In Your Pants with Dr. Susie G - Heal Your Pain w/ Dr. Joe Tatta

Episode Date: August 16, 2018

On today's show, Dr. Joe Tatta and I discuss simple strategies you can do to live a pain-free, healthy and happy life. No surgery, no pills with harmful side effects, no gimmicks. Dr. Joe teaches you how to retrain your brain and body so you can live the joy-filled and pain-free life you deserve. He's a doctor of physical therapy, functional nutritionist, integrative pain expert and #1 bestselling author of  Heal Your Pain Now.  He's known for integrating neuroscience, nutrition, psychology and movement into simple treatments for lasting pain relief. Dr. Joe's mission is to quickly and compassionately heal your pain and reverse the global pain epidemic.

You're listening to In Your Pants with Dr. Susie G, the physiotherapist for your private, helping you get in the know down below. Hey guys, thank you so much for joining me for another In Your Pants episode. Today's show is all about learning simple strategies to live a pain-free life, happy and healthy life. And to help me do this, I've invited Dr. Joe Tata on the show. Dr. Joe teaches you how to retrain your brain and your body so you can live the joy-filled and pain-free life that you deserve. We all deserve this, yes. He's a doctor of physical

therapy, a functional nutritionist, integrative pain expert, and the number one best-selling author of Heal Your Pain Now. He's known for integrating neuroscience, nutrition, psychology, and movement into simple treatments for lasting pain relief. Dr. Joe's mission is to quickly and compassionately heal your pain and reverse the global pain epidemic. Those are some big shoes to fill, Dr. Joe, but without further ado, welcome so much to the show. Thanks, Dr. Susie. I'm so excited to be here with you today chatting. Thank you very much. Thank you. Well, let's start off right off the bat. So tell me, you know, why is chronic pain so difficult to treat and what is happening when we still have

so many suffering in the world today it's a great place to start off a podcast between uh you know two dpts that's for sure um you know chronic pain is difficult to treat really because we we've lied to a lot of people and that's kind of a strong statement but i think it's a statement that needs to be said more and more and when i say lied it really is a combination of what big pharma and kind of the big medical complex has pointed people in the direction really as pills to be the solve you know the solving factor for their ills or for their chronic pain basically and you know if everyone is paying attention to the news these days and notices things on on television about opioids and addiction and you know deaths related to it and opioid addiction

ultimately leading to heroin addiction it's a big topic right now and you know we have to start to put a stake in the ground and say the reason why pain is so difficult to treat is because we are infecting people's beliefs with the fact that a pill can treat their pain so that's really first and foremost we know these medications don't work the cdc has provided a ton of great research and information and studies on with proof that these medications don't work work long term for people with chronic pain and you know in my bio i always have that that word compassion is in there and i don't want to come across as um not being compassionate towards people because when you have chronic pain it's not fun it hurts and there's there's a place for these medications but

it's a very short period of time typically in the beginning and then as you start to integrate other natural strategies into your life you take these medications out as rapidly as possible because they have side effects of addiction uh dependency and you know for some people it can lead to things like death so that's really where we start the podcast today right right and that's such a powerful message and you're right i mean most people or most individuals on medications don't realize the impacts of those medications that they're actually making their pain worse uh instead of better acutely they might have some short-term effects but long-term they're they're so detrimental as you listed a lot of those effects it's true and and aren't people

ready for this message Tuesday aren't they ready for a message that says okay this medication isn't working what else is there to do right right and then they often find themselves very um stuck in a rut or hopeless because you know medical doctors or conventional medicine doesn't have answers for them that's good but that's not we're here and we've got answers right we sure do we got tons of answers that's awesome so leading me to my next question so can you explain can you tell us what pain really is so we can understand it better for our listeners i look at pain is simply just a message and it's a message that your your body is sending you and you know if we want to boil down the word body into something that's a little bit tighter it's really your brain it's a message that

the brain is sending and that message like all messages are meant to alert you to something just like when you get a text message it's an alert it's meant to it's meant to grab your attention to look down at it. When you get the little messages that come off your email or a news feed, they're all alerts. It's meant to grab your attention. The interesting thing with chronic pain is that these messages or these alerts continue for longer than they should. So even though the damage may be healed, let's say you bend over and you pick up a heavy box in your garage and you strain your back. You strain some muscles in your back. Your body will heal that naturally. It's called the inflammatory process you know that susie and your body heals within a matter of you

