Episode #92- The FIT Criteria- How to ”Rule- in” Neuroplastic Pain

Here are the FIT Criteria- From Dr Howard Schubiner's book "Unlearn Your Pain".

 

The FIT Criteria are general ways that neuroplastic pain behaves, that are different than if pain was structural.

 

You do not have to answer yes to all of these, with just one there is a good chance your pain can be rewired with this method.

 

When you start proving to yourself that your pain is neuroplastic, you can retrain your brain and nervous system to produce less pain.

 

Here are Dr Howard Schubiner's FIT Criteria:

 

FUNCTIONAL: (Symptoms do not fit with known structural conditions)

-Symptoms began without a physical precipitation 
-Symptoms persist after an injury has healed (3-6 mo)
-Symptoms are in a distribution pattern that is symmetric
-Symptoms occur on one whole side of the body or occur on half of the face, head, or torso
-Symptoms spread over time to different areas of the body
-Symptoms radiate to the opposite side of the body or down a whole leg or arm
-Symptoms that occur in many different body parts at the same time
-Symptoms that have a quality of tingling, electric, burning, numb, hot or cold

INCONSISTENT: (Symptoms vary in ways that the structural condition would not)

-Symptom shift from one location in the body to another
-Symptoms are more or less depending on the time of day. Or they occur first thing in the morning or in the middle of the night
-Symptoms occur after, but not during, an activity or exercise
-Symptoms occur when one thinks about them or when someone asks about it
-Symptoms occur when stresses increased or one thinks about stressful situations
-Symptoms are minimal or nonexistent when engaged and joyful or distracting activities, such as when on vacation
-Symptoms are minimal or nonexistent after some kind of therapy, such as massage, chiropractic, Reiki, acupuncture, an herbal or vitamin supplement

TRIGGERED: (Symptoms are brought on by stimuli that would not actually cause the symptom physically, but they activate the brain to generate the symptom)

-Symptoms are triggered by things that are not related to the actual symptom, such as foods, smells, sounds, light, computer screens, menses, changes in the weather
-Symptoms are triggered by the anticipation of stress, such as prior to school, work, a doctors visit, a medical test, a visit to a relative, or a social gathering; or during those activities
-Symptoms that are triggered by simply imagining engaging in the triggering activity such as bending over, turning the neck, sitting or standing
-Symptoms that are triggered by light touch or innocuous stimuli, such as the wind or cold

 

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Transcript- Automatically Generated:

