“When I met Annie, I was in a very muddled up place. I knew in my head that my pain had to be the everyday mountain I had to climb. Yes, I was determined to get to the top of it, but then what? And how? Annie’s genuine kindness and determination to guide me up that mountain, was so strong. I felt strength and hope to know my pain was not who I am, but just something I had to deal with daily.
Annie, looked into my eyes with such understanding of how I could walk, daily with an organized way to deal, and cope with this infliction. Annie taught me how to connect my brain and my body to work together in such a way that I could arrange my normal and have a fabulous life. Thank you Annie and World of Hurt for your endless love, compassion, understanding, knowledge, guidance and innovation to win the BATTLE OF PAIN!”
Robyn
“My journey with pain started in June of 2015. I remember my back hurting during lunch, but once lunch
was over, I could barely make it out to my car the pain was so awful. The pain felt like someone had
placed a blowtorch on my lower back while simultaneously stabbing me with the sharpest knife. I was
no wimp, I could handle pain. Seven years ago, I had shattered my femur in a dirt biking accident and
laid on the trail for over 3 hours waiting for paramedics to arrive and never shed a tear. BUT THIS PAIN
was different. It completely debilitated me. I could not do ANYTHING without feeling it and it scared me
to death.
I sought the treatment of several orthopedics and each one came to the same conclusion. I had several
stress fractures in my lower back, a condition I had experienced in the past, but did NOT feel like this. In
past for this condition, I took a few Advil for a few days and moved on with my life, but not this time.
This time I was completely debilitated and in total agony. I went to several different orthopedics to
ensure they had it right and each one said over and over again, it should not hurt this bad and you have
had these before, there really is nothing that can be done. I tried numerous treatments, steroid packs,
injections, physical therapy, etc. I was desperate for answers. I ended up having spinal fusion surgery. I
cried in relief when the doctor told me I would be out of pain.
The surgery went well. I was recovering, and then four weeks out of surgery I developed severe burning
pain in my legs along with very strange coloring of my skin. The pain was again horrific, just as it had
been in my back. I immediately consulted the surgeon who performed my back surgery who ordered an
MRI to see if something may have gone wrong. The results came back clear and everything was fine. He
sent me to a neurologist who diagnosed me with CPRS, complex regional pain syndrome. I went
through the treatment for this diagnosis and still did not get better. The neurologist then decided on a
new diagnosis of erythromelalgia, but was still unsure, so she sent me to Mayo Clinic to verify it. I went
through a series of tests at Mayo Clinic and yet another MRI of my back and still everything came back
mostly normal. They gave me more spinal injections trying to block the pain, and still nothing worked.
When returning to my neurologist I was truly devastated. She told me there was one more approach to
try IVIg, a treatment used to treat autoimmune disorders. She explained that my blood results really did
not warrant such an extreme treatment, but she would allow it. I stayed at the hospital for five days
hooked up to an IV machine receiving the treatment. Due to my anxiety and the pain, sitting for five
days straight was like torture. I thought a miracle would happen, the medication would go into my
system and I would be cured! That did not happen. When I left the hospital, I was still in excruciating
pain, but now walked each step knowing I would have to live with this pain the rest of my life. I could
not accept that. I was an action packed kind of girl who loved to be outside and with her dogs. I came
home to an empty house, as my dogs were with my mom since I was in the hospital. I was given very
strong old school antidepressants when I was treated for CRPS and I was given large amounts of
painkillers due to all of the pain doctors I had visited. None of these drugs had worked, but I had all of
them. I began to research how much it would take to end my life. I had a plan. I decided to sleep on it
and decide the next morning if I was serious. I woke the next day and decided I was. I went to the store,
bought a bottle of vodka (I do not drink). I wrote a letter explaining that I could not live this way in
chronic pain. I loved life and loved my job, and I loved to be active, all of that was taken away from me.
