Amber Richard has a doctorate in physical therapy and many years of treating patients with both acute and chronic pain. She’s a coach for Menda groups and just completed her first cohort!
Arun: Hey Amber! Could you share a little bit about when you started working with people with persistent pain?
Amber: The honest answer is, I started working with people in pain from the minute that I started working as a physical therapist! However, it wasn’t until 8 years later that I began to recognize the difference between treating acute pain and chronic pain.
Before then, it was hard to recognize chronic pain as a separate issue. My focus to chronic pain was prompted by my own personal experience having chronic pain.
Acute vs. Chronic Pain
Arun: You're talking about acute pain vs. chronic pain, were you taught the difference in your physical therapy training?
Amber: This was not taught to me in school. I came to it later thanks to a patient of mine, which I think is pretty cool. The reality is that one in three people are experiencing chronic pain, and a lot of what's being treated as acute pain is not actually acute pain. Once I understood this, I see that we are not treating people in the way they need, for the best outcomes possible.
With chronic pain, science shows that people's thoughts, beliefs, and the way that they contextualize their symptoms, have a huge impact on the symptoms themselves. The biggest thing that I do now, is to give the patient an opportunity to tell you their whole story without discounting parts of it. This can open up their eyes to the full picture of what pain is.
A Story of Hope
Arun: Sounds like you are ahead of the trend of whole-person medicine. Can you think of a patient who had kind of a recovery in a way that you hadn't seen before, or was miraculous in some way?
Amber: I'll try to focus on one! He was a young man who developed chronic low back pain. He had scoliosis and had been told a lot of different things about how his spine needed to be corrected.
When we started talking, we discovered that the pain began around a very stressful time of his life, near the death of his mother. Making the link that the chronic pain started with this hugely stressful and emotional event occurred was highly important to the recovery process.
Understanding the emotional connection, and seeing that he wasn’t damaged, helped him overcome the fear of his own body and symptoms.
He became more willing to engage in activities that were out of his comfort zone. We were able to work through those triggers and get him back to running, moving, and doing the things that he really loved really quickly.
Amber's Pain Journey
Arun: Wow amazing. You mentioned that you had chronic pain. Could you tell me about your experience?
Amber: I always laugh about this, because it's such a good example of seeing others doing wrong than our own self. I had chronic neck pain for many years. When this patient of mine turned me on to modern pain neuroscience, I started thinking of all my patients that fit, but not myself. I didn't think of myself as somebody with chronic pain at the time.
The aha moment came when I had my first flare-up after learning the science. A small movement that triggered a pain response moved me from 0 to 100. In an instant, I went from being totally fine to “I need surgery”! In pain, my entire perspective of my body changed.
Once I was able to observe that, it was the light bulb moment. This is chronic pain. So from that moment forward I didn’t need to fear this anymore. And then I started to work with my pain and not be afraid of it. That paved the road to healing.
Coaching with Menda Groups
Arun: You just completed your first Menda group! What was that experience like?
Amber: First of all, I just absolutely love the Menda team. The people are all highly committed. Like me, they’ve all had personal experiences that drew them to this field, which makes a big difference. I think that that's really important because it's hard to imagine what it's like to live with chronic pain if you've not experienced it.
I also love that the program is really skills-based. Patients are given the tools that they need to be able to successfully manage and recover from chronic pain. This is not always the case in programs. The program is also group-based, which is really unique. Chronic pain can be extremely isolating and it can feel like you're the only one that's going through this terrible thing. There are so many moments in the group that I can think of that were really beautiful and inspiring.
Groups vs. individual work
Arun: When should you join a group versus doing something self-guided versus having a coach or a physical therapist?
Amber: The first thing that came to mind is that quote which is,
“If you want to go fast, go alone. If you want to go far, go together.”
I've mentioned before we look for those success stories where they suddenly recover and it happens really quickly. This outcome isn’t impossible, but it is rare.
If you're in a situation where you're experiencing chronic pain, you're feeling stuck, you're feeling hopeless and you're feeling like there's nothing that anybody can do for you. Sign up for a group because there are going to be a lot of other people who are in the same boat as you.
Arun: So you've been working with patients for a long time. You’ve also started your own PT clinic with a focus on chronic pain?
Amber: I created PT Mindfully because the system where I was practicing wasn’t ready to give clinicians the time and space to do what's right. Modern PT clinics are really more geared towards treating acute pain in a hectic, loud environment. It wasn’t helping what I needed to do with the people. I realized the current system wasn’t going to back me up so I had to try something different.
I have a class called stretching for relaxation that I'm playing around with using dance as a form of expression and movement that could be really cathartic and also just elicit a lot of positive emotions, which is helpful for someone with pain!
Arun: That is amazing. I love all of this, Amber thank you so much.
Modern research shows that psychological and emotional elements can play a major role in chronic pain. These non-physical components can help the brain “learn” to be in pain. Through a structured approach, we can break the bra-body habit.
Ready to start your healing journey?