Inflammation and pain: interview with the experts

Pelvic pain

Chronic pain is a complicated beast and there are no easy answers to what causes it or how to treat it. But what the research is starting to reveal is that, for many chronic pain patients, inflammation plays a major role in their pain.

Developing understanding about the role of inflammation and the autonomic system in chronic pain conditions is still relatively new. At The Pelvic Hub we’re absolutely fascinated by this research and the new treatments that are available that aim to modulate the autonomic nervous system and address systemic inflammation.

Dr Perry Nickelston

So, our founder and CEO Emma McGeorge sat down with chiropractor and functional movement specialist Dr Perry Nickelston and osteopath, chiropractor and functional medicine expert Dr Stewart Gillespie to discover more about inflammation and the gut-brain and gut-heart connections, and to talk about their upcoming workshop.

Dr Stewart Gillepsie

What we really love about these guys is that they’re all about treating the individual and not the diagnosis, and they are incredibly knowledgeable about how all our bodily systems are connected. Seriously, these guys hit all the right buttons when it comes to empowering people and practitioners to effectively manage and treat pain.

Em was actually really lucky to chat to them when she did as they’re preparing to launch their first ever Stop Chasing Symptoms: Functional Medicine and Movement Workshop on February 16 and 17 in Bondi. If you’re a health professional who wants to help chronic pain patients beyond just treating symptoms, this workshop is for you.

And if you’re looking for some practical things you can do today to help with chronic pain, check out part two of this interview where we give you Dr Perry and Dr Stewart’s top ten tips for reducing inflammation.

EGut health is having a big moment and I know it’s something you guys talk a lot about, so can you tell us a little bit about the gut-brain connection and the gut-heart connection?

Stewart: back in 2008 there was something called the human microbiome project. And because of this project our understanding of how gut affects different systems of the body completely changed overnight. 

We used to think about the brain, the heart and the gut as separate systems. But the human microbiome project revealed that that’s just not true. 

And we’ve known that for about 10 years now.

When we talk about gut-brain connection or the gut-immune connection we’re talking about how your immune system is trying to protect you from things that you eat. So, if you ingest some microbes in your food your immune system is right there to attack whatever is being ingested. That’s why most of your immune system is in the gut. When you start creating these immune cells they travel around the body and inflame other parts of the body besides the gut. And one of those big areas is the brain.

What’s super interesting is that there are other structural things going on as well. 

Embryologically there is a gut brain connection. The brain and gut come from the same layer in the embryo. Basically the brain and the gut are an extension of each other and they communicate with each other. 

We all thought that the brain just tells the gut what to do but it’s completely untrue. It’s actually a bi-directional system with the majority of the information going from the gut to the brain.

Perry covers this in our course with his stuff around the vagus nerve. What you learn in our course is that if you can start treating and calming the down the vagus nerve what you're really doing is calming down gut inflammation, which will calm down brain inflammation.

And that same inflammation has been shown to attack the heart as well. A lot of atherosclerosis and arteriosclerosis is actually gut inflammation that is progressing to the heart vessels via the vagus nerve. That's the gut-heart connection right there.

It’s only recently that we realised that our gut produces immune cells and that immune cells travel around the body and give you brain dysfunction, heart dysfunction, joint dysfunction. That research has only really been around in the last 10 years or so, which is why you may not see it in the mainstream and why you're only seeing the progressive doctors talking about this.

EStewart, I’ve heard you say that everybody has their own default immune system inflammatory response. Would you be able to tell me a bit more about that?

Stewart: Knowing that inflammation is the root cause of disease isn’t the whole story. We’ve made the switch from focussing on pain and symptoms to recognising that inflammation is the root cause, which is great. But we also have to understand that not everybody reacts to inflammation in the same way.

Everyone has their own different types of inflammation. And this is why you get so many symptoms associated with inflammation and they can present all over the body. Everyone’s pain pathways are different and their symptoms present in different ways.

The biggest thing we talk about in our course is how do you assess someone effectively? And how is the inflammation presenting, particularly with autoimmune disease?

When the immune system comes under stress, it produces different types of cells depending on who you are and depending on your history. It generally does the same thing in the same person time after time. So, when you go to someone's history you can assess how they're going to react to a gut microbe or an infection. You can assess how they're going to react to some sort of injury or emotional distress based on their history.

For example, some people go very allergic while others go very catabolic and start breaking things down. If you go very allergic you get very puffy and have lots of oedema and lots of lymphedema -  which Perry does a lot of great stuff on with this Lymphatic Mojo programs.

If you’re catabolic you’re always breaking yourself down. You’re always getting injury after injury. How you treat someone whose body is breaking down because their immune system is reacting to inflammation will be different to how you treat someone who swells up and gets puffy and gets allergies all the time.

E I know at times I could have put myself into a few of these inflammatory categories at once. Do people ever present with more than one system being affected?

Stewart: What we teach in the program and we go into depth on this, we spend a few hours on the immune system, is that one system inhibits the other. And so it is very unusual that someone would have both symptoms at the same time. It may look as though they have both symptoms at the same time, but when you really look at the history you can pinpoint how their immune system is going to react.

Because one system inhibits the other it will drive in that direction. The body will want to play in both systems and drive both systems to bring you back to balance. So, sometimes you might flip back and forth because, in order to take you out of an allergic state you have to stimulate the opposite side of the immune system to bring you back to normal. The body does this naturally, so that’s why you might get a little bit of confusion at first when you're dealing with the tougher cases. Are they going this way? Are they going that way? And they might be going both ways, but they should always come back to the middle.

Sometimes you stay stuck in a particularly stressful immune response. And that's when you start getting these autoimmune issues. 

