Ten Things Most People Don’t Understand about Chronic Pain

Chronic pain is an epidemic, affecting an estimated 100 million people in the United States and beyond. Unfortunately, chronic pain is quite poorly understood, even by doctors and other health practitioners. Many people afflicted by it never attain long-term relief, free of side effects. The good news is that, for most, that doesn’t have to be the case. It is possible to gain relief that lasts. The first step is to understand how chronic pain originates, why the mainstream medical system is not set up to treat it effectively, and how it can be treated.

Chronic pain can be defined as pain that is sticking around longer than is appropriate, or growing in intensity beyond what is appropriate with or without a clear cause. Typically this means pain that has been present for 3-6 months or longer, but for pain that is growing disproportionately, it might actually be sooner.

#1) Pain Originates in the Brain

This might sound like a strange statement. After all, if you burn your hand, where do you feel pain? Obviously not in your brain. The reason this is the case, however, is that your brain sends signals to the nerves in your hand to create the sensation of pain in your hand. Why does it do this? So that you take action – you can remove your hand and avoid doing more damage to tissue. Normally, pain disappears when an injury heals. Chronic pain then, is not typically a problem of the tissue, but rather a problem of the brain. In chronic pain, the brain has become “wired” to expect pain, regardless of what is going on in the tissue. In fact, the pain expectation may limit full tissue healing and function.

#2) Chronic Pain is Usually Defined as Pain That Persists for Three to Six Months

As described above, there are times when pain plays an essential role in our lives. It protects us from doing things that will cause further damage. When our bodies are functioning normally, the pain stops when it has served its purpose. For acute injuries, this is typically less than three to six months. Chronic pain, however, doesn’t relate to a discernible tissue abnormality. It may be hard to discover where chronic pain comes from, or it may be that chronic pain develops after an injury heals and the pain never goes away. If it remains for more than three to six months, it’s usually an indication that the tissue is healthy but the brain continues to register pain.

#3) Chronic Pain Is Regularly Overlooked

The sad truth is that, while millions of dollars are spent in an effort to cure fatal diseases, chronic pain research is underfunded. Why? Because chronic pain doesn’t usually kill people, although people may die from complications and comorbidities of chronic pain. For example, chronic pain may reduce mobility, or compromise sleep, leading a variety of health complications from weight gain, cognitive impairment, and other more serious comorbidities. But few people die directly from chronic pain. Unfair as this may seem, it means that chronic pain suffers from a deficit of attention from the medical establishment and most doctors have a limited arsenal of tools with which to address chronic pain. Generally speaking, clinicians have been trained in old pain science, called The Gate Control Theory of Pain, which was published in the 1960s, but may not be familiar with more recent pain science.

#4) Chronic Pain is Like Credit Card Debt

The nervous system’s primary job is to keep us alive. This means keeping us safe from things that harm us or compromise our ability to function in our environments. Because of this, the nervous system, specifically various regions of the brain record life experiences, which it perceives as threats to our ability to stay alive, such as injuries, traumas, disease, stressful experiences, throughout our life. These recordings are intended to protect us if we find ourselves in similar circumstances in the future. But this recording system can manifest in a maladaptive response. These recorded experiences can aggregate in the nervous system, like charges on the account. Chronic pain is less a “cause and effect” phenomenon like it is an acute pain, and more like credit card debt. Imagine that you have a credit card with a $3,000 limit. You regularly spend up to that limit, purchasing essentials such as clothes and groceries. What happens if you have a sudden, unexpected expense, such as a car repair? It takes you over your credit limit, causing you a lot of pain as you struggle to cover the cost of your weekly groceries. Chronic pain is similar. Whenever you go over your “threat limit”, it flares up. Therapies such as massage may bring you back below that limit, but unless you find a way to clear your “threat debt”, you will always be vulnerable to future flare-ups.