This is Betsy Jensen, and you are listening to Unstoppable Body and Mind, episode 92, The Fit Criteria, How to Rule in Neuroplastic Pain. In this podcast, we learned to upgrade our brain and understand the power of our thoughts, to heal and to create the results we want in our life. Become the person in control of your healing and make peace with your life.
Become Unstoppable Body and Mind. Hello, my loves. As you may know, I have been a long time Dr. Howard Schubiner fan.
I have recently been studying his book, Unlearn Your Pain for Book Club, and getting even deeper into what he teaches. And he really talks a lot about how to rule in, how to diagnose, how to understand and really see that your chronic pain is neuroplastic. Just as when you go to the doctor to try to rule in what is going on structurally or physiologically, these are ways of understanding how chronic pain behaves that's different than how it would behave if you had something structural, like cancer or a broken bone or infection.
But the thing about chronic pain is that it's tricky. It feels exactly the same as structural pain because all pain is created in the brain. Dr. Schubiner has been studying mind-body syndrome or neuroplastic pain for decades.
And he has classified the ways of ruling in that your pain can be treated in this way through the FIT criteria. FIT stands for functional, inconsistent and triggered. So I'm going to go over these with you so you can understand and start to look at the characteristics of your pain, becoming the detective for the opposite, like you're building a case that your pain is in fact mind-body, that it is neuroplastic.
It is the kind of pain that can be rewired so that you can get out of chronic pain. Functional means the behavior of the pain is not explainable by known structural conditions. So if your pain began without any physical cause, in other words, there was no injury that you really knew about.
You were doing normal daily activities when the pain occurred. If your pain persists after the normal amount of healing time for injuries, which is conservatively three to six months, if your pain has lasted longer than that period of time, then it's safe to assume that you have some neuroplastic pain, that the acute injury itself has healed. Even broken bones heal within six to 12 weeks.
So knowing that if your pain persists longer than that time, it is because of these neural pathways and habits that your brain has formed that are now causing the pain. Symptoms that are in a symmetric pattern. So maybe beginning on one shoulder and then moving to the other.
If anything is in a mirror image, it is highly suspect that you have neuroplastic pain. If your symptoms occur on the whole side of the body, the whole right side, or half of the face, half of the head, half of the torso, this is a good sign that nothing structural is going on to cause that because you don't have structures, nerves or muscles that just run on one side of the body. Symptoms that spread over time to different parts of the body, symptoms that radiate down the opposite side of the body or a whole arm or leg are not likely from a structural cause.
Symptoms that occur in many different body parts at the same time and symptoms that have the quality of tingling, electric, burning, numb, hot or cold, these are commonly mind body syndrome or neuroplastic pain, especially when there's no evidence of actual nerve damage. On the other hand, Dr. Schubiner does tell stories of people with compressed nerves that also have these symptoms that turned out to be mind body through this approach as they were able to extinguish and get rid of their chronic pain. But especially if there's no evidence of nerve damage and you're having some of those symptoms, hot or cold, electric, buzzing, tingling, it doesn't necessarily mean that a nerve is involved.
Your brain creates those same exact sensations in your body. The next section is I, inconsistent. These symptoms vary in a way that a structural condition would not.
So symptoms that shift from one location in the body to another, either within hours, days or weeks at a time. Symptoms that are more or less intense depending on the time of day or occur first thing in the morning or in the middle of the night. This is due to subconscious brain activity.
Dr. Schubiner is pretty clear that when you're just sleeping and turning, that is not enough to cause significant damage and pain. If you do have some pain, it should go away within a couple of days if there was an actual injury. But he is very doubtful that sleeping causes injuries, that that is usually neuroplastic pain when you wake up with it.
Symptoms that occur after, but not during activity or exercise. So think about this one. If it feels pretty good while you're doing it and hurts afterwards, that is not a sign of a structural injury.
If you were actually causing tissue damage, you would hurt at the time that you're damaging it and you would feel better with rest. Symptoms that occur when one thinks about them or when someone asks about them. This can be very common.
When you start being the observer of your pain, you'll notice sometimes when people ask about it, you talk about it. Or I know for me, when I would even think of drinking coffee, my stomach would grumble. So I knew that my brain had an association with that being a substance that would cause stomach pain for me.
If your symptoms occur with increased stress, or if they occur when thinking about a stressful situation. And if your symptoms are minimal to non-existent when you're engaged in something joyful or distracting, like if you're on vacation or not thinking about the symptoms, this is a very important one. Pain is in the consciousness.
So it's not that you are just good at managing your pain when you're doing something joyful and not feeling it. When you're not feeling it, it's actually not there. So look for those times that maybe sitting is something that bothers you, but when you were sitting watching a movie that you really enjoyed, you didn't even notice the pain for a little bit of time.
Start noticing if distraction ever helps your pain. And then if your symptoms are minimal or non-existent after some kind of therapy, such as massage, chiropractic, reiki, acupuncture, or an herbal or vitamin supplement, those are actually signs that this is neuroplastic. Doing these activities can calm the nervous system, can calm the danger signal and decrease your pain.
Now, none of these mean that the opposite is necessarily true. So if you haven't had a lot of relief from those things, it doesn't mean that your pain is not neuroplastic. But this is more if you have dramatic results where you go from a very severe pain to minimal to nothing at all with a treatment like that, that can be a sign that your brain and nervous system are calming down and producing less pain.
The last section is triggered. This means that the symptoms are brought on by stimuli that would normally not cause physical symptoms, but they activate the brain to generate the symptom. So symptoms that are triggered by things not related to the actual symptoms, such as foods, that even goes for IBS.
He's very clear that foods do not cause pain, smells, sounds, light, computer screens, menses, the hormonal fluctuations with women with their period, changes in the weather. And he says that weather has been shown in research to not increase pain despite what most people think, or if your pain is caused by specific movements. Now, if you want to argue some of these facts, you can probably make a justifiable case by what you've always believed, lots of evidence, what you've been told.
Even some research will corroborate that pain can be worse with some of these things, but it doesn't mean that the pain is worse because of something structural. It can be something that is generated by your brain and that means it's mind-body. That means that it's neuroplastic and can be rewired because the structural nature of these things in themselves should not need to cause chronic pain.
And so sometimes just opening the door, just a crack, so you can start to shine some light in and think maybe it's possible that my period is not affecting my pain as much as I think. And you start to look for examples of the opposite and start to be your own best evidence of how the pain may actually change and that stressful times are worse than others and thinking about it might bring it on. Or sometimes you have the pain when you're not having your period.
So just really starting to be objective and then you usually can find things. All of my clients have always been able to find something that starts to prove to them that their pain is mind, body, that it's this neuroplastic pain, and then they're able to get out of pain because of this change of beliefs. Symptoms that are triggered by the anticipation of stress, such as prior to school, work, a doctor's visit, a medical test, a visit to a relative, or a social gathering, or during those activities.
So anything related to stress and your pain is getting worse, then that is a sign that your pain is neuroplastic. It can be rewired. Symptoms that are triggered by simply imagining, engaging in the triggering activity, such as bending over, turning the neck, sitting or standing.
So this is a great way to actually even diagnose if your pain is neuroplastic, and to start the rewiring process to treat it if it is. So you can listen to migrated exposure meditation. You can get quiet and kind of tune into your body, listen to your body, and imagine yourself doing a painful activity, and just see how your body responds.
And sometimes it will actually respond with some tightening, with some contracting and with some pain. So you can start to imagine yourself doing the pain-free activity with joy, with happiness, with a smile on your face. And that is one way to start rewiring your brain.
Last, under the section of triggered, is symptoms that are triggered by light touch, or symptoms that are triggered by innocuous stimuli, such as the wind or cold. So in general, people with neuroplastic pain are sensitive to touch and light touch, but this is more indicative of a hyperactive nervous system than it is actual pain from structures, because the pain receptors are deeper in the body. You do not have to have all of the fit criteria in order to start believing that your pain is neuroplastic.
Look for any of these that might be true for you and start to be a very objective observer of your beliefs and of your pain. I've had so many conversations with people where I have just introduced the idea that the pain can be coming from these feelings of being trapped, from repressed emotions, from a stressful lifestyle. They start to open their minds to the possibility and within days, their pain is gone.
So become the detective for the opposite. Write down things that surprise you because your brain has a tendency to not acknowledge them or to forget them and keep making the case for yourself that your pain is neuroplastic and can be rewired. If you have been enjoying this podcast, please take a few minutes to rate and review it and to share it with someone you know that might benefit from this information.
Thanks guys, have a good one, bye. Thank you so much for listening. I hope you learned a little bit about your brain today that helps you in your life like it helped me.
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