The International Association for the Study of Pain defines pain as “an unpleasant sensory and emotional experience that we primarily associate with tissue damage or describe in terms of such damage.” The definition of pain has two parts. One part deals with the sensation of tissue damage: a burn is perceived as different from a blow from a hammer to your thumb. Its intensity is rated, and it is localized. However, the experience of physical pain involves an emotional response to that injury, a feeling about its unpleasantness and a reaction to the pain. Those who have experienced extreme anxiety or depression recognize easily that mental dysfunction may also elicit an emotional response that is experienced as painful.
If you are under increasing levels of stress, you will be more sensitive to pain. If you twist a back muscle while picking up your child after an enjoyable weekend when you are well rested, it won’t hurt much at all. But if you twist that same muscle with the same force after a stressful week at the office, when everything went wrong, you may find the pain excruciating. The same amount of “injury” is felt with a different intensity of pain. I learned this myself as I was writing my book in the final days against the deadline.
Pain signals the brain and its perception as pain can be modified by a number of mechanisms. Our body produces its own narcotic-like pain relievers – endorphins. These chemicals block transmission of pain. Endorphins also are released by regular exercise. Feeling good and reducing stress also can release them.
When physical pain is long standing, it often results in psychological pain of anxiety and depression. People with chronic moderate-to-severe pain become irritable. Many become listless or depressed. Some feel useless and unable to cope. People have ruined their lives because they enter – or are forced into – a downward spiral of incorrect diagnoses, unrelated pain, disability, depression, and more pain and suffering.
Most of my own patients are not disabled. I won’t let them go out on permanent disability unless they have a condition that is likely to worsen with time, such as progressive cancer. This is not because I am cruel or dispassionate, but because I am very aware of the economic, social, and psychological downfall of disability. Most Americans disabled for a year never return to work – or full enjoyment of life. And, as you know, life is not getting any easier or cheaper. Your disability payments of today may not be as helpful 10 years from now. But in all likelihood you’ll still be alive, in increasing financial distress, depressed, and in pain. Because of what chronic disability creates, you’ll have less financial and logistical means of finding and using high-quality medical care, including new, improved, but invariably expensive drugs and other pain-relieving treatments.
Should a one-on-one consultation with me regarding your pain management be impossible for geographical, financial, or other reasons, my book, “Say Goodbye to Back Pain,” can provide you with help on how you can discontinue or avoid disability. Of the patients on temporary disability I have worked with, I have been able to put the overwhelming majority back to work, sometimes with a different job from the one they previously had. The vast majority don’t even go on temporary disability.
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