#5) Pharmaceutical Treatments May Provide Temporary Relief, but They Can Often Lead to Side Effects

Since our primitive ancestors, we have realized that if we hurt, that if we take things like alcohol or opium, that we can feel better – at least in the short term. The pain management industry has been born primarily out of this type of approach. It is a highly effective short term strategy, but not a viable long-term approach. Not unlike drinking alcohol to “deal” without credit card debt. We might feel better in the short term, but not doing much to correct or better understand what may be really causing the problem. While drugs can certainly reduce the experience of pain, they may also lead to a multitude of side effects. Patients can experience, constipation, nauseous or feel numbed out. Worse, consistent usage of pain relief medication can lead to various risks, not the least of which is addiction. Opioid addiction has grown to epidemic levels.

#6) Alternative Therapies Often Don’t Provide Permanent Relief

Wary of becoming dependent on pain relief medication, increasing numbers of people are turning to alternative therapies or hanging their hopes on cannabis. Sometimes, these modalities are effective, at least in the short term. For many people, however, the relief is short-lived. The pain may return, leaving them in just as much agony as they were before. Any kind of relief is better than none, and there may be occasions when these therapies have permanent results, but millions of people are still looking for a permanent solution to their ailments. When we think of chronic pain as an aggregation of threat experiences, like the credit card debt example, it is easier to understand why these therapies can be helpful, but may not provide a more lasting level of relief.

#7) The Medical Establishment Isn’t Set up to Welcome New Approaches to Chronic Pain

As discussed above, doctors and clinicians are often trained in old pain science. And even if they do understand the most recent pain science, they have had limited options which are both safe and consistently effective, or which are economically viable. In fact, given that both consumers and professionals often chose therapies that are covered by insurance, there is an economic disincentive to migrate away from current approaches because they get paid for. The drug companies are the one of the most significant influencers in healthcare and spend many millions in advertising and studies promoting their approach. The insurance reimbursement model has resulted in most clinical settings being forced to adopt a throughput model, leaving little time for patient consultation and education. All of this has combined to limit innovation and restrict understanding of chronic pain and new solutions to it.

#8) New Therapies May Require a New Model to Operate Sustainably

Given both limited understanding of more recent pain science, and economic drivers that perpetuate the status quo approaches, it seems reasonable that new, innovative therapies may also require innovative business delivery. Because of this reality, real disruption, as has been the case in many other industries will come from outside players. Starbucks changed the way we think of, experience and value coffee – they didn’t just try to sell a higher quality coffee to the local corner diner. AirBnB, Uber, Tesla, and other notable disruptors came from outside of their respective industries, bringing new thinking and perspectives to solve their industry problems in more effective and interesting ways. So it will be with the company that changes the way chronic pain is understood and treated, even if the old guard resists or lags behind. New innovation in both therapy and delivery is coming.

#9) The Most Direct Way to Treat Chronic Pain Is by Reprogramming the Brain

If chronic pain originates in the brain, what’s the most effective way of addressing it? Through the brain. In chronic pain, the brain becomes hypersensitized, sending signals to the body to emit a pain response even when there’s no immediate threat. This leads to a body that’s constantly generating a maladaptive pain response. Therapies that “retrain” the brain are more effective than simply masking it with a drug or addressing only the tissue.

#10) For Most People, Long-Term Relief from Chronic Pain is Possible But it Starts with Better Understanding

If you or someone you love suffers from chronic pain, you may feel that you’ve tried everything to improve the situation. Perhaps you’ve sunk into despair, feeling that nothing has truly worked, or you’re frustrated when no one has the answers you seek. This is an awful thing that in fact may make the pain experience even more difficult. Better solutions are coming, but they start with better understanding of pain. To this end, I have written a book called, Radiant Relief, A Case For A Better Solution To Chronic Pain. The book is an Amazon Best Seller, and explains all of these aspects presented here in more detail, but also lays out a vision for disruption. For the last four and half years, I have been building a new approach to chronic pain treatment through my company, Radiant Pain Relief Centres, which is changing the way chronic pain is understood and treated. For more information visit, www.radiantrelief.com.

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