How I work
Persistent pain, and how I work with it
This page explains how I think about pain that has not resolved. It is an explanation, not a promise: I cannot tell you what will happen in your case, and nothing here says that chiropractic or the Elaris Method treats or resolves any particular condition. What I can do is set out why pain sometimes carries on after the thing that started it has settled, and what I actually look at when someone comes to see me.
Where people start
You have probably said one of these
Most people who come to see me about persistent pain arrive with a version of the same account. In their words, not mine:
- It has not resolved, and I have had treatment.
- The scan showed nothing.
- The scan showed something, but nobody could tell me why it hurts here.
- I was told to live with it.
- It settles, and then it comes back.
- I have tried everyone.
- Nobody has explained why it is still there.
These are descriptions people give me of what brought them in. They are not a list of things I treat, and this page does not claim that any of them will change.
If that is roughly where you are, the rest of this page is the account I would give you in the room.
Why pain sometimes carries on
Pain is not a straightforward readout of tissue damage. That is uncomfortable to hear when you can feel it, and it is not the same as being told it is in your head, which it is not.
There are three layers to how I look at a person, and I think of them as separate questions rather than as competing explanations.
Structure. What is loaded, what moves, what does not, what has changed since the injury. This is the layer most people expect a chiropractor to work at, and for a great many people it is the whole answer.
How you live. Sleep, work, load, movement, the things that recur every week. Pain that has gone on a long time is usually sitting in a life, not in a vacuum.
The nervous system, and perception. A nervous system that has spent long enough protecting an area can carry on protecting it after the reason has gone. That is a normal, well-described thing for a nervous system to do. It is also the layer that gets missed, because it does not show on a scan and because it is not what anyone is looking for.
Treating structure alone works for a lot of people. When it does not, my view is that the reason is usually that the question was only ever asked of one layer. That is an argument about assessment. It is not a claim that any of this makes pain go away.
What an assessment actually involves
01
What I ask
The history, at more length than you may be used to. When it started, what was happening in your life at the time, what has been tried, what helped and for how long, what makes it worse, what you have stopped doing because of it.
02
What I look at
How you move, how you load, where things are guarded and where they are not. Standard physical and orthopaedic assessment.
03
Where the pattern sits
This is the part that comes from the framework I built. I am looking for where a protective pattern is being held, and which of the three layers above is doing most of the work in your case.
04
What I tell you
What I have found, in plain words, and whether I think I am the right person to see. If I am not, I will say so, and where possible I will say who might be.
Everything above is a description of a process. It is not a statement of what any of it achieves.
What to read next
If you want the detail of the framework itself, how it came together and what happens in a session, that is the Elaris Method.
If you have read enough and want the practical part, the address, how to get there and how to arrange an appointment, that is where I practise.
Why I think about it this way
I read immunology at King’s College London and took an MPhil in molecular genetics at Cambridge before I ever saw a chiropractor professionally. I have a peer-reviewed paper from that period. That is background, and I want to be exact about what it is worth here: it tells you what kind of training I have and how I read a piece of research. It is not evidence for anything I do clinically, and I will not present it as such. The full citation is with the 1997 paper in the European Journal of Immunology.
The part of my history that is actually relevant to this page is the other part. I spent two years in pain in my twenties, and I was certain it was mechanical, and I was wrong. It took me years and a different framework to see it. That is why I ask the questions I ask. About Steve Davison has the whole account.
Common questions
Why does pain sometimes persist after an injury has healed?
Because pain is produced by the nervous system rather than reported directly by tissue, and a nervous system that has been protecting an area for a long time can carry on doing it after the original reason has gone. That is ordinary physiology rather than anything exotic, and it is well described in the pain-science literature. It is also the reason that treating structure alone does not always settle the question.
What is the difference between persistent pain and chronic pain?
They mean the same thing. “Chronic” is the older term and the one most people search for; “persistent” is the term UK clinical and campaign bodies have moved towards, because “chronic” tends to be heard as permanent and untreatable, which is not what it means. This site uses both, and prefers “persistent”.
What happens at a first appointment?
A long conversation first, then a physical assessment, then a plain account of what I have found and whether I think I am the right person for you to see. Details are in the assessment section above and in where I practise.
Is this suitable for me?
I cannot know that without seeing you, and I would not want to say otherwise. What I can tell you is what an assessment covers, which is set out above. If you want to ask before committing to anything, email me. Asking costs nothing.