Based on a Real Clinical Case
Alejandra Pérez *
*Correspondence to: Alejandra Pérez,.
Copyright
© 2026 Alejandra Pérez is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Received: 11 July 2026
Published: 01 August 2026
Do you know what chronic pain is?
Chronic pain is an unpleasant, persistent, or recurring sensation that lasts for more than three months, often exceeding the normal healing time. Unlike acute pain, this pain does not serve a protective function and can significantly affect quality of life, causing depression, anxiety, and sleep disorders.
It can originate from unhealed injuries, neurological damage, chronic diseases (arthritis, diabetes, cancer) or from a "central sensitization" of the nervous system, where the brain processes pain signals without there being a current physical injury.
The treatment aims to relieve pain and restore the patient's functionality, improving their quality of life.
The unconscious origin of chronic pain is rooted in the close mind-body connection, where unresolved emotional conflicts, past traumas, or high levels of sustained stress manifest physically a phenomenon known as psychosomatic pain. When the nervous system is unable to process an intense emotional burden, it can "transform" into a physical signal of persistent pain.
Key points about the unconscious origin:
It ceases to be an alert of injury and becomes a dysfunction of the nervous system, where psychological factors play a crucial role.
Common manifestations:
Pain always has a psychological component, which means that chronic pain must be understood holistically, considering both biological and unconscious emotional aspects.
If you've made it this far, after reading this brief introduction about chronic pain, let me tell you that I have experienced every point mentioned above.
My name is Alejandra, I am 42 years old and I have had chronic neck pain for 18 years.
It began one Saturday afternoon in 2008. I was sitting on a building's windowsill when a pain started at the base of my neck. It began simply as a minor discomfort. I was 24 years old at the time, and I never imagined that this day would mark the beginning of such an incredible, difficult, and seemingly endless chapter in my life. What started as a simple discomfort at the base of my neck, and which has persisted for 18 years, has led me to discover different aspects of my personality, my past, events I didn't even know had happened, and the inner strength I possess to face adversity. It has also led me to meet people and
These situations have completely changed my perspective on life, friendship, kindness, evil, and abuse. I never imagined that on that Saturday, a simple neck pain would be the trigger that opened the door to a completely unknown and unexplored world that lives in my mind, filled with unconscious memories and situations that are unfamiliar, yet very familiar to my subconscious and my body.
Could it be that this pain was necessary to discover and finally resolve aspects of my personality that I otherwise would not have been able to recognize?
As I mentioned at the beginning, I was 24 years old when I started experiencing pain. At that time, I had graduated from university two years prior. I am an accountant.
I was a public servant by profession and was not yet working professionally, I worked part-time in the afternoons at a dental office as an assistant, taking calls and scheduling appointments, the pain was not yet very intense but it was already constant.
I had two previous accidents in 2008; to some extent, these accidents.
These would be the physical cause of the pain; the first was in a taxi and the second was in a combi, with a difference of three months between them.
In the taxi, a drunk driver suddenly cut in front of the taxi and the taxi.
The car braked suddenly. I was turning toward the left window when it happened. The abrupt movement of my neck as it braked caused, initially, a grade 3 sprain. I immediately felt pain and dizziness. When I got out of the taxi, I was dizzy and in pain. I went to the orthopedist, who simply took x-rays of my neck and prescribed painkillers. I had continuous dizziness. He told me it was a consequence of the whiplash and that it would gradually subside, and it did. But the pain didn't go away; on the contrary, it worsened.
Three months later, in the second accident in the van, I was sitting in the back seat when the van collided with another vehicle. At the moment of impact, I was thrown from the back towards the front seats and landed on the large belly of one of the passengers. Once again, I felt the impact on my neck.
Intense form.
I went back to the orthopedist and this time, the diagnosis was that There was simply a contracture in the neck muscles, completely false.
Several years later, he discovered he had herniated discs in his C4-C5 and C5-C6 vertebrae, which would later progress to the complete destruction of the vertebrae and a painful spinal surgery in which titanium plates were inserted to replace them to damaged disks.
