Dear readers,
If I had to start my medical career from scratch, I’d devote more time to studying chronic pain. Specifically, I’d want to arm myself with more and better tools for alleviating it.
Over the years, I had many patients with chronic pain, and my success at treating them was spotty. Pain relievers were helpful–sometimes. Physical therapy and acupuncture were helpful–sometimes. A pain-management referral was helpful–sometimes. A conversation about past emotional traumas was helpful–sometimes.
But there were patients whom nothing seemed to help. Patients whose X-rays and CT scans and MRIs were often unrevealing. Patients whose pain migrated from one body part to another. Patients who insisted that something was wrong, while my investigations produced few answers.
The only thing definitely amiss was the pain they were feeling–pain just as real and severe as the pain I experience when I bang my head or stub my toe.
For those patients, I would encourage distraction and meditation. “Ignore the pain,” I’d tell them. Or “Welcome the pain in. You are bigger than your pain.”
I personally find ignoring pain to be a useful strategy. I grew up in a culture where boys were supposed to ignore pain.
What was I told when I hurt myself playing football? “Just rub some dirt on it.” Not exactly hygienic, but therapeutic, nonetheless.
The reality is that most pain does go away by itself. And it lingers if you dwell on it.
“The emergency-room doctor told me that my spine is crooked,” a patient with back pain would tell me.
“Everyone’s spine is crooked,” I’d say. “Your spine is normal. That’s not what’s causing your pain. Back pain is common. Your pain will get better with time. Trust me.”
My thinking was influenced by John Sarno, a rehabilitation doctor, now deceased, who worked at the Rusk Institute in New York where I spent a month shadowing him as a medical student.
Patients with chronic back pain would come to him bearing MRIs, which he would look at and toss to the side. Dr. Sarno believed that most chronic back pain was a defense mechanism–that the back was fine, and that the real pain was situated somewhere else.
“Your back is strong,” he would tell his patients. He’d explain that their pain wasn’t caused by defective anatomy. Rather, their pain was a coping mechanism: Their body was using physical pain to distract them from emotional pain. The solution to their pain was to believe in their back’s soundness–“Go ahead, do sports,” he’d tell them–and to address those issues that were gnawing at their souls.
He helped a lot of people–but not everyone.
I had a colleague who consulted with him and who wanted to believe, but did not get relief. He improved when he finally underwent spinal surgery.
Another colleague developed back pain severe enough to keep her out of work. She’d never experienced back pain before. Imaging studies were unrevealing. It was a mystery. Was stress the cause?
And then she developed jaundice, an ominous sign. It turned out that she had pancreatic cancer.
So while I’m a great believer in ignoring pain, there are times when that’s not such a good idea. And it’s easy to tell someone to ignore chronic pain when you’ve never suffered from it.
When I imagine having chronic pain, I think of driving down a rutted road, with my nervous system firing pain signals over and over, and no matter how violently I twist the steering wheel, the car just won’t veer back to smooth, level. ground.
What would it be like to have no choice but to accept this path of grueling pain?
This month’s More Voices theme is Chronic Pain. What’s been your experiencing suffering from chronic pain, treating chronic pain or living with a loved one who experiences chronic pain?
Share your story using the More Voices Submission Form. For more details, visit More Voices FAQs. And have a look at last month’s theme: Disability.
Remember, your story should be 40-400 words. And no poetry, please.
We look forward to hearing from you. And thanks for being a part of the Pulse community.
Warmly,
Paul Gross
Editor