55 years of pain I had a patient come into my office recently who represents one of the most remarkable turnarounds I have witnessed and she definitely has the record of being in pain for the longest time before she pulled out of it. She had been in pain for over 55 years when I met her about a year ago. Her pain was located over her thoracic and lumbar spine and she had spent a lifetime trying to solve it. I reviewed her imaging studies carefully and her spine had an expected degree of degeneration for her age. There was no identifiable reason for her unrelenting neck and back pain. Remember that disc degeneration is not considered a source of pain. It simply means that your spine has lost water content and is stiffer. I was not optimistic that she would do well in that she had been in pain for so long and did not seem open to engaging in a structured self-directed approach. Much to my surprise she worked with one of my colleagues and began to improve. I saw her on my schedule a few months ago and was curious why she was back. From a surgical perspective I had nothing to offer her. She was returning to thank me because she had gone to pain free. She was beside herself to the point of being euphoric. I have to admit that I did not blame her, as 55 years is a long time to suffer from chronic pain. I spent most of the visit calming her down. Learn to fail My first advice to anyone who experiences this sudden shift is to prepare to go back to being in pain. The pathways are permanent and will be triggered. Coming out of the pain pathways becomes a learned skill and you will figure out how to go into them less frequently and come out more quickly. Indeed, as I have followed her she has had significant recurrence of her symptoms several times – but she knows how to resolve them. A year later she has remained essentially pain free and has stabilized with fewer highs and lows. She remains very excited about her new life. The enlightenment light and judgment mirror Last week she showed me two objects she carries around her neck. One is a small light and the other a mirror. Whenever she finds herself being judgmental she holds the mirror up in front of her. If she has a moment of insight she turns on the light. Both are great visual reminders of significant aspects of her journey. Variations of her story are common. Hers is unusual because of the duration of her pain and the intensity of her healing. As pain pathways are permanent after 3 to 6 months the length of time you are in pain actually does not matter. It is also the reason you cannot solve or fix them. However you can shift off of them anytime with the correct approach. I see her back regularly because I enjoy talking to her. She exudes optimism and hope and can hardly contain herself. It is inspiring to be in the presence of that level of positive energy. She is one of many reasons why I find treating chronic pain so rewarding.