I took enough of the antidepressant and the painkillers to kill an elephant to make sure that I would die
and not end up brain damaged and drank the bottle of vodka and lay in my bed to die. I had a doctor’s
appointment that day to follow up with the IVIg. Three hours after taking my lethal cocktail, the
secretary called to let me know I had missed my appointment. I answered. I told her I took an overdose
and to please call 911 and to please call my mom. That was it.
The next thing I remembered was waking up in the psych ward at my local hospital. My wonderful and
amazing neurologist then had me transferred to the psych ward. I stayed there for a week. While there
she told me she was going to send me to another doctor, an internist that at times takes a different
approach. I went to see this doctor and I walked out a bit confused…he told me two things. First, “Paige,
you have been trying so very hard to get back to your old life, let’s call that A.” “Right now, you are at B,
way below A. Maybe your body wants to be at C, a totally different place than A, but better than A.” He
also told me that he wanted one of his patients to call me. I spoke with his patient who was my age and
CEO of a major company who had previously been in a wheelchair due to pain. Like me, she was also a
previous long-distance runner. Also like me, she had sought the treatment of several doctors without a
clear diagnosis. She finally fell upon “disorder” known as tension myositis syndrome (TMS). A disorder
in which stress, emotions, etc. can lead to real pain. Pain that can be so real, you would rather cut off
the appendage than keep it…believe me, I know how bad it hurts! Because this patient I was speaking
with was a highly successful businesswoman who was also a well-accomplished athlete, I listened.
Could she be right? I ended up seeking treatment for my stress and then was introduced to Annie
O’Connor and the World of Hurt Approach where the focus was on pain mechanisms and begun
treatment for the motor/autonomic pain mechanism where I retrained my brain to recognize my body
through the recognize program and believe or not, I got better! I still continue with this these
treatments today in prevention of reoccurrence.
It is very important to mention that I have had “flare ups” since this back and leg pain issue has
occurred. What Annie and the World of Hurt Approach taught me was each time, I must evaluate the
situation. I take a step back and look at the evidence, is it due to a real physical injury (as it can be) or is
my body trying to tell me to slow down or am I stressed about something? Or am I not meeting the
needs of my body in some other area? Please understand that TMS can cause physical symptoms. In
my case, I can have extreme swelling and discoloration of the skin, but there can also be a real physical
injury causing it that needs to be treated. It is important to work with well-trained professionals who
understand pain mechanisms as well as anatomy and pathology and can appreciate the strong mind
body connection and are willing to work with you in order for you to live a life free of pain. The greatest
gift a World Of Hurt gave me was the ability to understand what was happening, the tools and control to
evaluate myself, and the access when I needed the help. Forever grateful.”
Paige
“I am a 55-year-old male, wheelchair-bound C5-6 quadriplegic, 38 years post injury. For virtually all that
time, I have experienced chronic neuropathic pain and extreme sensitivity to touch and temperature.
The pain grew worse with each passing decade. In addition to various medications, strategies to endure
included self-hypnosis, meditation, mindfulness, and the entire exercise spectrum (from a ‘couch
potato’ do nothing on one end to an ‘Iron Man intensive’ do everything possible and occasional
attempts at the impossible on the other end).
Pain cycles would vary in intensity and duration. From the nagging to horrendous and from days to
months. Constant pain, hyper vigilance of potential threats, chronic insomnia mutually reinforced each
other, imperiling my physical and emotional health. Working grew ever more difficult. Fear of triggering
pain cycles became its own occupation. All these factors led to debilitating anxiety, panic and
depression.
Three years ago, I reconnected with Annie O’Connor a physical therapist and started to use what I call
the “high-sensitivity pain management” method – or, what the professionals call The Pain Mechanism
Classification System as described in the book “a World of HURT: A Guide to Classifying Pain.”
