It is pretty easy to diagnose a black eye, even without a medical degree. The same is true for broken legs, common colds, bloody noses, eczema and many other outwardly visible health issues. Pain, on the other hand, is entirely invisible.
Western medical science likes to deal with things it can measure. Before microscopes, bacteria and viruses were invisible to us, so we struggled with them. Then, once we could see them, we got very good at dealing with them.
Here in the early 21st century, pain is still ‘invisible’ to medicine, so it struggles endlessly with it. And it is not alone. Mental health falls largely into this same systemic crevasse.
Pain is invisible to the person who is suffering from it, invisible to other people, and almost totally invisible to the eyes and ears of modern medicine. There is no scan or blood test to diagnose you with a migraine. And in truth, it’s extremely rare that an X-ray or an MRI scan shows you the real cause of back, knee or shoulder pain.
If you have heel pain, there is no modern scan sensitive enough to show subtle scar tissue buildup in your foot, and of course, no blood test to confirm the diagnosis. We don’t have any technology that can measure or identify a locked sacroiliac joint. There are no lab tests for mechanical pain. And the overwhelming majority of musculoskeletal pain has its roots in biomechanics.
Up until the last 200 years, we suffered wholesale death and destruction at the hands of bacteria and viruses that we didn’t even know existed. Long after figuring out how to defend ourselves from wild animals, we struggled with microbes. Primarily because we couldn’t see them and thus didn’t know they existed. This situation is not too dissimilar from where we find ourselves with pain in the 21st century: we cannot see it; therefore, we struggle to manage it.
If you struggle to lose weight, it is pretty common knowledge that it’s at least partly due to your lifestyle. However, when approaching pain, we tend to overlook the possibility that it’s as lifestyle-oriented as issues like weight loss.
If, for example, you have a disc injury that needs keyhole surgery or you have torn a ligament in your ankle, you need a doctor. So, we can say that those pains are more injury-based than lifestyle-based.
But many pains relate to the levels of stress we live with, how happy we are, the amount of sleep we get, the amount/type of exercise we get, movement habits, the job we do, the childhood we had, our commitment to self-care, and a host of other lifestyle factors.
When pain is lifestyle-related, as much of it is, two major challenges arise—firstly, knowing which aspects of our lifestyle need to improve. And secondly, making lasting lifestyle changes is seldom easy.
Furthermore, the style of healthcare we are most exposed to isn’t geared for long-term lifestyle changes. The orthodox medical approach (pills & surgery) is very good at putting us back together when we are hit by a truck or have a massive infection. However, it is not predisposed to nuanced preventative measures like changing lifestyle and movement patterns.
The challenge of making fundamental changes to the way we live is a key reason why we struggle to manage pain successfully as a society.
In our culture, we have become very good at treating diseases, especially the infectious ones. And we tend to approach pain as if it’s a disease. We diagnose pain using old-fashioned medical terminology initially developed to diagnose illness. We prescribe painkillers, and we use surgery to ‘cut the pain out’. But these are tools of disease management.
Meanwhile, pain is a body feature, not a body bug.
Your fire alarm is not a bug. The red lights on your car dashboard to tell you you are running out of oil are not a bug. The rumble strips next to the highway are not a bug. Pain is the body’s warning system. So, approaching it as a type of disease will always yield average results, at best.
Collectively, we have given in to what may be the most profound misunderstanding we could have about pain, and it’s just one of many. Emotionally, it’s understandable that we want to get rid of our pain. However, when we allow that feeling to infuse into our healthcare system, we end up trying to kill pain itself instead of fixing the underlying problem.
Without framing pain correctly, we stand very little chance of managing it effectively. So, approaching pain as a disease or disorder in and of itself is one of the key reasons we struggle to treat it effectively.
The good news is that while pain is largely invisible to eyeballs, scans and blood tests, real experts can still identify the physical causes of pain. And treat them effectively.
In other good news, pain does depend heavily on lifestyle, but we seldom need to reinvent ourselves to remove pain altogether. Often, even small changes can bring significant results when combined with the proper treatment. As long as we know what those small changes need to be.
Furthermore, whilst we struggle with understanding pain as a culture, there is already a considerable amount of research that has uncovered plenty of the most practical truths about pain and how to manage it.
So, ultimately, we do struggle to manage pain as a society for some very clear reasons. But this isn’t a bad news channel. We do struggle with pain, yet there is so much hope for pain sufferers because we are getting better and better at managing it. Even though the uptake of good pain management is systemically a little slow going. The necessary knowledge to resolve pain does exist.
The good news is that while pain is largely invisible to eyeballs, scans and blood tests, real experts can still identify the physical causes of pain. And treat them effectively.
In other good news, pain does depend heavily on lifestyle, but we seldom need to reinvent ourselves to remove pain altogether. Often, even small changes can bring significant results when combined with the proper treatment. As long as we know what those small changes need to be.
Furthermore, whilst we struggle with understanding pain as a culture, there is already a considerable amount of research that has uncovered plenty of the most practical truths about pain and how to manage it.
So, ultimately, we do struggle to manage pain as a society for some very clear reasons. But this isn’t a bad news channel. We do struggle with pain, yet there is so much hope for pain sufferers because we are getting better and better at managing it. Even though the uptake of good pain management is systemically a little slow going. The necessary knowledge to resolve pain does exist.
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