I understand a lot of the criticism of this article, as a "pain survivor." Physical therapy, opioids, and finally, major spine surgery addressed a lot of my pain. They are not for everyone, (PT maybe is) but they got me over the hurdle of devastating 24/7 pain. But over the five years following surgery, I continued to have myofascial pain across my entire back. Reading compulsively about pain and treatments, and exercising in spite of the pain, got me to where I am today - virtually pain-free in my 50s. It won't work for everyone, I get that, but finding something I loved (zumba and samba class, after my physical therapist recommended dance... since she told me I shouldn't do basically everything I used to do) and building in the time for a hot bath and a nap after class, and opioids if necessary, took me from pain to recovery.
What I do hate, and what is not in this article is the old "pain is caused by stressed, so just calm down." I don't think that is what this article is saying. And I can guarantee that I resolved my pain while stressed out - as a bank lawyer, during the financial crisis, while my mother was dying. I kind of think dance saved my life....
I am not fooled by the pseudoscience promulgated by this article. Nor does it disguise its agenda of removing the only effective pain relief available. Namely, opioid pain medications. More than two thousand years have passed since the discovery of serious pain relief afforded by plant based narcotics. Now, because the medicine many of use require can also, in stronger doses, kill the patient, all manner of "do-gooders" seek to have them banned for all but terminal cancer patients yet again. And yet, it is this thoughtless attitude of prohibition that will force many chronic pain sufferers away from the care of a qualified specialist, and carefully manufactured pain medicine, and straight INTO the grip of the heroin dealer, and their God-knows-what packets. THAT is the reason that most people who die of opioid overdose do so as a direct result of street drugs, NOT prescribed opioid pain medication. The VAST MAJORITY of patients under a pain management specialist's care, do NOT fall into addiction and overdose. We are content and gratefully for the relief that these medicines provide. Absent such care, many of my fellow chronic pain sufferers would be unable to work, and would be utterly bed ridden. Faced with that prospect, many of us would have taken our own lives rather than become a burden. So before all of you well wishers force that choice upon us, make sure you are ready to live with the consequences of your ill-informed decisions.
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Thank You, well said@Indrid Cold
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As someone with spinal stenosis (C3/C4) and a person with chronic pain and chronic regional pain syndrome, it is so easy for people to say not to be afraid of pain. I am well aware that the pain I feel is not related to damage--the main function of pain--and that movements will not cause injury. That said, sometimes there is only so much many ice packs, heating pads, PT exercises, yoga, and soothing videos that help. I do not take opiates as I cannot tolerate them but I can understand how people get addicted. Knowing that use won't make the injury worse doesn't always help when you can't even hold your cell phone in your affected hand.
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I highly recommend googling Lorimer Mosley and Explain Pain. He has made videos that clearly talks about our body's response to pain.
The pain we feel is real based on our brain's message but the message may no longer true and that is what needs to be worked on to reduce chronic pain.
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it took years but once I discovered that pain hurts regardless and it 's just trying to get a message to the brain, I began to take the special muscle exercises seriously. Walking and cycling I did more religiously and , though I will never be pain free-(Not till I'm dead, anyway)- my pain in the various spots once affected is far less severe.
I FOUND that the best I can do is learn to live with it and to look upon it as a be-cursed, unhappy but permanent problem, which can be partly made to recede some, by judicious use of anti pyretics, exercise and careful muscle building: adults tend to lose a good 1 lb or more of muscle each year after they age out of baby making It is for this reason we end up skinny even when we overeat. Cars are never an answer. If i could, I'd tell folk to walk where they must & rather then fly, use a train. Airplanes destroy our planet as well as not being needed. We could save the Earth and get where we need to be with sails or, if absolutely necessary, in dirigible zeppelin type craft powered by electric motors that use H2,(hydrogen gas, to make electricity to run the motors-NASA did!
we could use sails to move our zeppelins. Anything but gas or alcohol.
See how much cleaner the skies were after 1 week of no flying after the 9/11 01? Humans reached an apogee of development in 1900-we CAN go back to the future-just bring along our clean and efficient 2nd Generation nuclear power plants! It is all in print-all public , on the net!-
Weights and or exercise never worked for me, no matter how much of either i did. But the Feldenkrais method has been a revelation. I recommend it.
A bonus is that it is a relatively gentle thing, and often, it involves laying down, and moving gently, so that chronic pain sufferers need not feel intimidated. At the age of 50 i am pain free for the first time in my adult life.
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There is extensive research being done about chronic pain by the International Spine & Pain Institute (ISPI).
ISPI has certified practitioners in Therapeutic Neuroscience Education, you can find them listed on their web site.
There is help available for severe pain.
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Just because they are doing "research' does not mean any of it is valid or meaningfull@Chris C
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So how do you explain being woken up from a deep sleep from severe pain. A lot of us deal with that. Your brain doesn't just turn off awareness of severe pain when you sleep.
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Ok, JJ, so it doesn't work in every case, just some cases. Sorry. Researchers should figure out which ones. And I can't explain any of it, that's the point. Sorry about your chronic pain.