From 2008 onwards, I began to experience chronic pain after these two events.
In accidents, at first the pain was tolerable, however, it was continuous and constant, It wouldn't go away and it got worse during the afternoons and evenings; it still wasn't.
I was working in a job related to my profession, and when I was an assistant in the dental office I already had intense pain, but it was still manageable.
Two years after the accident, in 2010, I was offered a job in a government-owned company, and I would accept. I started working at this company in From February 2010 to October 2013. When I decided to resign in October of this year was because the pain had become practically unbearable, Throughout this entire period of employment, I suffered from increasingly intense and continuous pain. The orthopedist who treated me at the end of this process...
My job made me decide to resign, because he indicated that if I didn't stop working it was very likely that on some occasion the pain could cause me to faint because it was so intense that he would no longer be responsible if any incident occurred at my workplace due to the brutal pain.
Unfortunately, I had to follow the doctor's instructions and resigned from my I worked in 2013.
26 years old (Year 2010, New Year's Eve Dinner, with work colleagues)
In addition to the doctor's instructions, I also decided to resign because my boss in On several occasions, she questioned the credibility of the pain. A few days before resigning, some colleagues informed her that I looked to be in very poor physical condition.
They asked him, looking pale, if it would be necessary to let me go, as it was obvious that I was unwell, and he replied:
- “No, it’s fine like this. If she faints, just let me know so I can come and pick her up.” “
A couple of days later, I would hand him my resignation letter.
When I decided to quit my job, I started handling tax refunds for mortgage interest on my own; I couldn't go back to working for a company. In 2014, I had a serious infection in my right eye.
The ophthalmologist who treated me had to perform a rather painful eye procedure to eradicate the infection. I had to attend continuous appointments after the procedure, and in this way, months later, the doctor would ask me to do his accounting, as it was a real mess.
These two job options were what helped me cover my expenses at that time, and I still work with the ophthalmologist to this day; the refunds would cease in 2016.
From 2012 to 2014, I swam every day of the week, hoping to reduce my pain. I had already tried several alternative techniques, such as acupuncture and kinesiology tape . Kinesiology tape uses adhesive cotton tape to treat muscle, joint, and lymphatic injuries without restricting movement. It helps reduce pain, improve circulation, decrease inflammation, and provide proprioceptive support. Common in physiotherapy and sports, it helped a little, but not much. Physical rehabilitation also helped, but none of these treatments worked. However, swimming did help reduce the intensity of the pain somewhat,
but it didn't eliminate it. By this point, I had been living with the pain for six years, and it was becoming increasingly unbearable.
I also tried meditation and music therapy; both helped somewhat.
They relieved the pain, but the results lasted a very short time, although they did help reduce the anxiety caused by the pain, as did dietary supplements.
The supplements helped me tremendously to reduce pain and inflammation. I still take them today.
In 2014, I tried another "non-surgical treatment for herniated discs in the spine," with disastrous results. It consisted of treatments with very strong anti-inflammatory medications intravenously, physical therapy, rehabilitation, and ozone therapy, which was applied to my back and rectally. The latter only caused
me to develop shingles on my neck and amoebas in my colon; this was the only result.
I obtained from this treatment.
In addition to sports, also in 2010, I began psychological therapy,
At first, my therapist seemed professional, and I believed she was helping me overcome and resolve childhood wounds and traumas. I was with her for 13 years. Unfortunately, after all these years, I realized that she hadn't actually helped me at all; she had only been collecting her fees for over a decade, and on top of everything, she didn't believe me.
I was in pain, and I kept telling myself it was all in my head. If it's supposed Had a mental health professional truly done their job, the pain would have decreased considerably many years earlier, to a certain extent if it were true that the origin of the pain was unconscious in nature; however, they never addressed it.
In a serious and professional manner, the only thing that interested him was collecting payment at the end of the sessions for 13 years.
Many years later, a true therapist and mental health professional helped me address the unconscious origin of the pain, resulting in a significant improvement and allowing me to perceive the true intensity of the pain's source.
