Solutions for anxiety and chronic-pain

The latest episode in our Resilience Unravelled series has now been released, Resilience Unravelled – Solutions for anxiety and chronic-pain.

In this episode, Dr Russell Thackeray talks to Dr David Hanscom who is based in Oakland, California. Dr Hanscom was an orthopedic complex spinal deformity surgeon in Seattle WA for over 32 years. He quit practicing surgery in 2018 to focus on teaching people how to deal with chronic pain.

For the first eight years of his career David was part of a team surgically solving low back pain with lumbar fusions. Then research came out that showed the success rate of the intervention was only 22%. David had thought that the success rate was over 90%. This surgery is a major intervention so David immediately stopped performing them.  

As a top-level surgeon, David had always suppressed stress and didn’t know what anxiety was but around this point he started suffering from chronic anxiety, panic attacks and a obsessive-compulsive disorder. He thought anxiety was a psychological issue and sought help but found it just kept getting worse. David tried a number of different approaches but found the one that helped him the most was expressive writing. Studies have shown that this can help people with physical health conditions but David found it made it easier to separate and regulate his emotions

David feels that anxiety is the result of the body’s reaction to a threat or stress and that chronic pain is generated from sustained exposure to a threat. When we’re threatened for any reason, our body releases stress chemicals such as adrenaline and cortisol. We then experience a flight, fight or freeze response, with an increased heart rate, rapid breathing, sweating, muscle tension and anxiety. If this continues for a protracted time, we become ill.

As well as being something physical, a threat can also be can be intrusive thoughts, repressed thoughts or emotions which are processed in the brain in the same way as a physical threat.  Mental threats are the bigger problem because we can’t escape their consciousness. The body’s response with stress chemicals and inflammation is the same whether the source of the threat is mental or physical. If the threat is sustained, ongoing exposure to this inflammatory reaction destroys tissues and causes chronic disease.

To deal with pain we need to be aware of the neurochemical nature of chronic pain and the principles behind calming the threat response. We also need to address all the factors that are affecting our pain and, as chronic pain is complex and each individual is unique, the only person who can solve the pain is the patient who must take control of their care. Every symptom is created by our body’s response to our surroundings so cues of safety create a sense of contentment and well-being. Threats have the opposite effect, including elevated stress hormones, increased metabolism, and inflammation. Sustained and prolonged threats (including thoughts and emotions) cause illness and disease. David feels the solution lies in increasing the capacity to cope with stress and also learning to process it so it has less of an impact.

You can listen to the podcast in full and find out further information about Dr Hanscom here. Our previous podcast episodes, upcoming guest list and full blog archive is also available.

You can find out more about Dr Hanscom at his website BackInControl.com or his program The Doc Journey His latest book is available from Amazon.