Chronic Pain: the Evolution of How We View It

The Evolution of How We View Chronic Pain

In recent years, the incidence of chronic pain has reached epidemic proportions. Unfortunately, there is a long history of discrimination related to pain, which has not only spurred controversy, but it has also changed the way we—and our doctors—approach its treatment.

Pain: the fight or flight effect

Pain, in and of itself, is a necessary part of life. Pain warns us about danger. It prevents us from doing things that our bodies were not meant to do. It signals injury and illness and, ultimately, it  keeps us from doing more harm.

In this sense, pain is a good thing. We need it to survive. It is imprinted on our DNA and, like an animal, we instinctively know that when we feel pain, we’re doing something wrong.

This model, however visceral it may be, is no longer the only construct of pain. In today’s society, we are increasingly sedentary. In many cases, we live in environments that are filled with airborne pathogens, we consume highly-processed foods, and put other things in our bodies, like drugs, that are not meant to be there. This situation has led to widespread nutritional imbalance, an epidemic of disuse syndromes, and a general decline in health due to inflammatory and immune conditions.

The global pain epidemic: where it really hurts

Without getting any more technical, these are contributing factors to the worldwide pain phenomenon, and it’s not going to get better any time soon.

For the pain sufferer, this is a mitigating issue that often drives them to seek relief. Some may attempt to self-medicate, and some may seek medical intervention, but in many cases, the exact cause of the pain is unknown.

Though there have been significant advances made in the medical profession in terms of how we understand pain and what treatments work best, those who suffer from the worst kinds of pain often receive little or no relief; this sort of approach, in itself, is a product of the modern age.

As doctors have become better acquainted with new philosophies on pain physiology, the various subtypes of pain, and options for treatment, they are confronted with an ever-increasing regulatory framework that continues to strengthen in response to the fallout of the pain epidemic – namely, overprescribing of pain medications and the resulting addictions that can, understandably, be seen as a state of emergency.

Whereas once, pain was an issue to be taken seriously, it is now often dismissed by the very people who have the power to heal it.

What is chronic pain?

There are, in general, two types of pain. Acute pain is the kind that is felt when we injure ourselves, from a burn, a fall, an injury, a strain – something tangible. It is a situation where you can say “I did this, and it hurt.” The pain can be attributed to something specific. Usually, if you look after it appropriately—set the broken bone, put ice on it, take a Tylenol—the pain will subside, and eventually, the hurt will heal.

Chronic pain is different than acute pain. For anyone who does not suffer from it, it may be challenging to understand. Chronic pain lingers even after the injury has healed. Sometimes, it has no connection to an injury at all, but even when it does, it is often seen as vague and unbelievable, a stigma that is neither new nor modern, at all.

Take, for instance, the case of “railway spine,” a 19th-century phenomenon that was related to injuries sustained (you guessed it) on trains. In this situation, patients presented themselves with multiple pain issues and complaints, but since no visible injuries could be found, doctors were hesitant to treat the pain. The railroads, of course, were then reluctant to provide compensation for the victims. After all, if you can’t see what’s causing it, maybe it doesn’t exist.

Sound familiar?

How we approach chronic pain today

Sadly, in many cases, this perception has not changed. People who suffer from legitimate pain, such as whiplash from a car accident, or spinal injury, will often be disregarded, leading the patients either to suffer needlessly or seek other alternatives, some in the form of physical therapy and alternative treatments, and some in the form of drugs, like opioids, that provide at least some relief.

The opioid conundrum

The unfortunate thing about opioid painkillers is not that they don’t work, but that they are not meant to be used for an extended period. For acute pain, they can be very helpful, such as in the days following a bad injury, or while recovering from surgery.

However, opioid tolerance builds up quickly, and pretty soon, the user will find they aren’t doing nearly as good a job as they once did. The pain from the injury might be gone, but the brain continues to tell the body that it still exists, resulting in cravings for more drugs and eventually turning into an addiction.

A more sustainable approach to chronic pain

Today, we know more about the psychology of chronic pain. We know that certain stimuli trigger pain flares and that, in many cases, it is possible to control pain in ways that do not involve opioids.

Some of the ways we approach chronic pain today include:


As stress, anxiety, and depression are chronic pain triggers, evidence shows that counseling helps to mitigate pain. Through techniques such as mindfulness, cognitive behavioral therapy, and self-hypnosis, many lifelong sufferers of chronic pain have found relief.

Physical therapy

In many cases, chronic pain was precipitated by an injury. Once the injury healed, the pain continued. Physical therapy can help by strengthening the joints and muscles around the area of pains, leading to better support and less pain. For example, many who suffer from lower back pain have found relief through core-strengthening exercises like yoga, tai chi, and Pilates.

Increased physical activity

Beyond physical therapy, increased physical activity has also proven to be very helpful for chronic pain. The simple act of walking for 15 to 20 minutes a day can vastly improve both the pain response and general mood. When your mood is better, the pain decreases as well.

Changes in diet

Eating a lot of highly processed foods and sugar can exacerbate an array of chronic diseases, including diabetes, obesity, and conditions that are related to inflammation, like multiple sclerosis, arthritis, lupus, uveitis, and Crohn’s disease. Studies show that changing the diet to eliminate processed foods and substitute fresh fruits, vegetables, whole grains, and healthy fats can reduce chronic pain and inflammation.

The role of medications in chronic pain intervention

Chronic pain is a complex subject. No one solution can be applied to its relief, and medicine still plays a vital role.

Depending on the cause of the pain—if one is identified—tens machines, nerve blockers, steroid injections, stem cell treatments, and medications that target neural receptors should also be considered as front-line therapeutic options.

If the objective is to live independently without pain, there may yet be a long road ahead. However, working closely with a care team that includes alternative practitioners such as chiropractors, acupuncturists, physical therapists, massage therapists, and psychologists, relief is within reach.

There is no question that the perception of chronic pain in the medical field must change. With access to the latest research and a multitude of proven intervention options close at hand, there is no reason why we can’t all get better.

Are you suffering from chronic pain? We can help. Reach out today to get started.

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