know three to six months at the maximum and after that that signal that message should go away it should decrease substantially 100 right and if it doesn't it just means that there's something else going on or there's other factors going on that is causing this text message if you will to come up in your body these text messages of pain to to arise and that's really just what pain is and you know a lot of people of course they're scared by pain because they think that it means that something is damaged and you know as well as i do the biggest take-home message of the most important message we can give to anyone with chronic pain is that it's not a sign of danger in many instances and that there are other signals that we need to start to look toward

in an effort to make that signal, um, decrease as much as possible and hopefully go away. Right. Right. And this is sort of not new stuff, right. And I'm putting this in quotation marks. I mean, uh, this, this research on, on how pain really works and operates has been for decades, you know? Um, and I think that in our society today, it's very difficult for individuals to wrap their head around the fact of, well, there's a problem and it needs to be fixed, you know, find it you know like a find it find it fix it model where is it yeah i mean that's that's showing those of us that that treat pain conservatively if you're a physical therapist or a chiropractor or um you know really quite frankly the very few physicians out there that treat

pain conservatively we know what this message means we know it doesn't mean danger we know it doesn't mean harm but for people who have chronic pain this is actually a very very new message for them and it can be a message that that takes time for them to really process and for them to really you know kind of sit with and understand what does this really mean to me personally in my life and now that i understand this message a little bit what do i have to do to reverse this message so it's interesting yeah when you talk to certain clinicians they get it very rapidly but when you talk to the public and i talk to the public a lot now So, you know, patients, those who are taking opioids, those who are looking to get off

opioids, these types of messages and lessons, they're really pain lessons, takes time because we're really undoing people's beliefs from decades and decades of wiring about what pain is and what pain isn't. Right, right. And I like to tell my patients too, it's like, you know, a new path, a hiking trail, right? How does a hiking trail become a trail? You have to walk numerous times. Many people have to walk down this trail so that it clears and takes care of, you know,

and then that's how you create a new trail. But you can also unlearn pain, like in the example of unlearn pain by just stop walking on the same trail and it's going to be overgrown and you're going to be walking down a new path, right? So it takes time though. It takes time is where I'm getting at. It's true. It does take time.

And, you know, the time can often be the factor that people become very anxious about because when you have pain, you want to be gone, you know, right now. And all of us wish there was a magic pill to make pain go away like that, but we don't have that. And I firmly believe we'll never have that. And it's actually a good thing that we'll never have that because pain is very beneficial to the body. When you have an acute injury, like you fall off your bike or you sprain your ankle as you're walking down that trail, that's an acute injury. And that pain is really important. It's meant to alert you. And with acute pain, it's wonderful.

We want to call that in. But there's never going to be a drug to shut pain off. And if there ever is a drug to shut pain off, we're going to see some really, really awful side effects. So helping people manage and cope with their pain as early as possible and as quickly as possible is the direction that all of us are moving in, in helping people with chronic pain. Right. And that's the key. I like that you stated as early as possible, getting the message out there and starting that training process as soon as possible so that we can eliminate fear and anxiety. and you mentioned anxiety and we all experience anxiety. I mean, it's part of the human condition, but can you explain, you know, direct the direct link between our thoughts and emotions and their influence on pain? I sure can. When you have pain, it's, it's really scary.

And when I say the word scary, it should make people think about fear. And it's that fear that I could be damaging myself. It's that fear that I could be re-injuring myself it's the fear of this pain will never go away it's the fear that i'm never going to be able to find a solution for my pain or i'm never going to be able to find a way to live beyond this pain and when you live with that that fear constantly day in and day out and the brain is doing what it's doing the brain was meant to think just like the heart was meant to beat the brain was meant to think and these these thoughts come up sometimes they're you know few and far between but for those with pain they're they're very um consuming and they can really consume your thought processes

and they can consume your your presence and your awareness all day long and when that happens it leads to this anxiety it's when is this pain going to go away how is the pain going to go away who's going to help me and when you have anxiety and if anyone's ever had anxiety before you know So public speaking is a really simple version of anxiety that most people can relate to. You know that your palms get sweaty. You may start to shake. Muscles tighten. You may get kind of those butterflies that are not in your stomach.

