This question was at the heart of a dialog I recently had with a trusted colleague about the approach I have presented in my recently published Book entitled, “A Way Out Of Chronic Pain, How It Happened and What To Do About It”.

Her: “The average person will not embrace a three part approach because first, they will not be interested in the neurobiological explanations about the sensation of pain, and second, you are asking too much of them. People want either a simple one-step, one-repetition approach or they want to be told what pill they can take that will immediately cure their chronic pain”.

Me: “I agree that this is exactly what most people want. This is precisely what i would want if I was in the middle of a chronic pain episode. 

Me: “However, the problem is, neither one exists!”. 

As you may have already discovered in trying to deal with either an ongoing or past episode of chronic pain, it can be very stubborn and persistent. Here is the reason. Any ongoing chronic pain involves much more than what is going on in the affected body part. For example, when there is long standing pain that is coming from a knee, there is much more involved than just the knee. What is also involved is at least one of the muscles that is attached to the knee, the nerves that send information from the knee muscle(s) to the nerve cells in the spinal cord, the nerve cells in the spinal cord that receive this information and the nerve cells in the brain that receive the information from the spinal cord nerve cells. As a result of your long standing knee pain, all of these nerve cells have been altered from the normal way they handle pain inputs coming from the affected knee. My own research has documented some of the ways in which spinal cord nerve cells get damaged when there is a long standing nerve injury. Recent research has documented the many changes that brain nerve cells and their associated glial cells undergo that result in persistent activity in pain pathways from a body part affected with chronic pain. It is these changes in the altered nerve cells that maintain the chronic pain despite what corrective measures we may take at the site of the knee pain. 

These neurobiological changes explain why attempts that are directed only at the affected knee can at best only provide temporary relief because they do not address the nerve cell changes that are sustaining the chronic pain. For example, today there are several substances that can be injected into a painful knee or other joint like steroids, hyaluronic acid, platelet-rich plasma or stem cells and these can provide some symptomatic pain relief. However, relief with such injections is usually temporary, typically lasting a few weeks or, if one is fortunate, a few months before they need to be repeated.

In order to have any chance to break the viscious cycle of chronic pain and for an approach to be successful, it has to address the affected joint, the affected muscles as well as the altered nerve cells. This is why a three part approach is needed. The three part approach involves eliminating sites of contraction inside of affected muscles, static stretches to lengthen these muscles and moving these muscles under load through their full range of motion. The details of the approach are presented in The Book []. For these reasons, once you come to the realization that there is no simple one-step solution to chronic pain, I hope you will embrace that approach because if you do, you at least have  a chance for a long lasting solution to a chronic pain episode.

Know this!