Not because it's really a disease, it's just that your immune system is stuck in one way and it can't return because it's constantly under stress. And so your body is trying to drive the opposite immune system to bring it back into the normal homeostasis, which is what the body wants.

EI love that you’re all about listening to the patient and their individual story and recognising that not everyone's the same. Even with the same "diagnosis" everyone's body responds differently and needs to be treated as the unique system it is.

Stewart: Thanks, and this is key. You can't treat every gut problem the same and you can't treat every inflammatory problem the same. You have to get protocols based on the individual, you don't treat the diagnosis.

It’s important also to note that how the body responds to emotional stress or emotional pain is the same way it deals with physical stress and physical pain. 

When you have an emotional outbreak it's a stress to the body and it’s treated the same way as an injury. You’ll experience the same inflammatory cascade from an emotional event as you would from an infection or a physical injury.

EPerry, I know you’ve had your own health issues, can you tell us a bit about how you came to this work and your own experiences?

Perry: A lot of the discoveries that I teach are from my own pain and misery. I had been searching for answers of why I was suffering from a range of things and I ended up getting an autoimmune disorder. And I kept asking myself ‘why did I get it in the first place?’

I had a lot of stuff that was looked at, but nobody ever paid any attention to my lymphatic system. Not even me! I just didn't even think twice about it because nobody told me the importance of it. And I knew that I had an immune system reaction going on, but unfortunately, I was doing all the wrong things to try to help myself. Even though they were good things to do, they just want the right ones for me. And this is exactly what we're talking about when we say everybody's a little bit different.

Eventually I had my lymphatic system worked on and I felt so much better. But it would always be coming back to inflammation. I was working on it but I still wasn't getting to the root cause. And then that's when I began working with Stewart.

With just a few changes I started to feel so much better. And I found it's what you stop doing that really makes a big difference. Within three days working with Stewart I was like a different person. I was just absolutely blown away by it. And then within a month, I was completely transformed.

There’s one phrase that really struck me when I heard it, and I can't remember who said it otherwise I'd give him credit, but it was this very simple you can't heal when you're defending. 

If you're always in defense mode, you're always in stress mode, fight-or-flight, you’re not gonna heal and then that's what we need to address. We need to take down that defense mechanism. And I do that through the vagus nerve reset, very simple things that then your body says, okay. I'm ready, bring it.

It's been a really great learning journey of trying to understand how all these different systems of our body work together. And I realised through my own suffering that because they all work together you can't just go after one. And that was a big thing for me. So, with the missing pieces of the puzzle and my new knowledge and learning from my own suffering I started my company Stop Chasing Pain.

E I’ve heard you say before that you are not married to your diagnosis, what do you mean by that?

Perry: It's really important for everyone to understand that words matter. Words matter a lot. And how you speak to your client or what you tell them they have? That's really important.

So, when you label somebody with a certain diagnosis, they pretty much become it and then they see all the things that they can't do. Or they start to manifest all these symptoms that they don't even have yet because they’ve read that they’re supposed to have them. It's like doing a Google search for like neck pain and then you end up with some African dung fever thing. People are always looking for an answer. Why did this this happened to me? And they don't really get it when they try to get help. They’re just given the diagnosis.

But you can explain things to the patient and say that it's from inflammation and that there are things you can do to help reverse symptoms and improve quality of your life. 

Your body is always working to heal you, it never wants to be sick and it's always trying to come back. It just needs a little bit of help.

ETell us a bit about your workshop, who is it for?

Perry: We’re really targeting healthcare professionals who deal with inflammation every day. Your chiropractors, osteopaths, strength coaches. They’re told “you can’t treat disease” or “you can’t treat diagnosis”. But a lot of what they’re seeing has inflammation as the underlying root cause and we want to help them deal with that inflammation they’re seeing in their clients and prevent diseases before they even happen.

E And what are you teaching?

Stewart: We’re teaching about inflammatory states, if you're trying to get someone out of an inflammatory state you have to know what type of inflammation they have. And the first thing that is going to be reactive is your immune system.

We show participants how to look for clues in someone that will reveal why they aren’t getting better, why they keep getting injured, why are they still swollen, why they are arthritic. What do they have going on in other parts of their body that are contributing to their joint pain and contributing to their poor athletic performances or poor mental function?

Because many practitioners have been told that they can't address these things. And because these practitioners are told they’re not educated enough, which is completely untrue, they don't ask questions about the other parts of the body. But if you do you’ll find out what's going on in other parts of the body is contributing to that person's presentation and that person's pain.

Perry: I focus on the vagus nerve and explain to people what that is and give them ways that they can help it for themselves or for other people. I focus on helping the body be more receptive to the protocols. Relaxing the whole body that’s been under stress for someone's entire life. What we call their life load, everything that's been coming at you. If you can relax the whole system then everything else that Stewart is going to be doing, your body can and now accept it easier. Because I’ve found that it's not necessarily the skill set or the technique that’s incorrect, but it’s that the body isn’t ready to accept what you're doing to it.

I also really stress the idea of moving more of yourself, more often, in more ways, and in more environments. Looking at movement as a state of play because there’s no wrong way to play. And play is nature’s way of getting your body more adaptable to the world and being able to deal with uncertainty in a safe environment. And that's really key.

Stewart: Participants of the course walk away with a simple, practical and applicable 30-Day system for helping clients regain health, including a step-by-step program anyone can implement immediately. Plus all the tools like intake forms, nutritional protocols and lifestyle protocols.

Oh, and they also get ongoing support. We have a Facebook group and mentorship community, if you have a new autoimmune patient present and you need help on what you can do for them that help and support is there.

Blog Photo credit: @nordwood on Unsplash