We have a deathly fear of pain in the Western world today. At the slightest hint of it we reach for the medication and head for a consultation with Dr Google. Could it be cancer? Might it be MS? Am I having an attack of angina? Our minds have made their way halfway to A&E before we remember that, oh yes, I did spend the whole day sat hunched over my laptop yesterday so perhaps that’s why I have a headache rather than a brain tumour.
Whether it’s the psychological pain of depression or anxiety, the physical pain of a herniated disc, or the whole-family pain of Alzheimer’s, our immediate instinct is to reach for the pills. Time-pressured GPs have less than 10 minutes per patient to greet, speak, and treat. That is by no stretch of the imagination long enough, either for the doctor or the patient. Most GPs feel that the best they can do for many patients in these situations is simply to decide a) is this a prescribable problem and b) what should I prescribe. If it’s not, the remaining minute or two of the consultation gives scant opportunity to consider or discuss alternative treatment options or even to fully explore a more specific diagnosis.
Our collective terror of pain is preventing us from hearing what our pain is trying to tell us.
If we immediately reach for the anti-depressants to stop us feeling, and if, as is sadly so often the case, we get ‘stuck’ on them, we are deprived from hearing many of the messages that sit behind our pain. Is it completely understandable that someone in distress wants to have it taken away, even if just by applying a pharmaceutical plaster? Yes! Is it understandable that doctors might want to meet that need – especially where the waiting list for alternative therapies such as CBT is long and the patient is desperate for something, anything? Yes! Is this, overall, the best way to feel into our pain and give us the best chance to fix it? No, I don’t think so.
By the time a patient with a chronic (long-standing) complex (having multiple underlying causes) comes to Core Clinics, they have become experts in pain; suffering from it, trying to manage it, trying different things to fix it, having it take over their lives, trying to treat it. All too often the treatment approaches that they have been recommended to try to seem to work, to an extent, for a while…but then the problem either returns in the same spot or pops up somewhere else in the body, like a symptom-chasing game of whack a mole. We regularly see patients who have had spinal surgery but are still in pain. Hip replacements but now have knee and back pain. They’re chasing the pain, chasing it away, instead of listening to it. It’s not their fault – it’s what many healthcare practitioners do too until they eventually get to the end of the line and say ‘there’s nothing more we can do’. Not what you want to hear when you’re still in pain and trying to have a life.
All too often doctors and other clinicians look at the pain itself and try to manage it by using drugs to make the brain think it’s not there. It’s like thinking you’ve fixed the fault in your car engine because you’ve stuck a plastic over the furiously flashing light on your dashboard.
Pain is the warning light on your dashboard. Think about that.
It doesn’t necessarily signify disaster. It might be a small electrical fault. It might be that your car’s trip computer needs a service. It might be the start of a small but treatable problem in the engine. Or it might be an urgent warning that your car is about to blow up.
If you only look at the pain warning light and you only cover it up with a pharmaceutical plaster, you are not looking under the bonnet to understand what’s causing the pain and whether you need a wire replacing or an ambulance to A&E.
Pain is a gift. Yep, I just said that.
Imagine a world where you couldn’t feel pain. There are some poor souls who suffer from a rare condition that causes them to be unable to feel pain at all, or in specific ways. Life is pretty bloody difficult and hellish for them. You could break a limb and not know it. Accidentally cut half your finger off with the paring knife and not realise until you notice a pool of blood on the kitchen counter. You’d have no idea that you were developing a serious health problem until it had just about killed you.
Pain is your mind’s and your body’s way of getting your attention so that you can take action to help yourself survive (if it’s the pain of a heart attack) or thrive (if it’s recurring headaches).
If you suffer from pain on a chronic basis, your best and only hope to heal is to get to the bottom of what is causing and sustaining that pain. It can be a complicated business to work out, and Dr Google is not your friend (or your doctor) in these cases. Ask people you know and trust, who have had similar pain or symptoms, if they have been helped by anyone. Go in search of someone who specialises – really specialises – in the type of pain in the type of places that you think you are suffering with. Go to someone who has successfully treated lots of people who have pain problems like yours. And by treated, I mean ‘healed’ not ‘cured’.
In our work with thousands of patients suffering from chronic back pain, we have identified a number of common pain patterns where pain experienced in different ways and different places around the body tend to be associated to a fairly homogenous combination of underlying causes. Having identified and treated each of those causes we set in motion a domino-run of healing within the body. Of course, there is the odd ‘shit happens’ case here and there where another random factor eludes us and we don’t get the full hoped-for result. But even in those cases, we can usually make a significant improvement.
So, if you’re in pain, or next time you’re in pain, don’t be so quick to pop a pill or panic. If it’s sudden and ominous, a potential sign of a heart attack, stroke or another emergency, then dial 999. If it’s not, then sit with it for a moment and listen to what it’s telling you. Most of us aren’t very good at reading our own pain after a lifetime of trying to ignore it and silence it. So if you’re struggling to hear, or you can hear but you don’t know what it’s saying, go and get help from someone who can interpret that kind of pain.
That’s what we do at Core Clinics. Every day. And that’s how we work with pain and through pain to change lives.