Well, a lot of those same things happen with anxiety around pain, except they're actually worse. So you get much more muscle tightening than normal. you get nerves that um are start to fire that really should be more at rest you get tremendous changes in digestive function that will lead to things like irritable bowel syndrome which can make your joint pain worse there are so many different things that happen in the body hormonal changes um nutrient deficiencies that all happen around that anxiety and that stress response and this is the kind of thing that you know most people don't explain this this cascade of what happens after the weeks and months of having chronic pain and once you start to explain

this to people they say wow i had no idea i thought it was just the physical pain i felt i had no idea there were other changes in my body and i had no idea how my thoughts and emotions can either you know upregulate that pain or actually inhibit that pain and obviously the inhibiting the pain is what we want to focus on with patients right right and this could be a very difficult not difficult but a very a complicated task to kind of work through someone in my opinion like sometimes you know you're it's it's kind of like you have to repeat the message a few times and even then somebody that's living through uh their lived experience of pain you know whatever meaning that they bring to that um how how do you help someone navigate through these

thoughts and emotions i'm just curious um how do you help them kind of work through these these messages or these thoughts and catastrophes you know from a clinical perspective when when i see a patient there are a couple of simple um forms and tests and measures that i give them that i should they're kind of like quizzes basically and you know some of those quizzes say things they ask that they ask the patient questions like do you find yourself being consumed by by thoughts of your pain and just that question alone if they mark that question they put a little x in the box next to that question i might say to someone what's the number one thought you have around your pain and they may say something like um i'm concerned that my the discs in my back

are damaged beyond repair and when they say something like that i now have information I can start to work with them around, meaning I know what kinds of thoughts that they're having. I know that if they're scared that their back is damaged, I know how I have to start to create my exercise program. And last but not least is what is the emotion attached to that thought? So I may say something like, okay, when you think that your back is damaged beyond repair, what type of emotions come up. And there's a whole cascade of emotions. As you know, the brain is very in-depth and emotions are really attached to your thoughts. But it can be anything from people having feelings of being not worthy, meaning they feel worthless. If my back is

damaged, I'm not going to be able to go to work. I'm not going to be able to help my kids. I'm not going to be able to be a good partner or good spouse so there's things of worthiness and then you know if you really peel that layer off and go you know deeper with people um there's feelings of being unloved that that are underneath all that and you know some of these things you can explore with people really easily and then sometimes people have to you know go on to counseling and um you know work with a professional who can you know kind of go you know one level deeper you know if we're talking with if we're talking with a patient who has had a significant history of some kind of emotional trauma that they have not worked through with a licensed health

professional then you know we want to point them in that direction but you know when you think of simple things things like mindfulness meditation they work with thoughts and emotions quite frequently and i love mindfulness meditation that's one of the things that i do with patients quite regularly because they're really easy ways and they're they're easy ways to approach thoughts and emotions without going into you know what was your mother like and what was your father like like that's that's important and there's a a time and a place to go there but a lot of people don't really want to go back in life they want to go forward so it's well i know i have these negative thoughts about my pain and like you said before my experience of pain what are some simple things i

can do each day well if 10 minutes of mindfulness meditation can show you how to bring some awareness to that thought recognize it and then gently just kind of brush that thought away and allow another thought to come in its place for a lot of people that's a lot more manageable as far as time it's a lot more manageable as far as expenses and effort and energy than going to see, let's say, a licensed medical professional twice a week. And I have psychologists and other types of counselors that I refer to patients regularly, but you'd be surprised a lot of people don't need that once they are told about some of these really easy strategies. I would have to agree with you 100% that just kind of helping them through navigating,

it's kind of like noting the thought. You were saying thoughts just think themselves. and people need to understand i some of them just don't realize that why are these thoughts just ruminating in my head you know and it's just that's it it's just a thought you don't have to resonate with that version of that thought right like don't what's the version that you're identifying yourself with you know that's right so in mindfulness um and also in other types of of therapies like there's something called acceptance and commitment therapy we look at that as either attachment or diffusing so attachment is that when those thoughts come up you pay a lot of attention to them you spend a lot of time thinking about them and you spend a lot of