Functional, and very tolerable, on the pain scale from 0 to 10, primarily known as the Numerical Rating Scale (NRS) or Numerical Pain Rating Scale (NPRS). It is a standardized tool where 0 represents "no pain" and 10 "the worst pain imaginable," facilitating the objective assessment of pain intensity. Perhaps the highest it has reached is a 5, compared to the level 10 I always felt, but until this well-deserved moment arrived, I had to endure many more years of unbearable pain.
In 2015 my quality of life had been severely impaired by pain and because of the lack of movement it was already causing me, since most of the One day I was sitting, unable to move because the pain was too intense; I had very strong attacks of pain that reached a level 10 on the pain scale.
The new orthopedist who was treating me at the time would tell me to get an MRI of my neck, because previously they had only ordered X-rays which showed no evidence of what was causing this severe pain, so as the doctor told me, I had an MRI of my neck in July of 2015 and this would not be the first nor the last MRI that they would order.
I remember very well that on the day I received the results, I arrived at. The lab was worried, but also happy because I believed that with such an in-depth study it was very likely that whatever was causing the pain would be found.
I had a solution and therefore the pain was going to disappear, I was very grateful, I was surprised when I opened the envelope with the results and saw the diagnosis, which read: “Pituitary macrodenoma with intra- and supracellar extension surrounding the carotid artery on the left side.” When I read this diagnosis, I had no idea what it meant. I knew it wasn't good; something inside me was definitely telling me that the diagnosis was serious, and unfortunately, I wasn't wrong. That afternoon in July, it was raining very heavily, so the power went out for several hours and didn't come back until the next day.
Once I got home, I wanted to consult Dr. Google to find out what a pituitary macroadenoma was. Unfortunately, I had to wait until the next day to find out what the results I had received indicated. Once I was able to check online what the radiologist at the lab had indicated in the report, I realized that the diagnosis meant I had a tumor in my pituitary gland. I was completely stunned when I read and understood what the lab doctor was saying: I had a brain tumor. At that moment, I thought it was the cause of the unbearable pain that had plagued me for seven years, but the tumor wasn't the cause of the pain, at least not directly.
This would be the beginning of a very intense and at times extremely dangerous and very overwhelming medical pilgrimage, stressful, tiring and full of ups and downs. physical and emotional.
Now that I had some hope of finding out what was causing the terrible pain he had in his neck led to a second situation, From my point of view, it was even more complex than the pain, because without me even imagining anything, a brain tumor was present and active.
She was very scared because she had no idea what was going to happen, so I nervously took the MRI results to the orthopedist, and at that moment the pain became secondary, as the doctor prioritized the finding they had just made. Despite the MRI, he still couldn't find the cause of the pain, so there I sat in front of the doctor with a new diagnosis, quite delicate and dangerous, and without finding any evidence of what was causing the pain.
Upon learning the new diagnosis, I was immediately referred to the neurosurgeon, and I remember that what scared me the most was when he said that surgery would be necessary to remove the tumor. I was sitting there listening to him say that it was very likely they had—or at that moment I imagined—that they were going to open my skull to remove a brain tumor. That wasn't the news I was expecting when I had the MRI, and I had somehow hoped that they would find the cause of the pain so they could eradicate it and make it disappear, but they didn't find anything either.
So, quite distraught, I left the office with a new diagnosis and no hope that the unbearable pain would disappear. The only thing the orthopedist did was refer me to a pain specialist. That
was all he could do, as he said he only performed spinal surgeries, and in my case, surgery wasn't necessary, at least not in that instance moment.
So once I left, I made an appointment with the pain specialist and the next day I called to Making the appointment with the neurosurgeon, everything that had started as a simple pain in the back of the neck was transforming into a series of situations and events that were becoming more and more complicated; it was as if one were watching a movie in which the plot was becoming more difficult and terrifying.
