While back pain is a common medical complaint, there often is no specific cause for the pain in up to 85% of cases with poor correlation between the presence of imaging abnormalities and pain (Sanzarello, Ilaria et al, 2016). In fact, abnormalities seen in imaging tests are often part of the normal aging process.
Check out this great video presentation by Dr. Peter O’Sullivan to learn more.
I read the other day on social media a suggestion for patients when selecting a healthcare provider to ask them their definition of pain to see if it is similar to the definition provided by the International Association of the Study of Pain (IASP).
The key for me is if they understand pain is biopsychosocial (BPS) in nature and treat it that way.
I may have to ask this going forward. What do you think?
Did you know?
Editor’s note: This article was written based on my experience and what I have researched about the topic. Everyone is different. The decision to use supplements should be a decision between doctor and patient.
As part of the week-long Mayo Clinic fibromyalgia program I attended in 2016, I met with a pharmacist to review the long list of prescription medicines, over-the-counter medicines, and supplements I was taking at the time. My medicine cabinet looked like a GNC store.
I was instructed to bring the actual bottles with me to the appointment, so I packed the bottles into a gym bag (yes, I was taking a lot of medicines and supplements) and went to see her.
I was surprised as she read each bottle, making comments and recommendations about each pill – including product quality, labeling issues, ingredient safety, and dosing.
When the appointment ended, my medicine and supplement list was much shorter with her recommending stopping most of the supplements and my gym bag much lighter – throwing away the pills was going to stop taking.
Unlike prescription or over-the-counter drugs, which must be approved by the Federal Drug Agency (FDA) before they can be marketed, the FDA doesn’t review supplements for safety and effectiveness before they are sold.
We don’t know where the products are made, how they are made, what is in them, and if the dosage is appropriate.
Safety is left up to the manufacturers and distributors of the supplements.
You assume all risk when using supplements. While some may be valuable, many aren’t.
A friend of mine, Sara Villa, a molecular neuroscientist who lives with chronic pain, recently posted an insightful Twitter thread about working with pain.
While her post was specific to working with pain, I saw in her tweet some key messages for anyone living with chronic pain and collaborated with her to distill the messaging into nine helpful tips:
Thank you, Sara!
How do you think about and react to your chronic pain? Are you the victim? Are you overly-worried about the pain?
We all experience pain. That we can't choose.
The choice we have as humans is how we respond to the pain. We can either choose to let the pain control our lives or we can choose to live life, despite the pain.
For many people with chronic pain, a vicious circle can form between pain and suffering. Research has shown the psychological and social distress associated with pain is often more important to the pain experience as the perceived pain severity.*
Resilience is important
I just watched a great TEDx Talk from Dr. Trung Ngo about resilience that everyone who lives with chronic pain or treats chronic pain should watch.
He talks about how there are three types of people: those who are victims, those who are catastrophizers, and those who are resilient.
I can identify with all three types during my personal journey with pain. Early in my journey, i was the victim. It was the surgeon's fault for my pain. I was set on on making that doctor pay for his mistake and make my pain go away.
As the pain continued, I became the catastrophizer. It quickly became gloom and doom. I become fearful of the pain. I worried about all the bad things that might happen because of the pain. And I worried about my future and the future of my family.
Fortunately, my mindset changed to resiliency. Many thanks to the Mayo Clinic Pain Rehabilitation Center for helping me transition to that stage.
How to be resilient
According to Dr. Ngo, the keys to being resilient:
* Ojala, T., Häkkinen, A., Karppinen, J., Sipilä, K., Suutama, T., & Piirainen, A. (2014). Chronic pain affects the whole person – a phenomenological study. Disability and Rehabilitation, 37(4), 363–371. doi: 10.3109/09638288.2014.923522
Chronic Pain Champions is an information resource/blog/support group to help chronic pain patients, their families, and friends, as well as healthcare professionals. Learn more about this site and the author.
Chronic Pain Champions