time trying to run from them and it's really difficult to diffuse from those thoughts because the brain like i said before the brain is thinking it's meant to think it's really doing its job and instead we really want to teach people to welcome those thoughts in to realize they're just thoughts they have really little uh bearing on what's going on in your life regarding pain and that once you start to diffuse from them and you stop struggling with those thoughts that oftentimes they can make your pain better they can lower your stress levels they can lower your levels of anxiety and depression and ultimately when you start to do that it it turns you toward um approaching pain or accepting pain and then from there you can start to

you know make the changes that are needed to live beyond your pain yeah living beyond the pain right getting back to life stop chasing pain right that's right it's really difficult to chase pain right right and we're so like fixed on again finding that one thing and like you said there it just doesn't exist. Unicorns don't exist. Neither do magic pills and magic fixes and quick fixes and you fill in the blank fix, right? Yeah. Especially, you know, Susie, as physical therapists, both you and I are going through the traditional physical therapy education. And even to this day, we are so focused on fixing things. And, you know, I'm sure there are practitioners as well as patients listening to this. From the practitioner side, once you realize

that your job is not to fix someone's pain. That's not what we do. And once you liberate yourself from the fact that I have to fix someone's pain, your job as a practitioner becomes a lot more enjoyable because then you fall into two categories. One, you fall into a teacher where you're teaching someone the skills

that they need to help themselves. And then two, you fall into the category of helping someone cope. so once they learn these skills now you're hoping that you're helping them persistently or constantly integrating these skills into their life in a way that is seamless for them in a way that's easy for them and eventually when that happens that the person now takes on these skills as if they're their own you know it's the teacher leading to the student basically the student surpasses the teacher and that's when they get better and then you know I think there's a third

level to that and what i see in my patients is that the ones that really embrace this kind of work eventually take this out into the community yes hands down you know you and i are doing this now obviously you and i are talking you know as clinician to clinician the patient's going to listen to this but the the bigger level and the the bigger picture with chronic pain is taking this into the community and saying hey there are natural alternatives to things like prescription medications. There are natural alternatives to opioids, to benzodiazepines, to the antidepressant or SSRI medications. There are natural alternatives to surgery. So many of the surgeries like meniscal repairs, rotator cuff surgeries, all sorts of back pain, a lot of that can be solved

naturally just with some exercise and lifestyle changes. And you're right, the person has to be open. I like that you brought that up. If they're ready to receive this message and they're willing to be, have some mental flexibility around a different approach, the message is well received and they can really integrate into their life. But when they're not ready and they're still looking for that one single cure and just so fixated, you know, kind of like concrete or sandstone, a conceptual construct that just is almost immovable, which I don't think is ever possible we're always changing but it does make it quite difficult you know along their journey and perhaps you know your message is not the time or the place that they're going to resonate with

you know no however i do think that all of us have uh you know a duty and a responsibility i take what i do i'm very very passionate about what i do and i think when someone comes to me it's the first thing is how ready are they for the changes that have to happen and if they're not ready my only job is to try to move them into readiness and this is going to be shocking probably for a lot of physical therapists but there are patients that i spend two or three sessions with now just just talking yeah me too yeah i don't put my hands on them i don't do any manual therapy i don't do any exercise with them i don't do any um you know modalities which i barely do anyway with with most patients i may just spend you know two to three sessions just

talking to them yes yes and that and i'm so glad to hear that and that's totally okay there's this thing especially as pts that you know we have to start them out in an exercise program right away and it's like well if your patient's not ready for that exercise program is that where you should be working from with them because if they're not ready for it they're not going to go home and do it right and then they're going to come back they're going to come back to you and of course as a therapist the first thing you say is how are your exercises going and they say well i didn't do them and you know the next question always follows is why not and that question of why not i'd love to put a barrier between that and say instead of asking why not ask how how can i

help you get to the point of being ready where we can talk about exercise or we can talk about nutrition or we can talk about meditation and thoughts and emotions whatever it is um there's so much of that that needs to be done first um because patients really show up with really different levels of readiness for the type of care um and responsibility that they're going to have to take to you know move them along to this life of less pain oh that's beautiful and i love that question. And if anyone takes anything out of this whole conversation is how can I help you to, to do that? Right. We're, we're ultimately all, you know, side-by-side with them on the journey, not powering over or, or any of that, you know, it's, it's collaborating with as a team,

