Your neck and shoulders have ached for several years, and your lower back has been sore ever since. Painkillers ease it for a few days, a course of acupuncture calms it for a few weeks; you change your pillow, change your chair, and exercise every morning. Then a busy season or a sad event in the family comes along, and the pain returns to exactly the same spot. When we see pain like this, the doctors at Tam Duc ask more about the years a person has lived through, because old emotions may be one of the things keeping the pain in place.
The longer pain lasts, the more readily the nervous system signals pain
For some people, even a light touch on the shoulder hurts sharply, although that spot healed long ago. When pain signals keep arriving, the nerve cells along the pain pathways in the spinal cord and brain can stay overexcited for a long time, a phenomenon that the review by Woolf (2011) calls central sensitization. The person feels more pain than the situation warrants. A light touch hurts, the painful area spreads, and the pain lasts after the original trigger has passed. The author also notes that this state can be reversed.
At the examination table, the doctor also often finds the muscles around the painful area slightly braced all day long, as if waiting for a blow that has not yet come. People usually don’t know they are bracing; only when reminded to drop their shoulders do they notice that the shoulders had crept up at some point.
Does a hard childhood leave a mark on pain in adulthood?
A meta-analysis of 85 studies (Bussières, 2023) covering 826,452 adults found that people who went through adverse childhood experiences, such as physical, sexual or emotional abuse or neglect, are more likely to have chronic pain as adults (adjusted odds ratio 1.45). The more adverse experiences, the higher the ratio, from 1.29 with one experience up to 1.95 with four or more.
Many people who had a hard childhood still have healthy backs; the figures only describe groups, and they do not make your pain imaginary.
A case of pain in many places over three visits
A woman over 50 came to see Dr. Dinh Ngoc Duc (MD, MSc in Traditional Medicine) because of pain in many places. At times her diaphragm went into spasm and left her short of breath, her neck and shoulders ached almost constantly, and her lower back was sore. Only through talking over several visits did the doctor learn that her life had been hard since childhood.
In the first two visits, the doctor treated scars and the related nerve receptors, and balanced the meridians and the endocrine glands. Near the end of the second visit, emotions she had kept locked away for a long time began to surface. The doctor suggested that at home she write down on paper the three things that troubled her most.
By the third visit, the pain had eased only a little. Her back still hurt, and every time she closed her eyes she still frowned. The doctor did a few more groundwork steps: giving her water, treating the Shufu point just below the collarbone, and, after testing showed that the thymus area was not responding correctly, correcting it with a psychological approach together with a set of points on the face. The pain softened a little more. The doctor then went straight to what had come up at the end of the previous visit, testing and treating the layers of stress one by one with Applied Kinesiology (AK). By the end of the visit, the pain felt much more comfortable, and she was shown exercises to continue at home.
The three visits had many overlapping steps, so it is not possible to single out which step helped most. This is also the course of just one person; someone else may need more visits or additional psychological support. In this case, the emotional layer was brought into the examination only after the physical layers had been treated and the pain still had not moved.
Muscle testing while you think about something from the past
AK assesses structure, chemistry and mind through muscle testing, combined with standard diagnostic steps (Rosner and Cuthbert, 2012). The test for the emotional layer, called the emotional challenge, is fairly simple. The doctor tests a muscle that is strong, invites you to close your eyes and think about one specific matter, for example one of the three troubling things you wrote down, and then tests the same muscle again. If the muscle clearly loses strength, the doctor takes it that the emotional layer is involved and starts treatment from there; if the muscle stays firm, that matter is probably not contributing to the pain right now and is set aside for the moment. You don’t need to put the story into words if you are not ready to.
One trial asked exactly this question: Yarns et al. tested it in 126 veterans aged 60 to 95 with musculoskeletal pain lasting three months or more, published in 2024. Nine sessions of therapy that helps people recognize and express emotions reduced pain more than nine sessions of cognitive behavioral therapy, with 63% of people reducing their pain level by at least 30%, compared with 17%.
When to see a psychiatrist or get checked early
Some signs mean you should see a psychiatrist without waiting any longer:
- Feeling low and losing interest in everything for several weeks;
- Severe insomnia, tossing and turning every night;
- Frequent nightmares, or old scenes replaying on their own as if they were happening again;
- At times thinking about harming yourself.
If you have thoughts of harming yourself, ask someone you trust to stay with you and go to a psychiatric service the same day. Pain that is new and quite different from your usual pain, or pain with fever or weight loss, needs an examination to look for an organic disease (one with a physical cause that tests can show) first.
The steps of a consultation at Tam Duc
The consultation begins with a clinical examination and the four examinations of traditional medicine (looking, listening and smelling, asking, and taking the pulse); if an organic disease is suspected, the doctor orders lab tests and imaging first. Muscle testing helps set the order among the sides of the health triangle (Structure – Chemistry – Mind): scars, joints and nerve receptors; water and micronutrients; emotions. Whichever side is holding the pain in place the most is treated first.
In traditional medicine, emotions are an internal cause of illness (内因 / 內因, nèi yīn): anger harms the Liver (“anger injures the Liver”, 怒伤肝 / 怒傷肝, nù shāng gān), overthinking harms the Spleen (“overthinking injures the Spleen”, 思伤脾 / 思傷脾, sī shāng pí), grief harms the Lung (“grief injures the Lung”, 悲伤肺 / 悲傷肺, bēi shāng fèi), and fear harms the Kidney (“fear injures the Kidney”, 恐伤肾 / 恐傷腎, kǒng shāng shèn). So the doctor takes the pulse and looks at the tongue to see which organ is bearing the heaviest load before choosing points and herbs. For people who tend to brace their neck and shoulders, acupuncture around the neck and shoulders helps the muscles relax while the stress layer is treated with AK techniques. People who worry a lot and sleep poorly are prescribed an herbal decoction modified to their pattern; micronutrients and exercises to do at home between visits may also be part of the treatment plan.
Worth keeping
- Keep a pain diary for a few weeks, and note the days when something sad or stressful happened;
- Write down the three things that trouble you most and keep the paper somewhere private;
- A few times a day, notice whether your shoulders and jaw are clenched, then let them go and breathe out slowly;
- Walk and move gently every day, within what your body can handle;
- If low mood lasts, insomnia is severe or you have thoughts of harming yourself, see a psychiatric specialist right away.
If you have thoughts of harming yourself, tell someone you trust or a doctor right away, or go to the nearest emergency room. In Vietnam, you can call 115.
References
- Woolf CJ (2011). Central sensitization: implications for the diagnosis and treatment of pain. Pain 152(3 Suppl):S2-S15. https://doi.org/10.1016/j.pain.2010.09.030
- Bussières A, Hancock MJ, Elklit A, Ferreira ML, Ferreira PH, Stone LS et al. (2023). Adverse childhood experience is associated with an increased risk of reporting chronic pain in adulthood: a systematic review and meta-analysis. Eur J Psychotraumatol 14(2):2284025. https://doi.org/10.1080/20008066.2023.2284025
- Yarns BC, Jackson NJ, Alas A, Melrose RJ, Lumley MA, Sultzer DL (2024). Emotional Awareness and Expression Therapy vs Cognitive Behavioral Therapy for Chronic Pain in Older Veterans: A Randomized Clinical Trial. JAMA Netw Open 7(6):e2415842. https://doi.org/10.1001/jamanetworkopen.2024.15842
- Rosner AL, Cuthbert SC (2012). Applied kinesiology: distinctions in its definition and interpretation. J Bodyw Mov Ther 16(4):464-87. https://doi.org/10.1016/j.jbmt.2012.04.008
