THE FRUSTRATION OF CHRONIC PAIN

BLOG #1 FEBRUARY 2022

The most frustrating part of having chronic pain is how unrelenting it feels. It hurts all the time. It just doesn’t let up no matter what you do or, for that matter, what you avoid doing. It disturbs your sleep. You can’t sit comfortably. You can’t walk normally. It prevents you from doing so many of the physical things you used to enjoy. Worst of all it makes you feel trapped with no way to escape it. It pulls you down emotionally and robs you of your joie de vivre.

I know that you would like to get to the “what to do” immediately.  However, in order to succeed with the “what to do” it is critical to first understand the “why” of it all. Or put another way, exactly what I’m up against here? If you buy the Book now, I would strongly urge you to first read the first few sections which deal with the “why” questions before proceeding to the “what to do” sections.

So why is it that no matter what we do, it does not seem to bring relief, or at best, provides only temporary relief with the pain only to return, sometimes worse than ever? The Book lists 31 things that are routinely tried in chronic pain situations which offer little or very limited relief including powerful drugs. Even opiates don’t seem to be able to stop it. As an orthopedic nurse practitioner once said to me, “the only thing opiates are good for is getting the brain to think that they are reducing the pain”.

The answer to many of these “why” questions is that when there is chronic pain in a body part, there are always two potential sources of it. They are 1) muscles and 2) their associated bones and joints. No matter what intervention we turn to, it will usually address only one of these sources. Therein lies the source of so much of the frustration when trying to confront chronic pain.

For pain originating in muscles, there is definitely something that we can do to eliminate it or at least substantially reduce it. However, if there has been extensive osteoarthritic damage to bones and a joint, there may not much that that can be done to completely eliminate it. For example, inside a knee or hip joint, if the cartilage that caps the ends of bones has been destroyed and the joint space has been reduced to the point where the bones are grinding against each other without the intervening cartilage, it may not be possible to eliminate the pain without surgically replacing the joint. In the case of the lower back, if the disks that lie between the vertebrae have been damaged to the point where adjacent vertebrae are grinding against each other, complete elimination of the pain may not be possible. 

However, the situation is far from hopeless. Even in the face of osteoarthritic joint damage, it is still possible to achieve much pain relief by confronting the pain originating from the associated muscles. Indeed most people over the age of fifty will have some osteoarthritic changes that can be seen in x rays; yet many of them have no pain at all. There are many reasons to treat the muscles of a body part with chronic pain. First, the number of nerve endings that transmit pain messages from muscles to the brain greatly outnumber those transmitting pain messages to the brain coming from joints. Second, eliminating muscles as sources of chronic pain, even if there is some pain coming from a nearby joint, the overall level of pain might be reduced enough to make it tolerable and greatly improve the overall quality of life. I hope these reasons are enough to get you to consider making a determined effort to confront chronic muscle pain. 

Confronting chronic muscle pain can only make your life better. Even in the worst case scenario where surgery may be necessary, it will be necessary to confront chronic muscle pain to fully achieve a pain free existence. After joint surgery, you are routinely prescribed a regimen of rehabilitative physical therapy in which the remaining pain coming from muscles is systematically addressed. Should chronic pain occur in your life, the sooner it is addressed the better. If it is confronted early enough, you could end up avoiding the possibility of joint damage and the need for surgery. 

The existence of chronic pain means that there are events going on inside of some of your muscles that need your attention. Neglecting them only means that they will get worse and increase the risk of joint damage. One of the surest things in life is that by doing nothing, the pain will continue. 

Future blogs will provide more insights into chronic pain that may be bothering you and will provide approaches to confront it. 

I hope you will continue to read them.