When I arrived at the neurosurgeon's office days later, I was thinking that Perhaps the lab doctor made a mistake in the diagnosis, Unfortunately, he was right and the diagnosis was correct. The doctor reviewed the MRI and there was definitely a huge tumor in the pituitary gland. A neck MRI wasn't the right study to diagnose a brain tumor in the pituitary gland, so he ordered a skull MRI to determine its size and what structures it might be compressing around the pituitary gland. What was absolutely certain was that I would need brain surgery because there was no other way to remove the tumor and find out if it was malignant or not.
Normally, the doctor told me, pituitary tumors are benign, and some produce hormones while others do not. To find out if mine was hormone-producing, in addition to the brain MRI, he instructed me to have laboratory tests done to see if it was producing any hormones in excess.
The cost of brain surgery is around $500,000; I have insurance for major medical expenses, but it was necessary to cover coinsurance so they could.
I had the surgery, so with the cost of the MRI plus the lab tests, the co-insurance price that the insurance company was asking for at that time was covered. The lab tests showed that the tumor was producing growth hormone, which meant that I had a disease called "Acromegaly," a rare and chronic endocrine disease caused by the excessive production of growth hormone (GH) in adults.
This is usually due to a benign tumor in the pituitary gland. It causes enlargement. Progressive changes in the hands, feet, and facial features, as well as affecting internal organs. If left untreated, it can reduce life expectancy. At this point in my illness, it was already very advanced. The neurosurgeon estimated that the tumor had most likely appeared in my pituitary gland when I was 19, and it was discovered 11 years later.
Therefore, I already had significant physical changes that I hadn't noticed because they were progressive and very slow.
The pain persisted, and now I had to worry, in addition to the already painful situation, about a brain tumor and surgery, so the pain intensified even more due to the stress I was experiencing.
When I had my first appointment with the pain specialist, a few days after the appointment with The neurosurgeon examined me and, like all the other doctors before me, couldn't find any likely cause for the pain. However, he told me that whatever the cause, it could possibly be controlled with spinal blocks. It was the first time I'd ever heard this term; I had no idea
what the procedure involved. He explained that it consisted of injecting steroids into the cervical vertebrae to significantly reduce the pain, along with anesthetics. It seemed like a...
It wasn't a very invasive treatment, so I underwent the procedure, thinking that afterwards The pain was going to improve considerably after the first block, as the doctor was very hopeful that this would happen and apparently had a lot of experience in his field.
bouquet. The afternoon I went to get the injection, it was approximately 6 o'clock. It was late and the procedure began; it didn't last long, it was around 20 minutes. I didn't feel much pain, as I was anesthetized with lidocaine and I thought that was all, that the pain would simply disappear in about 6 months, which is how long the block would probably last.
Ten minutes after the lockdown ended, I started coughing, and the cough began to the cough kept getting worse; it was quite deep, and I didn't understand what was happening. Suddenly, the cough turned into shortness of breath, until my throat closed up. I had a very acute allergic reaction to lidocaine. I hadn't known I was allergic to lidocaine, and I simply couldn't breathe. I was in the doctor's office, and there was no way to open my airways, but despite everything, I was able to breathe a little. I couldn't speak, but I could breathe through my nose. I had to stay in the office for another two hours, waiting for the allergy to subside and disappear; otherwise, they would have had to take me to the hospital for the necessary procedures.
So that I could breathe normally again, as well as administer medication intravenously. Fortunately, two hours later, my airways began to open and I was able to breathe normally again. I had never felt such a desperate sensation of suffocation as on that occasion, and this it was one of the first difficult and unforgettable events that I would have to experiment over the years.
It would have been worth going through this traumatic and severe allergy experience I would have done something about the lidocaine if the pain had disappeared, but it didn't. The supposed six months without pain only lasted 48 hours. The block didn't work. I had another block three months later, this time in a hospital, because the allergic reaction I'd had to lidocaine had been very dangerous, and the doctor wanted to protect me by doing it in the emergency room, with all the necessary and available sanitary measures in case I had another allergic reaction. This time, the pain skyrocketed to a disproportionate level, and all night after the block, I was in pain a thousand times worse than I'd ever experienced. To this day, I've never experienced so much pain as that night. I was in a hospital room in excruciating pain, and I regretted having undergone the procedure again.
