The Chronic Pain Solution

Six Myths That Can Keep You From Healing

Myth #1: You Just Have To Learn To Live With It

This is a line most chronic-pain patients have heard at some point from a doctor or caregiver. It’s usually said in an exasperated tone, implying one of two things, or both: (1) the physician has run through all the available options and there is simply nothing more to be done, or (2) the patient is being unreasonable and demanding in the search for pain relief.

In reality, there is an extraordinary number of therapies that can drastically reduce your pain or limit its effect on your life. Take America’s preferred method of pain relief: painkillers. If you’ve tried a conventional drug that worked but gave you intolerable side effects, you don’t need to give up. Other drugs in that same class of medications might well have a very different effect on your internal chemistry. Or you can try a drug from one of the other classes of pharmaceuticals. With a half dozen or so classes of pain-modifying medications to choose from, why some physicians give up after trying just one or two is beyond me. You might need to tolerate a little trial and error, but isn’t that preferable to just living with it?

Or perhaps drugs aren’t the best form of treatment for you. Some form of hands-on therapy, such as acupuncture, massage, or yoga, may ease your pain much more efficiently and pleasantly. The main thing to keep in mind is that there are more pathways to pain control, many more, than even your doctor may know.

Let’s also debunk the myth that the patient who doesn’t accept pain is being whiny or is putting too many demands on the doctor. Now, I’m certainly not going to encourage people to be rude to their physicians. We doctors work hard, and we appreciate consideration and kindness as much as anyone. But one key to getting good relief is persistence. If your doctor makes you feel like a pest for asking about pain control, I strongly suggest you find another one. The impulse to feel better is natural and healing. If you’re told that there’s no use in trying, you’re likely to feel something even worse than pain: helplessness. People who feel helpless tend to withdraw from the world, stop trying to eat right, stop making the effort to see friends or to do the things they love. Their lives become terribly unbalanced, and their natural bodily defenses weaken. They get sicker, and they hurt more. By contrast, a hopeful outlook, or even a stubborn attitude, can go a long way toward improving your health.

Myth #2: It’s All In Your Head

It really hurts to be accused of faking your pain, or to be told that it’s solely the result of some psychological problem. Then you’ve got anger, or worse, guilt, heaped atop your suffering.

This myth persists because pain is invisible. When people have diabetes, doctors can give them a concrete number, one that represents blood sugar, to explain their mood swings, thirst, and other symptoms. If you have heart problems, doctors will say: “No wonder you’ve been fatigued lately. Your arteries are ninety percent blocked.”But if you have pain, no one can legitimize your suffering with a number or a scan or a picture.

This myth is also based on a misperception about how pain works. Most people, doctors included, assume that pain is always the result of damage to the body’s tissues. They also believe that the amount of pain you feel directly corresponds to the extent of the damage. The fact is that many people with chronic pain don’t have any injury or illness that explains the pain’s severity. But that doesn’t make the pain any less real.

Chapter 3 will talk about the new model of pain. I won’t go into the details here, but we now understand that pain is a complex condition that involves many systems of your body, not just the part that’s hurting. Your nerves, your neurotransmitters, endorphins and other chemicals, and your mind and brain are all involved as well. If one of these starts misbehaving, you may well have pain, even if you don’t have an injury. Yes, bodily pain can be an expression of emotional suffering. That doesn’t mean the pain is made up. In these cases, neurons are indeed firing pain signals, chemicals are facilitating that message, and other physical factors are very much present.

Don’t let this myth keep you from using the power of your mind. Some people avoid mind-body therapies, thinking that they work only for people whose pain is purely psychic. In doing so, they’re denying themselves an important source of relief. Although your pain is real, it, like everything else in your body, is greatly affected by the workings of your mind. Your brain and your spirit are some of your most powerful tools for pain control. Even people with the most obviously devastating injuries, such as soldiers wounded on the battlefield, have been documented using their minds to reduce or even completely block pain.

Myth #3: Why Can’t You Take It? It’s Just Pain

Hey, it’s not like you have ______”(fill in the blank with any of the following: heart disease, pneumonia, a broken neck). People who utter these words believe that you should just dismiss pain and sweep it right out of your mind. They don’t understand that pain goes beyond a mere physical sensation; they don’t see that pain has the power to change your relationship to the world, to grip your mind and soul.