Regardless of its name, this protocol is easy to understand and has taught me to classify and act upon
symptoms related to the presenting dominating mechanism. After a few years and meaningful progress,
with admitted peaks and valleys, I have learned five key takeaways:
Takeaway #1: Differentiate hurt and harm. Harm is always bad, full stop (a ‘red light’ in the pain
management jargon). But, given that chronic pain has supercharged how I perceive and interpret pain,
‘hurt’ is more subtle. Over decades, my brain has likely rewired to amplify, rather than dampen, sensory
stimuli like touch and temperature. The message has taught me when to stop, when to pause (‘yellow
light’) and when to proceed and add exercises (‘green light’). No need to run from hurt, this method has
given me tools to face pain and to defang its emotional clench.
Takeaway #2: Recognize that chronic pain has three related components – biological, psychological
and cultural – and that this ‘high-sensitivity’ method has strategies to better manage each. Consider
combing the emotional limbic brain areas with the psychological strategy of ‘catch & correct & confess’:
catching constant, recurring often catastrophic negative thoughts and immediately correcting with a
positive counterpoint and most importantly confessing this out loud. So ‘dread and guilt’ become
‘gratitude and mercy’. Over time, decoupling emotional connections may rewire neurons in brain
(already known to demonstrate neural plasticity) and thus may lead biological changes in pain
perception. Together, the impacts from chronic pain’s biological, psychological and social dimensions
carry a powerful punch, but this time toward good health.
Takeaway #3: Movement (i.e., range of motion) and strength are more reliable indicators than
sensations (e.g. feeling sore). While not discarding my aches and pains, I discount them considerably
and trust more that, if range of motion and strength are fine, I am not setting myself back or aggravating
and injury. My symptoms are safe and normal process of training tissues and conditions.
Takeaway #4: Be realistic and consistent, then practice, practice, practice. This is a marathon, not a
sprint. I started small with fewer repetitions and slowly have built up on that. When setbacks come
(they inevitably do), don’t panic. Regroup, reaffirm and implement the program.
Takeaway #5: Find an experienced physical therapist who understands pain mechanisms approach
who is available in person, by email or even Skype, who can help talk through difficult moments or
provide a refresher on self-assessment strategies and techniques. The World of Hurt coaching is a
diamond in the rough.
To be sure, I still experience pain (sensitivity) and anxiety, amongst other matters. Life is not rosy, and I
periodically need to relearn lessons – such as, that my worst imagined outcome is not likely, let alone
inevitable. But life is much improved, and the outlook is promising. Compared to three years ago, I am
more active and more confident. I am exercising more, and am back doing a few kilometers on the hand
cycle, having even participated in a 10k event! As for medication, that has changed from a peak of 10-20
mg of Percocet daily, some tincture of opium and 3600 mg of Neurontin (gabapentin) to basically off all
of these drugs. I continue to take Ambien and a lower dose of Klonopin at night. Although I still despise
the cold, ice (on my neck and shoulders) is my favorite anti-inflammatory. The fear of spiraling down
into an uncontrollable pain cycle is gone, while the perceived threats and hyper vigilance are
diminished. Mind and body are less fragile. Resilience can be learned. Life is more enjoyable.
While I certainly do refreshers with my physical therapist, Annie, in person and by phone, I have the
tools to quickly self-assess symptoms and progress. Pain no longer has such a stranglehold, and a
powerful assist in loosening that grip has been consistently using the tools the high-sensitivity pain
management toolkit or what professionals call a World of Hurt Approach at Pain Classification.
My guess is that this pain management strategy applies to a much broader group of injuries than my
quadriplegia and can readily improve the lives of many individuals dealing with debilitating
consequences of chronic pain and injury. Thank you Annie and World of Hurt for giving me my life
back.”
