Understanding Widespread Pain (Chronic Overlapping Pain Conditions)

Millions of Americans suffer with chronic pain disorders, including: vulvodynia, TMJ, myalgic encephalitis (chronic fatigue), irritable bowel, IC/BPS, fibromyalgia, endometriosis, chronic tension headache, chronic migraine and low back pain. When someone has two or more of these conditions, they are diagnosed with Chronic Overlapping Pain Conditions (COPC). Do you have very sensitive skin, a wicked sense of smell, sensitivity to sounds, light as well as anxiety disorder? These are also signs of a more sensitive nervous system.

Jill’s Story

One of the reasons why I founded the IC Network and earned multiple college degrees (chemistry, pharmacology and psychology) was to understand why I had struggled, for so many years, with many different pain conditions. As the patient, I was confused, depressed and frustrated. It felt like I developed a “new” disease every year. While my peers were out enjoying their lives, getting married and having babies, I was at home, often laying in the fetal position, struggling with pain. Why? I just wanted to know why?

Like many other widespread pain patients, my symptoms began after a childhood injury. I broke my tailbone in 7th grade and began struggling with frequency and urgency. My teachers complained because I was always asking to use the restroom. I was  diagnosed with a urethral stricture (narrowing of the urethra) and endured many urethral dilations yet not single doctor checked my pelvic floor muscles which were, undoubtedly, tight and dysfunctional because of my broken tailbone. I became a master at finding restrooms throughout my town.

In high school, I developed what I thought were chronic yeast infections which felt as if someone had scrubbed the skin off of my vulva with sandpaper. My doctors only comment was “you have the most sensitive skin I’ve ever encountered.” In my early 20’s, IBS struck with daily “bend over and screamer” cramping that lasted for many years. Then migraines. I also noticed that I had become very sensitive to certain foods, chemicals and smells in my home. In my early 30’s, bladder pain hit for the first time and it was ferocious. I struggled with severe anxiety and depression for years.

Not only did I sustain a physical injury, I was also a victim of childhood trauma. In my neighborhood, we had a young man who was mentally ill and very violent. I was first attacked in fourth grade. From 4th grade through high school, I didn’t leave my home without fear.  He raped and murdered one of my neighbors the year that I went to college.  Can you imagine what this level of stress did to my brain? My brain became accustomed to “fight or flight.” My only safe place was at home. When invited to go out, I often said “No” despite wanting to go. Why? That’s a sign that the brain is in “guarding mode.” It’s trying to keep you safe and secure because of a long history of fear and/or abuse.

Childhood trauma plays a central role in the development of widespread pain. We have now interviewed hundreds of patients who struggling with widespread pain who also share a history of injury or abuse. One common story is growing up with an alcoholic parent who became violent while drinking. They, too, lived in a constant state of “fight or flight” only their safe place was school. Fear began every day as they walked home. This changed their central nervous system but there is hope. Treatment that focuses on calming the central nervous system and reducing “fight or flight” can reduce pain throughout the body. In fact, I am now pain free with not only pelvic floor muscle therapy but with nerve and anxiety calming techniques. You are not alone! – Jill Osborne – ICN Founder

A More Sensitive, Altered Central Nervous System

The Chronic Pain Research Alliance has worked for more than decade to help us understand why these conditions often occur together. Their studies continue to implicate an altered, more sensitive central nervous system. Adults with chronic pain often have a history of trauma or injury in childhood that has triggered dysfunctional changes in peripheral nerves and/or the brain. Brain studies in COPC patients have found that different regions of the brain are bigger (or smaller) and/ communicating differently than in those without chronic pelvic pain. For these patients (this author included), even minor irritants can provoke more intense pain.

There is hope. Just as the brain and nerves can be damaged through trauma, they can also be improved and this is where Mind-Body medicine succeeds greatly. COPC patients require a program designed to calm their nervous system and restore good brain function. This is known as the neuroplastic response (i.e. neuroplasticity). At no point is anyone suggesting that chronic pain is a mental illness. Rather, we are referring to the physical health and function of the nervous system throughout the body.

Helping The Brain Adapt & Manage Pain Better

The goal of therapy is to help the nerves and brain adapt and manage pain better. This can be done in remarkably simple ways. Regular exercise, healthy eating and quitting smoking create a foundation for good brain and nervous system health. Keeping the mind active, engaged and challenged is important. Yes, that means using your mind by reading, doing puzzles, learning new languages and so forth. Daily relaxation that keeps stress low is critical to “winding down” a more reactive nervous system. In contrast, the excessive consumption of caffeine can be overstimulating.

“Mindfulness” is one of the most effective ways to change the brain. The more calm and peace we teach our brain, the more we react to life stressors with that same sense of calm. Harvard Medical School has done multiple studies that show that Mind-Body Medicine that teaches patients meditation, yoga, cognitive skills and positivity result in less pain, fewer medical services and lower health care expenses. (Now and Zen: How mindfulness can change your brain and improve your health.)

Music can also help. It not only improves your mood it can also make beneficial structural and functional changes to the brain. Trained musicians have noticeably different development of key brain areas, such as the corpus callosum, cortex, cerebellum and gray matter. Turn on music that you gives you peace, joy and makes you dance!

Learn more about Mindfulness & Mind Body Techniques here!

Created by: Jill Osborne MA
Edited: September 27, 2022
Creation Date: Nov. 14, 2020