Pain is one of the darkest and loneliest places there is, nd I speak from experience. One in five Canadians suffer from the effects of chronic pain on a daily basis. The problem with chronic pain is that it’s not something we can ignore or put up with, because it feels like a constant assailant. It colours each day with grey or even black tones, so much so that many will reach for any solution to the dull throbbing or acute presence of this enemy. And, in the vast search by millions for relief we are now increasingly witnessing the heartbreaking effects of the overuse of painkillers.
In order to address this problem, many doctors are rethinking how and when they should advise or prescribe painkillers. And, that’s good news. But, is it enough? Both patients and doctors need to consider a wider, more nuanced approach to this serious national health problem.
In a recent conversation with family doctor James Melling, he raised questions about the source of some chronic pain, and whether doctors have enough skills, time and training to look more deeply at the root cause of prolonged suffering. His experience has shown that some chronic pain may be connected to or caused by emotional suffering, of which the patient is not aware. “A lot of teaching in medical schools is about listening and observing, but if you haven’t even learned that physical pain can have an emotional cause, you don’t look for that,” he said…
He went on to say, “Prescribing pain medicine that doesn’t improve the patient’s pain implies that the pain may not be due to the apparent cause. The response maybe should be more questions rather than more pills. People who have pain out of character or proportion to the described problem – for example, a back injury – could suggest that the back is not the underlying cause of the pain. … The patient may be unconsciously harbouring unhealed grief, emotional trauma or fear that has not been addressed. Pain killers do not work for emotional pain.”
This growing realization adds to the complexity of the issue for doctors who are already pressed for time and who are also having to learn to separate those struggling with pain from those seeking prescriptions for illicit purposes. A recent study published by the JAMA Institute found that instead of looking at less invasive approaches to back pain, doctors were actually increasing the use of painkiller medications.
Melling’s experiences highlight the need to look at different methods both to treat and to understand the cause and impact of chronic pain. And treatment methods are beginning to change, in large part due to patient demands. For example, some studies show meditation to be helpful for many experiencing chronic pain. Yoga, Chinese medicine and chiropractic approaches are also gaining ground.
However, whatever pain control method we use, if it is still focusing on the pain as solely physical, it’s missing a crucial part. For many, the pain is emotional – one might say it’s the “soul” that is hurting. So bringing a spiritual component to the treatment may be a useful approach for some. This does not necessarily mean something based in religion. The key is finding out what a spiritual approach means to that patient according to what they feel has been damaging them, and then identifying what will bring healing and renewal to their overall well-being. For me, the release from chronic pain came through quiet contemplative prayer that brought calm and insight to the grief behind the pain that needed healing.
Dr. Andrew Weil, the founder, professor and director of the Arizona Center for Integrative Medicine, recently said, “If we can make the correct diagnosis, the healing can begin. If we can’t, both our personal health and our economy are doomed.”
Addressing problems associated with chronic pain is not a one-answer-fits-all quick fix. As Dr. Melling points out, a deeper, more nuanced approach to understanding pain – not just as a symptom of a physical ailment – is needed for accurate diagnosis and treatment. And that takes compassion, patience, skill and discernment on everyone’s part, including the patient. The increase in addictions to, and overdoses from, pain medications, alone, should lead patients and physicians to seek the real causes for chronic pain. Such research will likely lead to better – less costly – treatments.
This post was published on my weekly blog, Owning our Health, in the Vancouver Sun on August 20th 2013. You can find it HERE