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Yes let me just ignore pain while it causes me to involuntarily throw up what food I have managed to eat. Don't worry about me I'll be quiet about it and not bother anyone.
Gee why didn't I realize that would help me sooner?
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I have been a pain management physician for 30 years and we already knew everything this study reported when I began my career.
I hope Ms. Malfliet doesn't believe she discovered anything new when saying patients with pain should stay active. I've always emphasized to patients that if they don't do this, they've given up any chance of the pain getting better.
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I can see this working for the mild pain but this like almost everything else out therr has nothing to do with people who have severe pain. Despite that, many people will read about this small study and assume it means no one actually needs pain medication. I know exactly where my pain comes from- poorly done surgeries for a birth defect I was born with and early wear in my joints and muscles from trying to be as active as I could. Knowing where the pain comes from, how pain works ect does NOTHING. I had more surgeries in my first decade than most people have in a lifetime. The general public and the majority of doctors never experience this level of pain but seem to think they can apply what works for mild to moderate pain to the whole different entity of severe pain. The next time you tell someone to try an "alternative" to pain medication consider what you would do if you were in 24/7 pain that led you to wake up crying every morning after the measly 2 hours of sleep you got and left you huddled in bed dry heaving because there is nothing to throw up since you are in too much pain to eat. I have tried other approaches and the choices I am left with are opiods that I can have a functional, happy life with or bawling and gagging all day long from pain until I die. I wish we saw more supportive articles for people in severe pain rather than ones stating the obvious-if you have mild pain lifestyle intervention can help. What a breakthrough.
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I have a painful connective tissue disorder. For the most part, I know how much and in what way my activities will cause pain, and I just accept it.
OTOH, there are rare times when my pain is so severe that am consumed—can’t think rationally or speak coherently. I experience flashes and jolts of pain like a torturer has attached electrodes and turned the voltage up high. Many people live like that all the time.
I don’t live in fear, but I do live in awareness that pain like that is possible, that I am merely fortunate not to experience it 24/7—and that those who have not experienced it will continue to deny that it is a valid medical problem that requires a medical solution.
People can ignore moderate pain. Severe pain requires real treatment, not mental gymnastics.
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@Abby I also suffer from pain due to a connective tissue disorder. Ehler Danlos Syndrome + Mast Cell Activation + Chronic Fatigue. Over exertion leads me to initially have a honey moon period, where the pain is better tolerated. And then the fatigue hits, and it feels as if there is a "short-circuit"/mini-explosion along the nerve conduction fibre. Other than analgesia, I feel that activity, emotional state and diet have the biggest impact on my pain experience.
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Since opioids are such a scourge, I guess we can just wish the pain away. Sounds like an insulting dodge. My doctor is on board. Sometimes it hurts to get out of a chair. He recommends a heating pad and ben-gay. This is treatment avoidance. "Staying active and moving" is a consummation devoutly to be wished, for I need to lose weight. But the more I move the worse the pain gets. Guess I just need an attitude adjustment. The pain must just be all in my head.
As an aside, the cracking down on narcotic painkillers will have little effect on trafficking or abuse. It will only hurt people in genuine need. Abuse happens when doctors don't know how to prescribe these drugs and patients don't know how to take them.
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Considering that there is no research demonstrating that opioids are beneficial for chronic pain, you can obtain just as good results from wishing the pain away as from taking opioids and with a lot less risk of side effects.
And by the way, even if your doctor is not aware of it, there are many effective non-opioid treatments for the most common form of chronic pain.
As to weight loss, there are only two ways to do this: exercise and reduction of calorie intake, especially the latter.
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Pain is all in your head because that's where you experience it. And if you don't believe this, find someone who is paraplegic and ask if you can strike them on the foot and see how much pain they feel.
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( Fred's wife here ) As a retired RN, I found that many of my former patients who took opioids, received quite a bit of relief from their chronic pain. I've taken opioids for acute pain and they worked extremely well. Fortunately, I only needed them for a few days.
Sadly, these days, people who live in severe pain are judge harshly and denied the drugs that often increase their qualify of life.
I live with chronic arthritis pain. It's not usually severe and I only take small doses of an NSAID to take the edge off of the pain. I agree that exercise does help decrease pain, but in some cases, people are either unable to exercise or their pain is so severe that the activity only worsens the pain. But, I would agree that remaining totally inactive probably worsens the pain, and exercise often helps mild to moderate pain.
And, people are different. My father suffered from severe pain for the last 20 years of his life. He claimed that his narcotic pain relievers didn't help, but when he stopped taking them, the pain was intolerable, so he always resumed taking them, despite hating them. My mother on the other hand, has always been able to focus on things other than her pain, but I have never met anyone with such a high tolerance to pain than her. So, I don't think we can judge everyone by her ability to deny pain.
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I was diagnosed with CRPS 1/RSD (complex regional pain syndrome, Type 1/reflex sympathetic dystrophy) 9 years ago after
falling down a flight of slate stairs in a restaurant, which resulted in 4 broken bones, one of which resulted from such a severe ankle sprain that it tore off the end of a bone over the top of the foot. The real problem, though, turned out to be the damage of nerves along the outside of the foot. There is no cure, and it is a progressive curse, following the course through with the additional complications resulting in severe muscle contractions, affected circulation, inability to regulate body temps, and the ever present, never ending severe pain.
