic pain and this is really refreshing to read.

It's very very difficult to talk to individuals about pain science without sounding like you are saying "it's in your head"

It is in your head but not in the way people hear that phrase.

Ultimately pain is incredibly complex, but it is the brain that interprets the signals and therefore "in. Your head"

Central sensitisation is a very real thing and I really feel for people who have x-rays, MRIs, nerve conduction studies etc etc and always told "no abnormality detected"
I try to reassure "structurally everything is good, this is great, we dont need surgery etc"

Always the reply comes "so you are saying I'm making it up, you are saying my pain isn't real"

No, I believe your pain very much. The problem is pain is the brains way of perceived danger (putting hand in boiling way - pain - quick take hand out.) (or protecting from further damage - pulled muscle in back - pain - protect the back so you don't further damage it and allow it time to heal)

The problem is long after an injury these signals can still be transmitting along the nervous system and sending unhelpful messages to the brain.

Take your smoke detector in the kitchen - your kitchen sets on fire and starts to spread - the alarm will sound to alert you to danger and thus you take action.

Now, you set the toaster a bit too high. You burn some toast and that smoke triggers the smoke alarm..........the alarm sound is EXACTLY the same as when you set fire to the kitchen. The Smoke detector (your brain) cannot distinguish between the two "dangers" only one of those is actually dangerous.

Lorimer Mosely is an incredible pain scientist and made a video called Tame the beast. Very worth watching.

Also watch his ted talk about being bitten by a snake in the outback on how the body perceived danger.

The best way to combat this is to do what you are doing. Do something you love. Go caving.

You know that hurt does not equal harm. You are going to be in pain, but no damage is being caused, just your annoying nerves being more pissed off than normal. But rather than sitting at home in pain, you are now underground looking at beautiful formations in pain. You were going to be in pain anyway, but at least you are doing something you love. One day hopefully your brain will learn that these activities are safe and that these signals are no longer helpful and it will diminish. Well done for grabbing life again and pushing on. You will have good days and bad days, but keep positive and keep caving. Thank you for being brave to share your story
 
This is really good to hear and you make some really nice observations that I wish my other patients would.

As a physio I receive and treat A LOT of chronic pain and this is really refreshing to read.

It's very very difficult to talk to individuals about pain science without sounding like you are saying "it's in your head"

It is in your head but not in the way people hear that phrase.

Ultimately pain is incredibly complex, but it is the brain that interprets the signals and therefore "in. Your head"

Central sensitisation is a very real thing and I really feel for people who have x-rays, MRIs, nerve conduction studies etc etc and always told "no abnormality detected"
I try to reassure "structurally everything is good, this is great, we dont need surgery etc"

Always the reply comes "so you are saying I'm making it up, you are saying my pain isn't real"

No, I believe your pain very much. The problem is pain is the brains way of perceived danger (putting hand in boiling way - pain - quick take hand out.) (or protecting from further damage - pulled muscle in back - pain - protect the back so you don't further damage it and allow it time to heal)

The problem is long after an injury these signals can still be transmitting along the nervous system and sending unhelpful messages to the brain.

Take your smoke detector in the kitchen - your kitchen sets on fire and starts to spread - the alarm will sound to alert you to danger and thus you take action.

Now, you set the toaster a bit too high. You burn some toast and that smoke triggers the smoke alarm..........the alarm sound is EXACTLY the same as when you set fire to the kitchen. The Smoke detector (your brain) cannot distinguish between the two "dangers" only one of those is actually dangerous.

Lorimer Mosely is an incredible pain scientist and made a video called Tame the beast. Very worth watching.

Also watch his ted talk about being bitten by a snake in the outback on how the body perceived danger.

The best way to combat this is to do what you are doing. Do something you love. Go caving.

You know that hurt does not equal harm. You are going to be in pain, but no damage is being caused, just your annoying nerves being more pissed off than normal. But rather than sitting at home in pain, you are now underground looking at beautiful formations in pain. You were going to be in pain anyway, but at least you are doing something you love. One day hopefully your brain will learn that these activities are safe and that these signals are no longer helpful and it will diminish. Well done for grabbing life again and pushing on. You will have good days and bad days, but keep positive and keep caving. Thank you for being brave to share your story
Thanks for your thoughtful comment Ben, will check out the links you mention. The first reading I did about Mind/Body pain was from John Sarno, then moved onto Alan Gordon (The Way Out) which I think is a really good resource. When my pain stated I was in a high stress work situation and high stress from neighbours, so a classic case of the body/brain being on high alert. I think it's been harder to get back to caving as there are elements of feeling fearful when caving, especially after a long hiatus, hoping it will improve in time as I become more confident again. It took me a good 6-8 months of trying to 'solve' the pain before someone recommended reading about Mind/Body pain, the recommendation didn't come from the NHS. I think there is very little guidance or knowledge around mind/body pain in the NHS, I sometimes ponder if I would have made a quicker recovery had I had the knowledge earlier on.
 
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