Apparently, it had been a somewhat normal reaction to the medication and the procedure itself. The pain lasted approximately eight hours, and it was a real ordeal. It was torture being in that level of pain; again, the block had failed, because...
The pain was present for both days; I wouldn't undergo this type of procedure again for another two years.
It really caused me trauma and a great feeling of frustration to have felt this level of intense and desperate pain without any subsequent success.
On the other hand, the brain surgery had been put on hold because he needed to have enough money to perform it, so 6 months would pass from when the diagnosis was made in July 2015, the surgery would be performed until February 11, 2016.
By the date it became affordable, I was experiencing tachycardia in the early mornings, as my heart had grown slightly larger than usual.
Normal for the same disease, I had lost peripheral vision in my left eye due to compression of the optic nerve by the tumor, I had significant and evident physical changes ( see photos above ), increased size of hands, feet, facial features and very severe acne that lasted for 10 years; they asked me for laboratory tests again for the surgery and when the results came out, they were totally out of sync in several hormones, such as IGF-1, insulin-like growth factor.
IGF-1 is a peptide hormone produced primarily in the liver, essential for cell growth, development, and regeneration. It functions as the main mediator of growth hormone (GH), which stimulates bone, muscle, and organ growth, in addition to having anabolic effects, was well above normal levels, as was glucose. how other alterations in other hormones.
The disease was very advanced and I was terrified by the idea that I was going to I was scheduled to undergo brain surgery, in addition to suffering from unbearable chronic pain for seven years at that time. I didn't know what worried me more, the pain or the surgery.
The doctor explained that once the surgery was over, I would spend a night in intensive care as a precaution because it was a major and very delicate surgery, so they had to take care of any small problem that might arise.
It was a very terrifying wait, because I never imagined I would be in an operating room. being a patient undergoing brain surgery to remove a tumor.
The resection surgery was performed via a transsphenoidal approach, a minimally invasive surgical procedure primarily used to remove pituitary gland tumors and other lesions at the base of the skull. Unlike a traditional craniotomy, the surgeon accesses the brain through the nasal passages and the sphenoid sinus (a hollow space behind the nose), thus avoiding visible external incisions. Due to the same condition, the nasal septum had grown and become completely deviated, blocking access to the brain. Therefore, the nose first required surgery, including rhinoplasty, to straighten the septum bone so that the neurosurgeon could subsequently access the brain cavity. The surgery lasted approximately 5 hours. I had three surgeries in one. The neurosurgeon was only able to remove 95% of the tumor because the remaining 5% was lodged in an area called the cavernous sinus. This is a pair of trabeculated venous cavities located on either side of the sella turcica (base of the skull), crucial for venous drainage of the brain and eyes. It acts as a complex dural "cave" containing the internal carotid artery and key cranial nerves (III, IV, V1, V2, VI) that control eye movement and facial sensation. It is a dangerous area of the brain to enter due to the nerves located there. The tumor had overflowing from the Turkish Chair.
The sella turcica is a bony structure at the base of the skull, located in the sphenoid bone, which houses and protects the pituitary gland. It is saddle-shaped, measures approximately 1-2 cm, and regulates the endocrine system. The tumor had grown enormous; they had to extract fat from the lower abdomen and use it as a plug in the sphenoid sinus to seal it off.
To conclude the surgery.
When I woke up I had an oxygen mask, oxygen in my nose, a catheter in my heart, a urinary catheter, and I felt a burning sensation in my groin at the site where they had removed the fat to seal the sphenoid sinus.
After I was conscious in the operating room, I suffered a panic attack. I have a very intense phobia of vomiting and diarrhea. As a consequence of the anesthesia, I vomited, and that triggered the phobia. I hadn't vomited in 16 years. Since I couldn't move or sit up, I was kicking and thrashing about because of the great anxiety I felt. They couldn't control me. A stretcher bearer tried to hold me down with the intention of subduing me and making me stop moving, and all he managed to do was give me a tremendous scratch on both arms, because he couldn't stop me from thrashing around.
