10 things most people don’t understand about chronic pain

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Chronic pain is an epidemic, affecting an estimated 100 million people in the United States and beyond. Unfortunately, this affliction is poorly understood even by doctors and other health practitioners. Many people who suffer from chronic pain never attain long-term relief that’s free of side effects. 

The good news is that that doesn’t always 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 sticks around longer than is appropriate, or that grows beyond what is appropriate with or without a clear cause. This typically extends to pain that has been around for 3-6 months or longer, though there are exceptions.

Here are 10 things everyone should know about chronic pain and its sufferers.

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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 there. It does this so that you take action. You can remove your hand and avoid doing more damage to its 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. With chronic pain, the brain has become “wired” to expect pain regardless of what’s going on in any tissue. In fact, the pain expectation may limit full tissue healing and function.

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2. Chronic pain usually persists for 3-6 months

As described above, there are times when pain plays an essential role in our lives. It protects us from doing things that can cause further damage. When our bodies are functioning normally, the pain stops. For acute injuries, pain 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. Maybe an injury keeps hurting long after it’s healed. If the pain remains for more than 3 to 6 months, it’s usually an indication that the tissue is healthy, but that the brain continues to register pain.

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3. Chronic pain is regularly overlooked

The sad truth about chronic pain is that while millions of dollars are spent in an effort to cure fatal diseases, chronic pain research is underfunded. Why? Well, chronic pain doesn’t usually kill people, although they may die from related complications. For example, chronic pain may reduce mobility or compromise sleep, leading a variety of health complications from weight gain, cognitive impairment and other comorbidities. Few people die directly from chronic pain, though. 

Unfair as this may seem, it means that chronic pain suffers from a deficit of attention from the medical establishment, and that most doctors have a limited arsenal of tools with which to address it. Generally speaking, clinicians are trained in old pain science that dates to the 1960’s, but may not be familiar more recent methods.

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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 records life experiences to protect us if we find ourselves in harmful circumstances more than once. However, this recording system can manifest as a maladaptive response. These experiences can aggregate in the nervous system like charges on account. 

Chronic pain is less a cause-and-effect phenomenon 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 on 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.

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5. Pharmaceutical treatments can have side effects

We have known since ancient times that if we hurt, we can ingest substances like alcohol for short-term relief. The pain management industry was born primarily out of this approach: Effective in the short term, not so much in the long term.

While drugs can certainly reduce pain, they may also lead to a multitude of side effects. Patients can experience constipation, nausea or feel numb. 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.

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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 in 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, as with the credit card debt example, it is easier to understand why these therapies can be helpful, albeit not long-lasting.

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7. The medical establishment isn’t ready to welcome new chronic pain treatments

As mentioned above, doctors and clinicians are often trained in old pain science. Even if they do understand more recent methods, they often have to choose between methods that are effective and methods that are economical. 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 approach because they get paid more.

The drug industry is one of the most significant influencers in healthcare and spends millions to cement that advantage. 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. The industry is thus short on new solutions.

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8. New therapies may require new models to operate sustainability

Given limited understanding of recent pain science, as well as economic drivers that perpetuate the status quo, it seems reasonable to assume 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. It didn’t just try to sell a higher quality coffee than the local corner diner. AirBnB, Uber, Tesla, and other notable disruptors came from outside of their respective industries as well.

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.

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9. The most direct treatment for chronic pain is to reprogram the brain

If chronic pain originates in the brain, what’s the most effective way of addressing it? Through the brain. with chronic pain, the brain becomes hyper-sensitized, 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.

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10. Long-term relief 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 sunken into despair or are frustrated that no one has the answers you seek. This is an awful reality that may make the pain experience even more difficult. 

Better solutions are coming, but they start with better understanding of pain. Only by communicating closely with chronic pain sufferers and empathizing with their ordeal can we begin to give these patients a better tomorrow.

The author, P. Brendon Lundberg, is a previous chronic pain sufferer with deep experience in healthcare management, marketing, business development and sales. He also is the author of Radiant Relief, A Case For A Better Solution To Chronic Pain.

This article was syndicated by MediaFeed.org.

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