The Truth About Chronic Pain - Central Wellington

The Truth About Chronic Pain

As a society, we struggle to manage chronic pain, much like we struggle to address mental health. Interestingly the most wealthy country on earth (America), has a more significant problem managing pain than the rest of us. This fact alone poses some fascinating questions about the nature of pain and how we are supposed to handle it better.

One of the many problems that we face when managing chronic pains like back pain, sciatic pain, hip pain and frozen shoulder better is that there is no expert consensus on how to manage them. Or even what causes them. Whether you are a pain sufferer or a clinician, it is somewhat concerning when you climb to the top of the science ladder, and all you find is a group of experts arguing about the basics.

But despite all our failures and confusion, there is a list of important things we do now know about pain. Here are five of them:

1 - The Best Way To Manage Pain is The Interdisciplinary Way

If you speak to your friends, colleagues and family, you will often find that they are loyal to one type of pain management. Your uncle Jeff had a great experience with chiropractors when he had sciatic pain, so he believes Chiropractic is the only way to go. Your squash partner may have had excellent results with a Physiotherapist for their knee and shoulder pain, so they will believe that Physiotherapy is the only way to go. However, perhaps unsurprisingly, a more flexible mindset is often required if you have chronic pain.

For all the confusion about pain, there is one thing that all the experts can agree on, an interdisciplinary and flexible way of managing pain is superior to the mono-disciplinary and inflexible way of treating pain, which makes logical sense.

An individual’s pain is usually complex and involves various body parts, needing multiple types of intervention. Pain sufferers also vary from person to person greatly. As a technician, if you intake 100 ankle pain sufferers, what you find is that they don’t all respond to the same treatments despite seemingly having the same issue. Much in the same way as we all like different types of food, we are all individuals—these variations and complexity point to the need for an interdisciplinary and flexible approach to pain management.

1 - The Best Way To Manage Pain is The Interdisciplinary Way

2 - Pain is Serious

If you have a very mild case of lower back pain, head pain, or shoulder pain that resolves quickly, that’s not a big deal. However, chronic pain, which lasts for months or years and comes back repeatedly, is often a severe health issue.

Research shows that chronic pain profoundly impacts and correlates with poor health and mobility outcomes in the long term. Research has also shown that chronic pain correlates very strongly with mental health issues and long term financial issues.

In some ways, we are lucky to be able to be concerned with chronic pain. We had to deal with chronic pain and other horrendous public health issues a short time ago. Now, however, we have made significant gains in the public health sphere, but we still struggle with pain as we do still struggle with our mental health. As time goes by, we will undoubtedly learn to conquer our problems with chronic pain as we did with so many other public health challenges in our recent past.

3 - Pain has a Physical Component

Chronic pain, in almost every instance, has a vital physical component. In virtually every case, we don’t struggle with this acknowledgement. Suppose you have osteoarthritis, chronic back pain, rotator cuff issues, frozen shoulder, or sciatic pain. It stands to reason a genuine physical issue underlying the pain in those cases.

Things can get a little more confusing when you get back the results of your X-ray or your MRI and find that there is nothing to be seen. Furthermore, things can get even more perplexing and convoluted when extensive investigations into one’s pain fail to reveal any real substantial physical cause. This type of scenario has often led to the age-old question; is it all in my head? If it is all in your head, nothing is happening physically, but that is never the case with the most chronic pains.

As we will discuss shortly, there is no question that chronic pain has a substantial mental and emotional component in many cases. This doesn’t mean that there are no physical causes of pain with an emotional or stress element. Without exception, there is always some biological component to the most chronic pains.

One of the significant challenges we face with diagnosing chronic pain is that our current scans and tests often don’t show the physical cause of the pain. MRI scans are fantastic for identifying tumours, but they are not good at identifying muscle wasting behind the shoulder blade. X-rays are excellent for diagnosing fractures, but they do not reveal subtle traits of scar tissue in the hip, lower back and shoulder. These limitations mean that most pains are not visible, but this doesn’t mean that the physical causes of the pain are not any less real. It just means that we don’t have a scan that identifies them.

