CHRONIC PAIN
FACTS AND FALLACIES

By Mark Grant M.A.



Fallacy #1:

Pain always means there’s something-physical wrong.

Pain, particularly chronic pain, is much more complex than that. Pain usually starts with some kind of physical injury. This pain is called acute pain. It serves as a warning signal. But the kind of pain that most people worry about is chronic pain.

Chronic pain is by definition, pain which persists beyond the usual healing time. Most acute diseases or injuries heal in 2 to 6 weeks. Chronic pain occurs when things have not healed and complications occur. In addition to the initial injury, other problems arise including muscle tension, changes in circulation, postural imbalances and changes in the functioning of the central nervous system. The exact causes of chronic pain are not fully understood. Pain is also a subjective experience. This means it involves your mind and your emotions, as well as your body!



Fallacy #2:

If the reason for your pain can't be found, then there must be something wrong with you.

The sad truth is that there are many occasions when pain is inexplicable in terms of current investigative techniques and knowledge. A survey in the USA a few years ago, of 10,000 cases of low back pain, found that in over 75% of cases there was no adequate medical explanation for the pain.

Unfortunately, some people, including professionals who should know better, will use this lack of a discernable cause as an excuse to blame the patient. Malingering and 'Secondary gain' are labels that are often attached to patients where the cause of the pain is unknown, or where they fail to respond to treatment.

The reality is that pain is a complex personal experience. Someone once defined pain as; "Whatever the experiencing person says it is, whenever the experiencing person says it does." You may have to learn to live with not knowing, which can be hard, but don't let others add to the burden of your pain with unnecessary guilt!



Fallacy #3:

Some people don't want to get better because they are benefiting from being in pain.

Nobody enjoys being in pain. Frustrated doctors or workers compensation assessors most commonly express this idea. It seems to be an attempt to subjugate the pain sufferer.

'Secondary gain' is the medical jargon for any benefit the patient gains from having the pain. Secondary gain is always talked about in negative terms. But secondary gains such as attention and assistance from others are appropriate when pain limits activity or financial compensation is due for a work-related accident.

Research has shown that exaggerating about pain or malingering is actually rare!



Fallacy #4:

The doctor knows more about your pain, and how to treat it, than you do.

According to some alarming statistics, Chronic pain is "grossly under treated" in most patients.

In a recent survey, 50% of chronic pain patients had inadequate pain relief and had considered suicide to escape their pain.

The reasons for the under treatment of pain include;

  1. The low priority of pain relief in our health care system.
  2. Lack of knowledge among health professionals and consumers about pain management.
  3. Exaggerated fears of Opioids:

    1. Side-effects and addiction.
    2. Under reporting of pain by patients.
    3. Cultural and social expectations.

It's a mistake to assume that everything that can be done, has been. Especially if you are still experiencing intolerable pain. You are the only one who really knows what your pain is like.

Don't be afraid to exercise your rights as a consumer!



Fallacy #5:

If you complain about your pain too much, you're weak, a nuisance or a bad patient.

Most chronic pain sufferer's feel trapped and helpless. They are sick of how they feel and don't want to burden anyone else with their seemingly intractable problems. They think there's no point talking about their pain because it doesn't help. Unfortunately, this often leads to under-reporting their pain when seeking medical help.

This results in under-prescription of medication, failure of treatment and unnecessary frustration and suffering.

Pain is invisible and subjective.

It's vital that you describe fully how you feel and how it's affecting you. Whoever is treating you is totally reliant on what information you give them.

The doctor's surgery isn't the time to be a hero!



Fallacy #6

If a cure can't be found, "you'll just have to learn to live with it."

With a few rare exceptions, but there is no need for anybody to have to live with unbearable pain nowadays. There are more treatment options available than ever before. They range from advanced medical procedures to alternative approaches such as acupuncture, TENS machines and psychological approaches, to powerful Opioids. One option that many people are reluctant to consider is Opioids. Opioids are considered a last resort for pain sufferers who have tried everything else. Opioids can often offer a safe and effective alternative for managing uncontrollable pain and are a better alternative than a life of inactivity or even suicide.

Although very powerful, Opioids are not effective for all types of pain. Particularly some types of pain involving damaged nerves. Medical advice from a well informed, open-minded practitioner or specialist is recommended. The dangers of addiction are frequently exaggerated.

A recent survey of 11,884 chronic pain patients who were treated with Opioids narcotics, over a four year period, found that only 4 developed addiction problems.

It's a mistake to equate the use of Opioids to manage chronic pain with the abuse of Opioids by addicted persons.

You actually have a legal, constitutional right to receive adequate pain-relief! YOU DON'T HAVE TO LIVE IN PAIN .



This information is not meant to substitute for proper medical advice, but to assist you make the best of the advice and treatment that is available.
Further reading: Salerno, Evelyn & Willens Joyce; Pain Management Handbook. C V Mosby & CO St. Louis 1996




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