Pain - it's not always as simple as you think.

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I had a prolapsed disc in my lower back some years back that required surgery, and since then I have taken particular care to look after my spine - staying lean and fit, working on my core stabilizers and being careful about how I lift things. But the passage of time will often over-ride all our good habits and things still get "stiff and sore". Now I suspect, one of my facet joints is giving me some localized grief, and leaping out of bed in the morning has been replaced with a well thought out "log roll" onto my side, a steady lift to the vertical sitting position and then engaging the legs to lift me to my full 182cms in height! I have also decided to take an anti-inflammatory to get on top of the situation and to try and stop this from becoming a chronic situation.

All of this brings me on to what is pain and how do we treat it: and when does acute pain morph into chronic pain?

There's not enough room in one- or indeed several blogs - to cover the subject of Pain. For a start, one persons pain is another persons discomfort: and what type of pain do we mean - aches, shooting pains, pins and needles, burning pain - the list is enormous! And methods of treatment vary from local ice or heat: simple pain-killers to long acting Opiates: acupuncture to surgery and all stops in between, so you begin to get the idea that this is not a simple subject, so please do not think that there is a "one size fits all" solution to managing pain - like a good fitting suit, the treatment has to be tailored to the individual in order to maximize a successful outcome.

A very simplistic way to understand pain is to divide it into Acute and Chronic pain. Obviously Chronic pain lasts longer - it's usually been around for 6 months in order to be classified as such - and by that stage it's not the local problem - the arthritic knee, the neuralgia caused by that bout of Shingles that you had, or the trauma sustained in the MVA - that is the area that needs sole attention: rather it's the way the brain has taken over your perception of pain and how your brain now influences all things to do with "that pain" and which is affecting your whole life. So in chronic pain it is so important to look at the whole person and not just the injured part, and to focus the treatment more on the brain than on the injury - and that will often mean the use of a completely different set of "tools" in order to be successful.

Management of Chronic pain is a challenging subject but is one where, with the correct approach and the involvement of a whole team of people -Doctors, dieticians, psychologists, physical therapists, occupational therapists etc, and which also vitally includes the patient and his/her family - then there is a real hope that lives can be radically altered and individuals can return to a normal life which is not dominated by pain or pain-killers.

The message: If your pain is not responding to simple solutions - get professional advice. If you've been in pain for more than 6 months then you need the help of a team of Pain Experts. And remember to be patient if you don't want to remain a patient!

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