Leah Dwyer has suffered from chronic neck pain for a decade, and until last year she says it devastated her life.
After injuring her neck from a fall she sought medical advice and was told she would heal in a matter of weeks. When the pain persisted, her diagnosis changed to dystonia, a neurological movement disorder that produced pain and spasms.
“The pain was isolating. You don’t want to be with people or try new things. All you talk about is your pain,” says Dwyer.
“If I wanted to buy a coffee, I wondered what they would think of my twitching … If I wanted to take a day off work on a bad pain day, I was scared I’d be fired.”
Dwyer followed the treatment recommended by her neurologist for a year but after experiencing little improvement she decided to medicate with an over the counter opioid. It began as two tablets a day, but quickly escalated.
“I took 14 – which is a lot of codeine - but it really wasn’t making the pain any better,” says the 54-year-old.
When the opioid she relied on became prescription only, Dwyer was determined to re-evaluate her options and turned to cognitive behavioural therapy (CBT).
Psychological intervention aims to improve pain management and perception, and is often paired with medication says Pain Australia CEO, Carol Bennett.
“Cognitive behavioural therapy enables people to consider how they deal with pain, their resilience and how they can manage their pain more effectively,” explains Bennett.
CBT explores how psychological and environmental factors can also influence someone’s experience of pain.
Genetic characteristics like age, sex, ethnicity and personality have all been linked to pain responses, as well as situational variables like mood, stress and attitude.
“We’re not saying the pain is not there, but that it may be heightened by other factors… above all, you need to remember pain is unique and this won’t work for everybody,” says Bennett.
"For a long time, I really discounted the emotional element.”
Looking back, Dwyer says learning to understand her pain was the best thing she did.
“For a lot of people, I think we associate pain with damage and we know now this is absolutely not true. The brain doesn’t need damage to produce pain,” says Dwyer.
“I realised things like anxiety, fear and worry were really enhancing my pain.”
As Dwyer evaluated different aspects of her life, she began to understand why her pain had persisted: “I looked at my life ten years ago and at the time I was experiencing a career change and a divorce - it was an enormous upheaval in my life.”
“When I was diagnosed, the neurologist said the trigger for the condition is a physical or emotional trauma. For a long time, I really discounted the emotional element.”
Dwyer says once she dealt with her past trauma and accepted her day-to-day concerns related to her pain, she dramatically decreased the amount of medication she was taking.