Living With Chronic Pain – A Different Approach
Chronic pain affects more than 100 million American adults, according to the Institute of Medicine. That’s more than the total affected by heart disease, cancer and diabetes combined. A diagnosis of chronic pain spells trouble, as it implies that it cannot be cured– sort of like a perpetual, terminal illness. While chronic pain does not have the scary reputation of a terminal disease where one is told he has x-months left to live, it is nonetheless devastating to those who suffer from it; relentlessly sapping quality of life for years on end.
The conventional approach to chronic pain treatment is prescribing powerful drugs; i.e. opiod analgesics and non-steroidal anti-inflammatory medications (NSAIDs). But taking these powerful drugs comes at a price. For opiods, it’s addiction, nausea and constipation primarily; for NSAIDs, its gastrointestinal bleeding, increased heart attack risk and kidney damage.
But there is a school of thought that says what is really needed is a transformation in the way chronic pain is viewed.
A program at Mercy Hospital in Portland strives to do that by shifting chronic pain sufferers away from medication and toward behavioral therapy.
The Living Life Well Pain Rehabilitation program is a 12-week, group-based program that helps people learn to cope with chronic pain. Medical director Dr. Stephen Hull says it combines multiple strategies: behavioral therapy, medication management, and physical exercise. The goal at Living Life Well is less about reducing pain and more about helping people resume the activities that are important to them. Participants in the program see an average of about a 40 percent increase in function and a 20 percent improvement in pain.
According to Dr. Hull, when patients make a conscious effort to carry pain with them and move towards the people and things important to them, they actually do better. They have improved function and less pain– and it’s not clear which one enables the other. The pain becomes less of a directing force in their lives.
With pain, the natural tendency, encoded in our genes, is to stop doing the activity that causes it. This is a primitive protective mechanism, and is indeed one of the reasons we need pain. However, with chronic pain the damage has been done, and what people are dealing with is the residual effects of it. In other words, it’s like a perpetual fire alarm that continues to ring, despite the f ire being put out years ago, and all that is left is smoldering embers that are manageable.
So the strategy involves talking to patients and suggesting that they view their pain differently.
Joe Guarna, the program’s psychologist, spends hours in class teaching participants to stop interpreting their pain as a threat; that they can do many of the things they want– basically, make a strong, conscious effort to liberate themselves from their pain. When the patient embraces this and gives it her best effort, most of the time the results are positive. Call it psychosomatic, the power of mind over matter, or other nebulous phenomena of the human body, what matters most is that chronic pain patients get a part of their life back, without the help of powerful drugs that take away other parts of one’s life in exchange for pain relief, a trade more and more people are refusing to take.
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If you experience chronic pain, my suggestion is to talk to your doctor to see how much physical activity you can attempt without adding too much risk to aggravating your condition. You can also consider seeing a personal trainer at your local gym. Personal trainers have more hands-on training and intimate knowledge than most medical providers on the various ranges of motion of joints, muscle function, balance and strength, and they can evaluate your level of physical ability and recommend a customized program for you.
As always, cleansing the body’s tissues and organs is important in the battle against chronic pain. You want to do all that is within your power to give your body a fighting chance to heal and regenerate. Limit your diet to naturally occurring, organic food sources; eliminate overly processed food (which includes all wheat and grain-based food and added sugar and its derivatives); avoid environmental toxins in your environment (there are many!), get adequate rest, keep yourself busy, find a good cause, associate with positive people, and tell yourself you refuse to be hostage to your pain.
Lastly, Tai Chi, Qi Gong, yoga, conscious breathing exercises and meditation can be helpful in reducing the effects of chronic pain.
Dr. P