I have tried spinal blocks, opioids (one at night to get sleep, but they really don't affect chronic pain), many other meds, meditation, acupuncture, and a pain clinic which included physical therapy and sessions with a rehab neuro psychologist.
I live in fear of further accidents/incidents which will result in surgery or broken bones and additional pain as the illness creeps into other areas of the body.
If you think many people live with nerve pain in their feet, and so on, and thus, not a big deal, consider the pain you feel when you have a tooth ache or accidentally hit your "funny bone" in your elbow. Then consider having that pain 24/7. Think you would be afraid?
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I hope you realize this is the only life you're going to get. So you can do nothing for the rest of your life which, by the way, eliminates any chance that your pain will get better as this is the only predictive factor we've found for improvement in any chronic pain condition including CRPS. Or you can deal with the pain as best you can and get on with your life. Those are your only choices. It's up to you to decide.
This may sound unfeeling but it's the reality of the situation.
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phillhere, I am sorry to hear about your injuries, which sound pretty serious. I was diagnosed with CRPS after wearing a cast "too long" after breaking my foot (a Jones fracture). The cast was immediately removed, and I was prescribed physical therapy, which I started the next day. I read about the long-term effects of CRPS (which I'd never heard of before), so I did these exercises religiously -- and for years after all symptoms of CRPS disappeared. PT may not work for everybody, but I was so grateful that it worked for me. In fact, I still do some PT for old injuries -- one almost 50 years old!
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pendragn52, you wrote: "I need to lose weight." So why not do it? A fairly easy way is to eat a whole foods plant based diet, where whole foods means unprocessed, and plant based means no animal products. If I was in the amount of pain that you describe, I would try it right away. In fact, this diet has so many health benefits that I already eat it! And yes, it's much easier to maintain a healthy weight eating this way. All benefits, no adverse effecs. "Get Fit in the Gym; Get Thin in the Kitchen." Here's a source for further easy to understand science-based information about a wfpb diet: https://nutritionfacts.org
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Interesting, timely article for me. I had a hip replacement 2 1/2 months ago. Now that it's mostly healed, I'm marveling at the lack of pain.
The funny thing is that prior to surgery, I noticed the big jolts of pain, but obviously must have been ignoring the orchestral accompaniment of ache, tingling, stinging, shooting, needling, throbbing etc. The absence of pain is amazing.
I didn't limit my physical activity a lot before surgery. I hiked with a lurching gait; but I kept hiking. I knew every time I bent down to tie my shoes, it was going to hurt. Oh well. I had things I wanted to do. Ignore it and keep going.
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Our bodies have the ability to turn off our awareness of pain while we sleep. I wish someone would research how that works, so we could harness it to help people.
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Mindfulness meditation is an excellent approach to living with pain. The practice can be viewed as an exercise of the mind where you "observe" pain and any other feeling or thought. As meditation progresses, you become better at seeing how you experience pain and the difference between sensing it versus how you react to it.
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That is deceptive, in fact people commit suicide when they are told to do "Mindfulness rather than get pain treated. They just don't count the dead! If only it was that simple, but many gullible people want to believe. People with serious conditions have had their pain misdiagnosed, or treatment postponed due to replacing medical care with Mindfulness. @Emergence
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Agreed. complaining and moaning about pain is no good.
Any type of activity/therapy that has proven over time to alleviate pain is the answer.
I believe in the equality theory of life, ie, everything has good and bad.
Pain is heavily ladened with bad but can teach you how to deal with life and overcome problems.
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My mom was so terrified of old age pain that she fried her kidneys with OTC NSAIDS.
The medical profession whipsawed from giving opioids out like TicTacs, and now they have been scared / regulated into giving them out like Faberge eggs. When my wife had major surgery, I had to run to the doctor to get a prescription and fill at the hospital pharmacy every THREE days.
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What a timely article. As a late middle aged man i find enormous differences in how my peers react to the the infirmities of aging. It has been clear to me that those who pay much more attention to pain have many more complications from simple injuries than do others. The worst is back pain and the wrong assumption that not exerting yourself is the best thing. Once you stop moving ( especially due to fear of pain) the body reacts by breaking down.
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My neck pain was the result of my bifocal line being set too high. New glasses fit by an expert, pain gone. I was tilting my head back all the time but unaware of it.
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A program of strengthening the back via old-fashioned, barbell exercises has proven very effective for many people, in some cases ending their chronic pain in a matter of weeks. The exercises can start as light as is necessary, then be gradually increased in weight. The body responds by adapting and getting stronger. The usual stretching and toning-type exercises usually prescribed do not have the same ability to improve strength. And the strength of our back muscles, as developed by classic exercises like the deadlift, seems to be key to supporting the spine and preventing pain. Check out the Starting Strength program. Their website has articles and videos about people of all ages and medical/injury backgrounds who have beaten their back pain with a few hours a week of strength training.
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