Dr. Rachel de Simone
Owner of Lotus Yoga & Integrative Health in Shelburne, VT
Hi, I’m Rachel!
I’m a Doctor of Physical Therapy and a certified chronic pain specialist on a mission to change the way we treat chronic pain.
Too many people, myself included, have gotten stuck in a pain cycle because our medical system is treating the wrong thing.
Treating chronic pain the same way we treat acute pain is kind of like patching a hole in a wall to try to turn off a fire alarm.
To break the chronic pain cycle, we need to address the alarm system, not the structure.
Ready to stop chasing pain?
Chronic pain happens when the nervous system becomes hypervigilant, causing the pain alarm to be easily activated.
The heart of my work is helping the nervous system feel safe enough to turn down the volume and sensitivity of the alarm.
EDUCATION & TRAINING
You can’t heal pain if your nervous system thinks you are in danger.
Pain is an alarm to warn you about potential danger. The brain on pain can become incredibly sensitive, and the longer you have pain, the easier it is to trip the pain alarm. To heal the root causes of pain, rather than just mask the symptoms, we have to heal the nervous system.
Signs of nervous system dysregulation:
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Depletion
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Chronic Pain & Illness
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Feeling Overwhelmed
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Irritability
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Fatigue and Sleep Problems
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Difficulty Concentrating
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Skin & Gut Issues
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Sensitivity to Sensory Stimuli
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Hormonal Imbalance
• Depletion • Chronic Pain & Illness • Feeling Overwhelmed • Irritability • Fatigue and Sleep Problems • Difficulty Concentrating • Skin & Gut Issues • Sensitivity to Sensory Stimuli • Hormonal Imbalance
I lived with persistent pain for years.
I know how frustrating it can be to navigate a medical system that doesn’t really understand pain.
Each provider I saw only looked at one piece of the puzzle, and only treated the symptoms, which simply didn’t work. The longer my pain lasted, the more I felt I had to prove that it was real.
I finally broke the pain cycle when I stopped focusing on structural issues and started addressing the root causes.
My experience living with chronic pain changed my life. I may not ever be able to do a handstand again, but I have learned how to slow down and listen to my body. I know how to take care of my nervous system so that it doesn’t feel overloaded or depleted.
It is such a gift to know how to speak the body’s language. It has transformed my clinical practice from mechanic to healer, and it has given me a deep capacity to hold space for people when they’re really suffering. I’m able to help people who haven’t found success with other treatments, because I understand chronic pain from the inside out and the outside in.
My journey
My nervous system-informed approach to pain evolved from my own experience traveling through the underworld of chronic pain and bumping up against the limits of conventional medicine.
In my first year practicing as a PT, a colleague demonstrated a manual therapy technique on me during a training. She used too much force for my hypermobile body, and I ended up with a serious nerve injury that led to burning, shooting pain, and electric shocks from my neck to my hand. My arm felt like it was on fire, and I couldn’t turn my head.
I was an eager new clinician, and I thought I knew how to treat injuries, but nothing prepared me for that level of pain, so I sought help from a colleague who was an excellent physical therapist. I was a good patient: I did my homework and I tried so hard to get better, but I didn’t get better.
I’d make progress, but my nervous system had become very sensitive, and little things easily reactivated the pain. I got lots of tests and saw a lot of specialists, but no one could explain why I still hurt, and the longer the pain lasted, the more medical gaslighting I experienced. I remember seeing a neurosurgeon who looked at my MRI for two seconds and told me I was fine, but I wasn’t fine. I was in serious pain, and I’d experienced a progressive loss of strength and function to the point that I couldn’t make a fist with my right hand. I wasn’t able to write, cook, or get dressed by myself, and not being able to use my right arm made it difficult to do my job as a manual physical therapist and yoga teacher. I was not fine. Instead of taking my pain seriously, he dismissively suggested I see a psychiatrist.
My pain was very real, and it took years to unravel. Along the way, I had to confront a lot of demons, including fear that I had irreparable damage and would live with this pain forever, worry that, after years of study, I might not have a career as a physical therapist, grief over all that I had lost, and shame that I was a PT and I couldn’t even help myself.
I studied healing traditions from around the world to help me break the pain cycle. The first thing to give me hope was CranioSacral therapy. My first session was magical. I could feel the tension in my nervous system unwinding, and it helped me reconnect to the wisdom of my body. It also opened my mind to an entirely different way of practicing manual therapy and treating pain, and I’m so grateful for that because CranioSacral therapy has become the primary modality I offer in my clinic.
I also started studying pain neuroscience, and I learned that the recurrences of pain were not happening because I was re-injuring myself, but because my nervous system was interpreting everything as a threat, and it was just trying to keep me safe. Pain science finally helped me understand why I hurt, which made me less afraid of the pain and improved my symptoms and function.
It also taught me several lessons that inform my clinical practice:
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The body is exquisitely designed to heal, so within 6 - 12 weeks, most injuries will be repaired. When pain lasts for more than three months, when pain keeps coming back, migrates, or spreads, or when pain exists in the absence of injury, that’s not a sign that the tissue needs to heal, that’s a sign that the nervous system needs to heal.
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I started seeds indoors for the first time this year, with mixed results. Some of my seedlings turned yellow. Some of them withered, and others got really tall and leggy. Those symptoms weren’t just problems; they were also solutions. Each one of those seedlings was communicating a core need, and that was such a gift because I didn’t have to guess how to help them.
Similarly, if we know how to speak our body's language, it will tell us exactly what it needs. When it comes to chronic pain, chronic fatigue and depletion, autoimmune conditions, long covid, or other complex, mysterious conditions, the body is telling us that it doesn’t feel safe. To heal the root causes and not just mask the symptoms, we have to get curious as to why
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The nervous system is designed to activate and respond to an emergency. Once the danger has passed, the alarm should turn off. We live in a complex and stressful world, and for many of us, it feels like we are constantly in a state of emergency. This was certainly true for me. The stress of grad school, finances, parental health challenges, and injury made my nervous system feel like it was being chased by a lion. I had to shift things in my life so my nervous system didn’t constantly feel like it was under attack, and I built a growing toolbox of nervous system supportive practices drawing from Eastern wisdom traditions and vagus nerve research to restore my resilience so that I could resonate with, instead of react to, the world.
Kind Words