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Discussing: 5 Surprising Lessons I’ve Learned about #ChronicPain

All pain is real. And we should not have to validate it to anyone

5 Surprising Lessons I’ve Learned about Chronic Pain is a good read and worth discussing his points so lets get into them.

  1. All Pain is real. "Chronic pain sometimes has no concrete, identifiable cause, but that doesn’t make the pain any less real.". He says that with many of us with chronic pain the Validity of our pain is suspect. Pain is of course subjective. There is no way to actually measure pain levels. "Each individual’s interpretation and expression of pain is based on a complex interaction of physical, psychological, and emotional factors, all of which originate from the brain." Therefore pain can be doubted. They can look at you with gender bias and think you are a woman therefore you are exaggerating your pain. There is no way to say my 7 is in fact a 7. In fact my 7 is someone else's 10. Our pain scales get skewed anyway just from having chronic pain. Therefore doctors should treat all pain patients at their word. My 7 is a 7, for me, therefore it is a 7. 
  2. Emotions drive the experience of pain. "Emotional pain is very much a part of chronic pain. In my experience, chronic pain is about 20 percent sensory, and the rest, the other 80 percent, is emotional. There are five key emotions that make pain worse: fear, guilt, angerloneliness, and helplessness. " I would not think That emotional. I am pretty stoic in pain. However, people get irate when this is pointed out. When they are told emotions are tied to pain. I am not sure why we all know emotions effect pain levels. Not only that but when they look at pain in the brain, pain is more like a circuit and it does link to the emotion centers. So we are wired to have a Reaction to pain. This is normal. I burn my hand on the stove and I curse like a sailor. Normal. What is unfortunate is with chronic pain we can get bogged down in the damned emotional clutter we are experiencing because of the pain. The frustration, the endless guilt, anxiety, anger, helplessness, depression, fear. This is why some forms of therapy are beneficial. Work through the emotional crap and we can view the pain without the emotional reactions, and lower our suffering, which helps us cope with the sensory experience of the pain.
  3. Opioids don’t always make chronic pain better; they may make it worse. "Opioids are extremely effective as pain relievers; however, because many people develop a tolerance to the medicines within two to three months, it is often necessary to increase the dosage. Therein lies one of their primary dangers—as the dosage increases and the drug is used over time, physical dependence, and possibly addiction, develops." Very Rarely does addiction develop. But, yes, physical dependency and tolerance do. But in fact painkillers are actually considered to be poor pain relievers, just the best we have. But it is part of pain management. How does someone in chronic pain for over 2 decades begin physio and exercise? With painkiller treatment to help manage the pain. Also, sometimes it is the very last resort and what happens when you get there? It is the Last resort. "Opioids have many side effects, and sometimes, using opioids actually causes more pain—a phenomenon known as opioid-induced hyperalgesia." Yes, that is a risk, that does not happen often. The treatment is taking them off that Specific opiate and putting them on a different one. Done.
  4. Treat to improve function. "If we are treating with the goal of taking pain away, but the person is getting worse in terms of his or her ability to be active and productive, that is not good pain treatment. With most chronic pain conditions, the goal of eliminating pain altogether is simply not realistic. When treating chronic pain, improvement of function needs to be taken into consideration." This is a fact. One we have to accept if we have chronic pain. And we do. We get it. The pain doesn't go away. We are aiming for functional and manageable and tolerable. All things we desire in order to have a life. I think of the painkiller I am on and it feels like it isn't that strong at all. I have no clue how much I'd have to take to be free of pain but I am positive it would be an overdose.
  5. Expectations influence outcome. "The answers to many of the problems that plague those with chronic pain lie in the powers of their minds. There are many studies that prove that believing a treatment will work results in a significant percentage of subjects having an effect. What creates this effect? It is the belief that there will be an effect. This belief causes significant changes in the brain and body, which translate into a different experience." People are forever discounting the power of belief. It is strong. Think placebo effect. I know of people when you offer them a viable suggestion they shoot it down right away. That won't work. Nothing works. If that person were to get that treatment it would in fact have less of a chance working according to studies. Personally I like to have an open mind about every treatment. I say it might work a lot, but even a little would help. You fear it won't work so you say to yourself it won't so you will not be disappointed. But it is better to maintain some optimism and be open to the possibility it could help to some varying degree.
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