4 - Pain is Psychological

The experience of pain most definitely feels very body-based, and of course, all of the physical harm that pain relates to does happen in the body. Like a trip to the movies, the sensory experience occurs on the screen, when the images are actually created on the projector. Like those images, pain occurs in the brain but feels body-based. Of course, broken bones and bad backs are real, but the pain that tells us about them happens in the brain.

So, as is so common in life, things are a little more complex than they seem on the surface when it comes to pain. This applies to chronic pain as follows; In many cases, the brain portion of the pain becomes quite dominant, usually due to old traumas or ongoing stresses. When the brain is hit with the double whammy of physical problems in the body and stress, it tends to generate more pain than it would otherwise.

If you suffer from chronic pain, only a tiny percentage of your pain may be stress-related. Often patients with old injuries fall into this category, where most of their problem is a lack of rehabilitation or incomplete healing rather than emotional stress. At the other end of the spectrum, there are pain sufferers who have minor issues with their bodies but experience much pain because of emotional stress. Like most other parts of human life, chronic pain’s psychological and emotional aspect is spectrum based. It is, however, essential to acknowledge that if you have had pain for a long time, it is likely that it has that psychological component to it, to some degree or another.

4 - Pain is Psychological

At the other end of the spectrum, there are pain sufferers who have minor issues with their bodies but experience much pain because of emotional stress. Like most other parts of human life, chronic pain’s psychological and emotional aspect is spectrum based. It is, however, essential to acknowledge that if you have had pain for a long time, it is likely that it has that psychological component to it, to some degree or another.

5 - Pain is Cultural

As we have seen repeatedly in this short discussion, chronic pain is often a little more complex. When an American falls over and bangs their knee, we can assume that they feel much the same pain as an Egyptian. When Kiwis stub their toe, chances are they experience it just as much as Japanese people. One of the undeniable truths that have emerged from research into chronic pain is that all countries have the same amount of pain. Yet, not all countries deal with their pain in the same way or with the same success. Some nations have catastrophic levels of disability caused by back pain, while others haven’t heard of someone missing work because of a bad back.

The most apparent difference between nations regarding chronic pain may be the different lifestyles that people lead from country to country. A nation still heavily driven by subsistence farming is highly likely to have other pain statistics than a country predominantly populated by office workers.

Perhaps more surprising than variations in lifestyle, the research shows that cultural beliefs about pain determine how well people cope with their pain and how likely they are to suffer from chronic pain issues. Furthermore, a nation of highly stressed and overworked individuals experience far more pain and disability when compared with those living a less stressful lifestyle.

Based on old fashioned assumptions about chronic pain, we would expect a nation of physical labourers to experience more pain than affluent individuals who lead an easy life. Within the research data, the exact opposite is true. America has the worst record for chronic pain and chronic disability; who have been the most affluent country on earth for many decades. This fact speaks to the profound influence that a person’s culture has on the likelihood of struggling with chronic pain and corresponding disability.

Conclusion

Despite all the confusion and disagreement that remains around chronic pain and its treatment, there are many things we can say with confidence. Fortunately, there are already many solutions that have been shown to work effectively. If you have struggled with the uncertainty of failing to resolve your pain for a long time, it can feel like there are no real answers. However, the opposite is true; there are many worthwhile answers and solutions. If you suffer with chronic neck, shoulder, back, hip, sciatic, knee, ankle, or foot pain and you haven’t found answers yet, take some optimism from knowing that there is sound knowledge about pain in the world we live in, but sometimes you do have to dig for it a bit.

0 replies

Want to join the discussion?
Feel free to contribute!

1 - The Best Way To Manage Pain is The Interdisciplinary Way

1 - The Best Way To Manage Pain is The Interdisciplinary Way