you know, and helping them navigate through their journey, their entire journey, you know, the entire time, you know, you're kind of creating the support system for them, um, for their, their lifelong health, you know, and it's not just 30 minutes of hands-on treatment or exercise and I'll, I'll see you in a couple of weeks or something, you know? Yeah. I think especially as, as PTs, we have like these codes that we follow and we have fallen into this. Um, here's what I do. I do exercise. I do manual therapy. You know, I do pain science, whatever that means um you know where if you really said if you really sat a patient down for a couple hours and really talked to them and asked them what value they found in working with

you 99 of the time the value the patient sees is is in the knowledge that you're you're giving them yes and the care and that you listen to be honest i like to add that that you actually gave them the time to let them sit there and talk and the space, a safe space. You created a safe space for them to tell their story. That's right. And I'm a big meditator. I meditate probably about an hour plus a day. Sometimes that's in one chunk. Sometimes it's in multiple chunks. And sometimes it's just a basic breath meditation. Other times they're meditations that are focused on intention other times they're mantras and when the new year came around this year i was like i have to create a new mantra for myself of how i'm going to live my life because that infuses

everything it infuses how i treat my patients it infuses how i interact on this podcast with you it infuses how i interact with my loved ones and the three words that i came up with for my meditation mantra wisdom compassion and love and you know applying that first to the patient perspective the most important thing you can give your your patient is knowledge now if you're delivering that knowledge in a way that's not compassionate then it doesn't usually stick well with people that compassion is often the through line that informs how you interact with that patient and then last but not least you know that exchange of love is really what's happening and i know that can be really really deep and too spiritual

for a lot of people but think about this you're a obese 50 something year old woman who's had fibromyalgia who's on an opioid and let's say an antidepressant and you've been able you have not been able to find um a solution for your pain finally you find someone great like dr suzy who spends time with you who talks to you who knows how to put her hands on you in a way that's gentle and doesn't cause pain um is able to talk to you about different types of lifestyle that person sees that has finally found someone to care for me to love me basically that's really what your patients want yeah that's what your patient doesn't want to see what their their goals are in front of their face that they have to meet at week four and week six and week eight.

Now, we know that's important and we know we have to do this as professionals. But if we're talking about chronic pain patients, that's what they want. They want wisdom, they want compassion, they want love. So those are my three words that I often meditate on. And I really, you know, I work on them. I work to infuse that into my life, but it's so important when it comes to, for both practitioners and patients who have pain. oh dr joe i love that i love that and you know what you are totally your work and what you do and and this whole podcast those wisdom compassion and love i mean that is just resonating throughout through your words through the ethernet and everything that you do and speaking of so tell

tell our listeners you know what you've been up to how can they connect with you um and all that fun stuff yeah i mean this is a super exciting time for me um we're coming up on a year of my book heal your pain now was released a year ago so it's going to be the one year anniversary you know with that that book has really um put me on on a very interesting path um of you know leading people um toward natural ways to heal their pain so they can you know hear about those things on my blog and my podcast the podcast is called the healing pain podcast i also have programs for patients on my website at drjoetata.com and then you know really over the course of the last year i've had a lot of practitioners from all walks of life and all

professions reach out to me and say hey i love your work i love your book um it's really a guide book on how to treat pain naturally um i'd love to know what you know i'd love to learn from you so with that, I've created the Integrative Pain Science Institute. You can learn about that at theintegratedpainscienceinstitute.com. And there's a series of courses from the biopsychosocial aspect that will lead to a certification unlike any other that we have. And hopefully I can, you know, help train clinicians in really providing integrated care for patients because that's what we need. That's the direction we're going as we move away from drugs and surgery to help people. That's awesome. That's beautiful. So I've definitely have this in the podcast show

notes, links, um, and Dr. Joe's information for you guys to check out. But Dr. Joe, thanks again so much for being on the show today. And for honestly, all the work that you're doing to helping, uh, people live a pain-free, healthy and happy life, as you say. And, um, it's just wonderful that you're bringing this workout to the world and the community. So thank you so much for all that you're doing thanks for having me on dr suzy much love yeah thank you and guys thanks for listening to the show as always in loving wellness for your pelvis this is dr suzy g until next time my friends i'll see you later thanks for listening to today's episode be sure to head on over to drsuzyg.com where you can get more information show notes and related articles

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