In this condition I was transferred to intensive care, which was the only thing that managed to calm me down.
It was then that the neurosurgeon held my hand, and feeling his support, the anxiety It began to gradually decrease. I noticed that the peripheral vision in my left eye had returned to normal. It was a very difficult night for me, not so much because of the discomfort of the brain surgery, but because of the pain;
I couldn't fall asleep all night because the bed bothered me terribly and the pain was very intense despite the strong painkillers I had been given after the surgery. I tossed and turned, feeling very uncomfortable, and I began to feel a lot of anxiety and despair. The pain was becoming increasingly.
It became more and more intense, and I obviously couldn't move or do anything at all. Nothing, this would be a night I will never forget, it was completely etched in my memory and it was really because of the intensity of the pain.
At 5 a.m., the neurosurgeon came into the room and asked me how I was feeling and how long I had slept. I told him I hadn't been able to sleep all night because I was in a lot of pain. He gave instructions for that day in the
Later, the pain specialist could come to the hospital to help me control the pain, because Beyond the discomfort from the surgery, what was really overwhelming me was the intense pain. Hours later, I was moved to a regular ward, and the day was very difficult to get through. Because of the rhinoplasty and brain surgery, I had nasal packing, couldn't breathe properly, and being in bed practically all day caused me even more pain and discomfort.
In the afternoon the pain specialist arrived and gave instructions that I should be given more painkillers to control the pain; they worked and I felt a little more relieved.
I spent 8 days in the hospital recovering from the surgery, and everything seemed to be going smoothly, that the surgery had been successful to a certain extent, even though they hadn't been able to remove the entire tumor. Unfortunately, they couldn't.
That's how it was; the day they let me leave the hospital, I was readmitted 24 hours later.
Because I had a condition called “diabetes insipidus”, which caused grade 2 dehydration. My sodium and potassium levels became unbalanced.
Diabetes insipidus is a rare disorder of water metabolism.
Characterized by extreme thirst (polydipsia) and excessive production of very dilute urine (polyuria), often exceeding 10-20 liters per day. It occurs due to a lack of or resistance to the antidiuretic hormone (vasopressin), preventing the kidneys from retaining water, as a consequence of the surgery itself.
I was back in the hospital for five more days, and when I left I was in very bad physical condition; it would take me two months to recover from this surgery, and once I was fully recovered, I would begin a cycle of radiotherapy with the intention of eliminating the part of the tumor that remained as a remnant. I received 25 sessions of radiotherapy.
Unfortunately, they were unsuccessful; all they did was increase the pain 100 times more than it already was, in addition to several side effects. As a result of the treatment, I lost 13 kilos, had nausea, diarrhea, stomach pain, extreme sleepiness, extreme fatigue, paleness, very deep dark circles under my eyes, and a lack of appetite, but the worst thing was the pain; it became burning, as if
He had a permanent burn at the base of his neck and cried out in pain.
The pain specialist tried several medications and none worked. The last medication
he used was a powerful painkiller (oxycodone). It worked and he continued taking it for 8 more years. When I stopped taking it, I had a very strong dependence on the medication. I had to go through withdrawal in the hospital in 2024.
I would fully recover from the radiotherapy 6 months later, without any success, and as a secondary consequence, it burned the optic nerve and destroyed part of the pituitary gland; it didn't even tickle the tumor. 2016 was one of the most difficult years of my life; I was 32 years old and i had already had brain surgery in April and May of that same year, and I would undergo intensive radiotherapy treatment.
She thought that to improve, and that these experiences, although difficult, would be the only ones she would have to experience, was very wrong, because this was only the beginning.
A couple of months later, in April 2017, while I was taking a bath, I felt something in my groin on the right, a small lump; it hurt when I touched it and it was already a certain size.
I was quite scared, so I went to the gastroenterologist and she ordered an ultrasound.
The result was that I had an inguinal hernia on the right side. The diagnosis was that surgery would be necessary and imminent; otherwise, the hernia could become strangulated (the intestine gets trapped and without blood), a potentially life-threatening medical emergency requiring immediate surgery.