Dealing with Daily, Persistent Pain Levels

Back pain, chronic illness, and more...

This is a loaded topic, and not in the way anyone wants to carry it around. Chronic (persistent) pain is exhausting.

This post isn't going to give you the 'one best exercise' or link to the best therapist out there. It is going to talk about the complexity of pain and how we need to consider the bigger picture when we are dealing with chronic pain.

Typically when we are in pain, we all think (likely unconsciously) of how we were taught pain worked... you touch a hot surface, a pain signal goes to your brain, brain sends a signal to pull your hand away. TaDa! So when we experience pain, we automatically think that there is structural/tissue damage that needs to be fixed. I get it, it is how we were taught to think of pain. However, in the last few decades, there has been much research in this area and I'll talk about the basics here.

First, let's set up the discussion with pain in 2 areas: structural and complex.

Now, if the pain had a distinctly related event, then it is likely there is structural damage. So for the sake of this post, if your pain originally came from a distinct event/trauma, this is not the pain I am speaking of.

Complex pain is the pain that seemed to come from normal events like sleeping and waking up with a bad back, or reaching for something within your normal range of functional movement and BANG something happens and you are in pain. And it lasts!

So, what do you do? Structural pain, we go to doctors and physiotherapists to get help to heal the tissues and get back to life. But what happens when the pain is complex? First, we usually rest, stop doing a lot of things and hope it gets better after a couple of days. But then that couple of days turned into a month, or two. It is frustrating. We then head to our doctor for help (or a physio/chiro/acupuncture/osteopath/massage). This sets us right on the path of looking for something structurally wrong with us. But this is just a small piece of the puzzle.

Below is an image that was constructed with input from the multidisciplinary panel of 27 experts in preparation for the symposium at the 26th Annual Meeting of the North American Spine Society (2017). Diameters of the circles are proportional to the number of experts identifying these factors and the number and strength of connections with other factors. It shows just how many factors of our lives contribute to the experience of pain and many of the ways that they are connected.

Complexity of Pain

Now, don't panic. If you work with someone knowledgeable in this area, it is more than manageable to navigate. But it begs to question... when you are experiencing daily persistent pain is the best treatment surgery/injections/drugs?

And that is the million dollar question.

Watch for part 2 in this 4 part series!