Article
Why Your Doctor Hasn't Cured Your Chronic Pain
Written by Dr. Huggins
You’ve been on the medical merry-go-round for years; My favorite term for the cycling of medical doctors and treatments people go through in the often desperate search for a cure for their chronic pain.
Some people say it’s the most frustrating part of having chronic pain. If there were just one frustration.
The Snowball Effect
Instead of just one frustration, chronic pain is what seems to be an endless cycle of challenges; a series of frustrations.
Another one is the difficulty it is to treat this type of pain medically. Many find that one treatment ‘works,’ only to fall short later. Or, a treatment works sort of or partially, if we’re lucky.
Sound depressing? It certainly is for many suffering from chronic, or persistent, a term I prefer, pain.
Doctors often don’t know why a person has chronic pain or what to do about it.
With the best of intentions, doctors sometimes help to keep people with persistent pain on the medical merry-go-round, gaining snow on the snowball of pain, longer than they may have needed.
Why doesn’t my doctor know how to treat my pain effectively?
It comes down to training. How are doctors traditionally trained?
To look at problems in the body and fix them.
A Robot with a Series of Parts
When considering chronic pain, doctors can sometimes relate to the body as if it were a robot with a series of parts that may be deemed as broken when viewing the pain from a purely biomedical perspective.
The problem is, we’re definitely NOT robots. We’re thinking, feeling, behaving humans, and chronic pain is a thinking, feeling, behaving problem, it turns out.
In the case of chronic pain, we may hear some of the following from doctors:
Your pain is due to this or that structural abnormality on your MRI.
You have Fibromyalgia. There is no cure; we can only manage the symptoms.
You have migraines, we can try [insert a slew of medications], and we don’t know how to cure migraines; they’re often a chronic problem.
We don’t know why you have pain; you’re going to have to learn to cope/manage/live with it.
If you’re like me, these medical statements can be downright scary!
It’s important to know that:
Chronic pain can rarely be narrowed down to ONE factor.
What we are learning about chronic pain is that the “pain generator” concept: “You have pain because of X,” generally doesn’t add up.
Acute pain is very different than chronic pain.
With acute, or temporary pain, “You have pain because of X” DOES add up!
For example, a broken arm is an example of acute pain. Doctors do very well in diagnosing and fixing acute pain.
BUT, Chronic pain is not acute pain. In fact, it’s a completely different animal!
The problem we run into is that most doctors and people with chronic pain continue to think about, react to, and treat chronic pain as if it's acute. Hence, the medical merry-go-round and the rolling snowball effect.
What do we know? What can help you with chronic pain NOW?
The first thing that will help you turn the pain train around is to STOP thinking about it like it’s acute pain, and focus on the pain generator, or the ONE FACTOR that you believe, or have been told, is wholly responsible for your pain.
Said another way, it is to begin to understand that this type of pain is much more complex.
What does Complex Pain Mean?
Chronic pain can also be called “Complex Pain” in that we now know that it is maintained and increased/decreased by MULTIPLE FACTORS, many of which are psycho-social in nature, such as the thoughts we have, most specifically about the pain, our emotional world, behaviors, lifestyle, and what are called psycho-social stressors, or issues in our lives, like job, relationship, or financial stress.
THE BRAIN AND PAIN
We also know that once pain has gone on for longer than 3-6 months, called chronic pain, the brain/nervous system plays a HUGE role in its persistence, and the pain becomes a nervous system problem above & beyond anything else.
Are you saying the pain is “All in my Head?”
No. But I am saying the pain is in the brain.
The brain is the organ that sends the pain signal down into the body, where you feel pain, and that signal comes back up to the brain, where the pain is processed and understood.
With acute pain, this is no big deal. The centers of the brain that fire when we are in acute pain are very different than the brain areas that fire when we are in chronic pain. With chronic pain, we know now that several different areas of the brain fire than is the case when we have acute pain; specifically, brain regions responsible for the processing of emotions.
We also know that the thoughts and emotional reactions we have to this type of pain fire up the nervous system BIG TIME, creating more pain, and other problems commonly associated with pain, like depression and anxiety.
With chronic pain… “The mind/brain plays a crucial role in what you feel.” – Dr. David Schechter from the book Think Away Your Pain.
Begin to consider this, perhaps a very new concept. Your pain is real and it is a multifactorial problem.
Could it be possible that the beliefs you’ve been holding about your pain could be keeping you stuck?