Persistent Pain: When Does Shift the Field Become Relevant to You?

by Anne-Martine Dicke

I’ve been thinking about the people I tend to see after pain has been around for quite some time.

Those are often the people I think about. They’re very rarely short of information.

By the time somebody has been dealing with something for several months or even years, they can usually give me a thoroughly detailed history. They know what the scan said. They remember which treatment helped and for how long. They know which movements tend to cause trouble, what happened after the injection, what the consultant thought, what the physio thought — and often where those opinions differed.

They’ve usually become very good at navigating the whole thing.

And yet there’s often one rather important question that nobody has quite answered.

Where does this actually go from here?

Because there comes a point where gathering more information doesn’t necessarily change what happens next.

You may already know what the structural findings are. You may have an established diagnosis. You may have been told there’s nothing particularly concerning to find. You may even have reached the point where the remaining medical option is simply another intervention when things become bad enough. But none of that necessarily tells you how to live differently in the meantime.

The people I’m talking about aren’t incapable. They’re often exactly the opposite.

They run businesses. They’ve had careers, make complicated decisions and solve problems. They’re accustomed to taking responsibility for things and finding a way through them.

But pain presents a very unusual problem.

You can spend years becoming extraordinarily knowledgeable about it without becoming any clearer about the route out of it.

And that is really where Shift the Field sits.

It isn’t about knowing more about pain.

It’s about what you do with everything you already know when it still hasn’t given you a way forward.

There’s another group of people I want to include here because they may be much less likely to recognise themselves in that description.

These are people who either don’t understand their symptoms at all, or who have been given an explanation but no real way forward beyond learning to live with them.

But what if there is an underlying condition?

This can be particularly relevant when there is a systemic or inflammatory condition involved.

Understandably, if you’ve been given a diagnosis that explains why you’re in pain, you’re unlikely to think something like Shift the Field applies to you.

There is a physiological process taking place, so what exactly is there to shift?

Quite a lot, potentially.

And I say that because I’ve watched it happen in practice, sometimes with people who have been genuinely astonished by the changes themselves.

That doesn’t mean the underlying condition has somehow disappeared. It means the presence of a condition doesn’t necessarily account for every part of somebody’s experience of it, nor does it tell us exactly where the limits of their improvement are.

This is actually something I’m working with constantly during treatment, although the person on the treatment table may have no idea that I’m doing it.

I’m not simply applying acupuncture or manual treatment to the painful area and hoping the intervention changes something.

I’m looking at the whole response around it.

What happens when we approach a particular movement? Where does the resistance appear? What does somebody expect to happen before we even get there? Does changing the angle, pressure, load, speed or timing change what becomes possible?

Very often it does.

And this is where people who have experienced both treatment with me and Shift the Field begin to recognise the connection.

Things I may have shown them during an appointment suddenly make sense in a different way because they can identify what was happening, how it felt when it changed and how that relates to what they’re now doing through the programme.

A diagnosis can tell us something extremely important about what is happening physiologically. It can guide treatment and give us information we absolutely need.

But it cannot automatically tell us the full extent of what that individual person may still be capable of changing.

The same is true of a scan.

Structural findings can matter enormously. Sometimes they change the direction entirely.

But findings on imaging also exist in people without pain, particularly as we get older.

That doesn’t make scans irrelevant.

It means they have to be interpreted alongside the person in front of us.

The scan is part of the picture. It's not the whole person.

And perhaps that is one of the most important reasons Shift the Field exists.

Not to tell somebody that what they’ve been diagnosed with isn’t real, or that they should simply believe they can get better, but to show them where there may still be room to move when they had assumed — or had been told — that there wasn’t any.

If you’re in the acute stage of an injury, Shift the Field steps aside. Allowing the expected physiological window of healing to take place. Those are necessary processes the body must go through to heal. We don't interrupt those.

Tissue needs time to repair. An acute presentation needs assessment, treatment, appropriate loading, further investigation depending on what has happened. Acute vs Chronic Pain have a different process and therefore requires a different approach. Each has their own respective lane and therefore so does the program.

I see people who have been everywhere.

They’ve seen different practitioners, specialists and consultants, sometimes over many years. Some have been given very clear explanations; others have been left with symptoms that still don’t make much sense to them.

And some have effectively been told that there isn’t anything further to offer and this is now something they will have to live with.

There is another reason I think so much about people who have been in pain for a long time.

I know what it is like to feel as though there is no way out, in more ways than one.

And what it can take to turn something around when doing so requires almost a 180-degree change — not only in how you think, but in what you actually do next.

From where you are standing, that can seem impossible.

Particularly when you have already tried so much.

But it isn't impossible. I have watched people discover it for themselves in ways they genuinely did not expect.

There can be an extraordinary loyalty to our own discomfort. Not because we want it, but because we know it. It's familiar. We know how to organise ourselves around it. We know what to avoid, what to watch for and how to protect ourselves from making things worse -that can become its own kind of certainty.

And changing it can ask something very different of us.

It may mean approaching something differently to what you feel. Allowing a good day to be a good day rather than waiting for the consequence. Beginning to question what your experience has taught you to expect.

That is a difficult place to reach when part of you is already thinking, I don't have anything more to give to turning this around.

But this is exactly why Shift the Field exists.

Because imagine not having to live at the mercy of something you have come to believe is outside your control.

Imagine the pain you thought you would always have to live with no longer being there in the way you believed it always would be.

I created Shift the Field because I know this process can change things. I know that from my own experience, and I have watched it happen in the people I work with. I wouldn't ask somebody to place hope in something I didn't believe could genuinely help them move forward.

Shift the Field isn’t something you simply listen to and put away.

It is designed to be used. When the pain appears. How you respond or catch yourself before responding. When you’re deciding whether you can do something. When a recurrence makes you question the progress you thought you had made. When you notice yourself responding in the same way you always have.

That is why the programme matters outside the treatment room.

It gives you access to the process yourself. Autonomy. Control over your life.

You may have persistent musculoskeletal pain. Symptoms that come and go without making much sense. An established diagnosis or an ongoing systemic condition. You may have improved considerably but still be living cautiously around the possibility of recurrence.

Or you may simply have been told that this is something you now need to manage.

The circumstances are different, but the question underneath them is remarkably similar.

What is still possible from here?

Shift the Field to find out.

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