Let me make an exception here. Sometimes pain can wind people up so tightly that they stop thinking about anything else. They become exclusively focused on their disorder. In these cases, it can be helpful to say, gently, kindly, “It’s just pain.”This is a compassionate act of putting pain in perspective for a person who’s fallen into a downward spiral, who has come to equate pain with the worst possible of human experiences. From time to time you may need to remind yourself that it’s not death, it’s not the loss of a loved one; life will indeed go on, even if it’s not the life you had before. In the end, you decide how much quality there is to that life.

Myth #4: If I Hurt, My Body Must Be In Danger

Pain is one of the most powerful of human experiences. It’s meant to get our attention: to pull our hand out of the fire, pry the splinter loose from our foot, rush to the hospital to have our appendix removed. It’s natural, and life-preserving, for us to feel that pain signals danger, and that the more pain there is, the graver the danger. The reality is that when pain is chronic, all bets are off. Of course, many progressive diseases such as muscular dystrophy and cancer produce continuing damage that’s quite painful. But as I’ve pointed out above, pain doesn’t always represent ongoing physical harm. It may be the result of a nervous system firing off erroneous messages, or of your body’s inability to produce its natural painkilling substances, to name just two possibilities. This is especially likely for people whose pain has inexplicably continued after an injury has healed, or whose level of discomfort seems inappropriate for their disorder.

The fear of damage and illness that naturally attends pain may alter your nervous system so that you hurt even more. That tense state of “pain alert”can also give you headaches, insomnia, digestive troubles, and other woes. Knowing that pain is not actually harming your body may not eliminate it. But if you can disconnect anxiety and tension from the hurt, you’re on the path to significant relief.

Myth #5: There Is One Special Doctor/Pill/High-Tech Procedure/Alternative Method Out There That Will Stop My Pain

This is the magic-bullet theory of pain relief, and its refrains go something like this: “I have to keep trying new doctors until I find the one that will fix me once and for all.” “There’s an herb that’s supposed to take away pain. I’m sending in my money today.” “This painkiller doesn’t work. I took it and I still feel some tenderness in my muscles.”

For most of our lives, we go to see doctors when we’re sick. They give us a pill or perform a procedure, and we feel better. If we have a bacterial infection, we get an antibiotic. If we have a blockage in our arteries, a surgeon performs an angioplasty to reopen the blood vessels. We’ve grown accustomed to this one-to-one correspondence: one illness, one treatment.

But chronic pain isn’t like other disorders. In most cases, there isn’t one single problem we can point to, such as a bacterium or a blockage or a malfunction in enzyme production. That makes diagnosis difficult and sometimes even impossible. Chronic pain is usually the result of several things going awry, mechanical, chemical, and neurological, and it also is affected by the state of your soul. There’s rarely one simple solution that can penetrate to all the layers of pain. If someone promises you a cure-all for pain or tries to sell you a “miracle” potion, I’d advise you to run the other way (and alert the Better Business Bureau).

The solution this book offers is integrative medicine, the combination of conventional and alternative therapies. Each of your treatments will have an aspect of your pain written on it. But just as the alchemy of baking transforms ordinary flour, sugar, butter, eggs, and heat into a glorious birthday cake, a group of well-chosen therapies is more than the sum total of massages and injections and breathing exercises. There’s a synergy among the treatments that adds up to something bigger, to your very own chronic pain solution.

Myth #6: A Life With Pain Isn’t Worth Living

The goal of this book is to help you control pain. I have every confidence you can do it; I’ve seen it happen for thousands of people. The techniques and knowledge exist. But it’s possible that your pain won’t completely disappear. Lots of programs promise a “pain-free life”or say that they will cure your pain. You may have tried them, and if so, you know that they don’t fulfill those promises.

I think it’s important to ask yourself at the outset: What will you do, and how will you feel, if your pain doesn’t completely disappear? It may be that you can cut your pain by three-quarters or one-half. The quality may change from an unbearable piercing sensation to a more tolerable ache. Or you might go from having pain all the time to having periodic flare-ups. But you may still have some pain.

A good strategy when you’re faced with pain is to break the experience into two parts: the pain itself, and the suffering, the havoc pain wreaks on your life. Pain causes suffering when it takes away your focus, your ability to perform tasks, and your control over your emotions. After experimenting with the therapies in this book, you may still have some physical pain. But your suffering may be nearly eliminated. Maybe you’ll be able to play with your grandkids again, or attend parties, or make your bed in the morning, even though once those activities were out of the question. Maybe you’ll feel more like your old self again. When these things happen, your life is significantly better and more satisfying. That’s the ultimate goal of treatment.