If you are one of the millions of people who struggle with chronic pain, then there is a good chance this is a question you have asked yourself many times. “Why won’t my doctor believe me?” “Why won’t my family believe me?” “Am I going crazy?”
Well, you are not alone in asking these questions. Chronic pain can be very difficult to live with, but equally difficult to understand for a lot of people that don’t personally experience it. This even includes the medical professional you may seek out in order to get help with this daily struggle.
Current trends in treatment
The truth is that a lot of the medical community has not educated themselves on the recent findings regarding the mechanisms behind chronic pain. When addressing an issue, modern medicine typically uses the Biomedical Model. This model focuses on finding the physical problem and trying to fix that problem. This model works great for people who have an acute problem such as a muscle, joint, organ or any kind of “tissue issue” that simply needs to heal or be repaired.
But what about the people whose “tissue issue” has had time to heal or has been repaired, but continue to live in persistent pain? Doctors and therapists may still be seeking to find a tissue problem for a patient’s pain but sometimes to no avail. This patient may end up with many different diagnoses and many different treatments. Some treatments may have slightly helped but the problem seems to remain unresolved.
Tissue issue vs. Pain issue
Chances are the “tissue issue” has become a “pain issue.” Over the last 20 years, there has been a great deal of research in the area of chronic pain. We have a much better understanding of how the body adapts and actually becomes better at producing pain. This adaptation manifests itself as physical and/or chemical changes within a persons’ nervous system, which includes the 40 miles of nerves throughout your body, your spinal cord, and your brain.
When physical and chemical adaptations occur within your nervous system, your body becomes much more efficient at interpreting non-dangerous signals as threatening. Pain can be a good thing, in that it acts as an alarm to keep you safe by warning you of potential or actual tissue damage. However, our nerves can become too sensitive and cause that alarm to go off constantly, for even the most insignificant of reasons. When the alarm becomes too sensitive, it can cause confusion for you, your family/friends, and even your medical providers.
Thankfully we now understand better how to handle a “pain issue” as well as a “tissue issue.” This field of study is relatively new and the medical community is still learning about it. Most university medical programs do not yet include this study in their curriculum. It is up to the professional to get specialized training, once they begin practicing in their prospective field. It is becoming more prevalent among practitioners each year and will continue to grow. Unfortunately there are millions of people that need help now.
As mentioned above, the main model of treatment was the Biomedical model. In recent years there has a been more of a push to use what is called the Bio-Psycho-Social Model. We now understand that when dealing with someone’s health, we need to address many aspects. These aspects include the biological, emotional, cognitive, social, and spiritual components to one’s well-being. When treating chronic pain, we now understand that ones’ biology, thought processes, and emotions all work together to drive the pain processes.
Treatment for Chronic Pain
A proper pain treatment program is going to involve education to help answer questions you have about your pain. Such questions include, “Why is my pain so bad when other people say I shouldn’t be in pain?”, “Why does my pain move around to different areas?”, “Why am I so tired all the time?” and “Why have I had multiple surgeries, yet my pain is just as bad or worse than before?” Research has shown that when you understand more about your pain, the threat from pain becomes less. Your nervous system becomes less agitated.
Your treatments should also include movement and exercise. This is the area that requires skill and patience on the part of your physical therapist. They must properly grade your activity to avoid a constant cycle of good days and really bad days. We lovingly refer to this as the “Boom-Bust Cycle.” Other therapy includes meditation, mindfulness training, cognitive-behavioral therapy or sleep hygiene training. There are even techniques to exercise the areas in your brain that control movement without actually moving your body. This is helpful for people that have high anxiety or pain with even the smallest movements of certain areas.
So as you can see, there are lots of options when it comes to treating chronic pain. The amazing and hopeful part is that there are many more than the ones listed here. The clinicians that partner with you on your pain journey will need to understand you and your symptoms. Then they can provide you the best modes and sequence of treatment.
Hope for the future
You may be someone who has seen multiple professionals, received multiple diagnoses and heard many explanations for your pain. Yet, you may feel you have made little progress or know there is something more to your problem. I invite you to not give up. Your medical community is accepting the challenge to help those who are misunderstood and possibly misdiagnosed. We see the need and there are professionals out there who can and are willing to help you. There is HOPE!
Jeff Mullins, PTA, Therapeutic Pain Specialist
Hope Rehab Katy