James
“I am a 32-year-old male, wheelchair-bound C5-6 quadriplegic, 12 years post injury. I was living life just
fine independently, participating in sports. Out of nowhere for no apparent reason I began sweating
profusely and having leg spasticity that threw me out of my manual chair and now unable to transfer or
care for myself. This journey was as bad, if not worse than my original spinal cord injury. It not only
affected me, but my family who I needed to move back in with in order to care for myself. I began a
medical journey that took 2.5 years and included massive drugs, procedures, hospitalizations, and
surgeries to only get worse, contemplate suicide, decondition myself beyond understanding and ruin my
mental sanity. Sometimes in life you have to hit rock bottom to see the light. That’s how I felt. I was a
prisoner to my own body. I was maxed out on multiple medications and still had no relief. Spasticity had
taken over with such force I was falling out of my wheelchair. I saw the light after an encounter with
Annie, a physical therapist, who explained to me after hearing my history that sometimes losing motion
in the spine can affect blood flow to the nerves of the legs and can result in spasticity in someone who
has had a spinal cord injury. That day she gradually postured me on my stomach for 45 minutes and for
the first time in 2.5 years my legs were relaxed and I was able to transfer to my chair with significant less
difficulty. To be honest, I did not believe it. After this one time encounter I remembered what she said
and when I was discharged from the hospital with no hope other than another surgery or no explanation
I started forcing myself on my stomach and really got into a routine of daily full range back extension,
everything changed drastically. I reached out to Annie as she gave me he cell number and said call
anytime. I at that time lived 3 hours away and she coached me over the phone and through pictures and
texts how to progress my routine. It was unbelievable how much relief I felt. This change in my routine
literally gave me life back. I initiated seeing her twice a month and within 3 months I was able to move
back to my apartment and resume my independent living again and return to my sports. I came off all
the meds and felt whole again. I took control of the situation and was a prisoner no more. As I now
understand what happened I have been able to help so many of my other friends who suffer
uncontrollable spasticity with the same approach a pain mechanism approach for spasticity treatment a
non pharmacy, movement based approach modeled after the book “ a World of HURT: A Guide to
Classifying Pain.” Thank you Annie and World of Hurt for giving me the light.”
Cody
“I count Annie O’Connor as one of the most important people in my life. I spent years coping with
debilitating back pain and bouncing from specialist to specialist trying to find a solution. Annie’s
approach following her book “a World of HURT: A Guide to Classifying Pain” was a breath of fresh air
and gave me both the tools and confidence to overcome my difficulties and prevent their return.
Most therapists I’ve encountered are tethered to the same theoretical thinking that has been in place
for decades. Annie is constantly calling upon her patient experiences to push the envelope and revisit
established protocols. The pain mechanism approach taught me it is not about where I hurt it is about
why I hurt and redirected my thinking to understanding how our bodies get pain and root caused to why
I hurt. She quickly identified a number of directional movements specific to my body and function that
gave me immediate relief. She has taught me how to assess pain and evaluate the root cause so that I
can make the changes necessary to improve and prevent return of the problem. Equally as important as
the prescribed movements, she’s given me a mental approach to better cope with the fear and anxiety
that amplify physical pain. Now I know when I need to look at movements to rid my pain or knowing
when I need to look at my thoughts and emotions to rid my pain. This honestly was a gold for me.
While I can’t avoid periodic episodes of pain, she has armed me with a tool set that has always gotten
me through them. The World of Hurt Coaching Services offered has kept me free of the medical system
for years for both my son and me.
In addition to my back troubles, I have a son who has a neurological condition impacting one side of his
body. Our family has worked with countless pediatric therapists to ensure that we maximize his physical
capabilities but none of the pediatric therapists have been as impactful as Annie. She has brought a
unique perspective with focus on the methods that she’s employed in her book “a World of HURT: A
Guide to Classifying Pain” and with world-class athletes. Rather than relying upon the established
pediatric protocols, Annie treats his spasticity with a mix of nerve stretching, sport specific and
functional training, directional exercises focused on his spine and working on his left right discrimination
speed and accuracy - the results have been astounding and we believe her approach to be the primary
driver of the significant and progressive functional gains he’s experienced. Annie has had such a huge
impact on our entire family - we do not know what we would do without her.”
Barrie & Alec
Mother & Son Pair