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Everyone knows what pain is because we’ve all experienced it. Put simply, it’s a signal from the body that something is wrong — whether due to an injury, damage, or maybe even an infection. This damage sends an impulse to the brain, which produces a pain response in the body.
This definition of pain is ubiquitous within the traditional framework of medical education. However, our Chief Pharmacist, Gene Gresh, noticed that while it may be accurate for acute pain, it isn’t necessarily as accurate for chronic pain. Recent discoveries have shed light on how chronic pain differs from acute pain and why chronic pain is so difficult to treat. Until recently, chronic pain has been treated the same as acute pain, but it’s clear today that this approach does not work. In this post, we will explain the challenge with chronic pain, new research on the subject, and new treatment options.
Typically speaking, acute pain has a known cause and seems to serve a specific purpose. It alerts us to a problem, which gives us an opportunity to find a remedy. It usually subsides in a short time with or without treatment, rarely lasting longer than a few weeks or months, and disappears when the underlying cause is resolved. Chronic pain, on the other hand, can be entirely different. It generally serves no purpose in the body and may or may not have a known cause. Often, it can get worse over time for no apparent reason.
Pain has a direct correlation to changes in our nervous system. In turn, pain can change the way the nerves function. These changes allow for the transmission of a pain signal from the brain without a corresponding input. Essentially, we can experience pain without an identifiable cause and it can persist long after the injury heals.
A classic example is a condition known as “phantom limb pain” where a patient who has had an amputation complains of pain in a limb that no longer exists. Another example is a condition called “post-herpetic neuralgia”. This occurs in a patient who has had a recent shingles outbreak and the severe debilitating pain persists long after the shingles has disappeared, perhaps even for years. We classify these forms of chronic pain as “accepted” forms of pain because we have an idea of what caused the initial onset of pain, however the current state of pain can remain unclear.
The real problem is when a patient continues to have severe pain after an injury has healed, or even worse, who never had an identifiable injury to begin with. This creates a predicament without any measurable way to formulate a diagnosis. Yet, so often we see doctors of all kinds resort to pain medications, especially narcotics, under these circumstances. This is the unfortunate reality of pain as it relates to our modern day healthcare system. All too often people are prescribed very strong pain relief medications that don't address the root cause of the problem, and therefore, have no beneficial effect. In fact, in many of these cases the patient will experience more harm than good.
Pain is certainly objective in many ways which makes for a huge challenge in identifying the correct path for treatment. Pain can’t be physically measured and can only be quantified based on how the patient says they feel. When we actually look below the surface of pain, an entirely different picture emerges. That’s why conventional medicine has been failing miserably in its ability to effectively treat pain.
The good news is that recent documents and research shows actual changes in the nervous system, especially in an area of the spinal cord known as the dorsal root ganglion, in which physiological changes have been identified in chronic pain conditions (even when there is no known cause for the pain!).
These abnormalities include decreases or increases in certain chemicals, over-activation of certain nerve pathways, and involvement of nerves previously not associated with pain. With this new research, our understanding of acute and chronic pain is constantly changing. The more data we collect through clinical research the more evidence we can compile supporting the need for alternative therapies.
Historically, pain was treated based on three main principles: cause, location, and severity. The most popular pain assessment tool was the 0 to 10 scale where 0 was no pain and 10 is the most pain. We often saw mild pains and headaches being treated with Aspirin, Acetaminophen, or Ibuprofen. And in more severe situations, we have often seen stronger medications, like opioids, used to treat patients.
Opioids are among the oldest known drugs. They have been the standard of pain treatment for a very long time and have been used (and abused) for centuries. Opioids attach to proteins called opioid receptors on nerve cells in the brain, spinal cord, gut, and other parts of the body. When this happens, the opioids block pain messages sent from the body through the spinal cord to the brain. Unfortunately we know that many people become easily addicted to opioids which leads to a cascade of problems.
According to the Institute of Medicine of the National Academies Report, in 2011, over 100 million adult Americans had chronic pain. This estimate didn’t include acute pain or children. The entire population is estimated to be about 311 million people, or almost one-third of the U.S. population. This same report estimates that the cost to treat pain in the U.S. is between $560 and $635 billion a year.
There is no doubt that we are all experiencing an epidemic of chronic pain in modern day society. And the outlook is even more grim, which is why this conversation is so important. A review published in The Clinical Journal of Pain revealed that, “None of the currently available treatments eliminates pain for the majority of patients.” This may be the saddest, most concerning fact of all. Report after report indicates that many pain patients, unhappy with the lack of success of therapy, tend to visit multiple physicians in search of a solution to their pain.
We have a standard of care in which patients diagnosed with pain are routinely prescribed addictive drugs classified as narcotics that usually don’t work, at least not completely. So, patients seek another doctor or attempt another medication because they are still in pain. This system not only encourages drug-seeking behavior, it creates it. Patients whose only goal, at least originally, was to seek pain relief are now caught in a lose/lose situation. Their desire to pursue pain relief has resulted in a social stigma so catastrophic that it, in addition to their pain, can destroy their lives
This problem is very real and could be one of the most significant silent catastrophes of our time.We don’t hear about this silent epidemic the same way we hear about cancer, Alzheimer’s disease, Multiple Sclerosis or any other diseases. Chronic pain is like the black sheep that nobody wants to talk about. There are many reasons for that, but ultimately we need to figure out a solution. A solution for those already struggling with various forms of chronic pain so we can provide immediate relief; and also a solution to be more proactive in taking preventative measures so less people suffer from these conditions to begin with. This is why The Feel Good Lab has rooted itself in the philosophy of Functional Medicine. As the Institute of Functional Medicine states, “The precise manifestation of each cause depends on the individual’s genes, environment, and lifestyle, and only treatments that address the right cause will have lasting benefit beyond symptom suppression.”
We know it takes personalized medicine and individualized care to combat this chronic pain epidemic. We hope The Feel Good Lab and our network of professionals can be a resource for you and your loved ones who may be struggling with chronic pain. If you want to connect with our team to learn more about our products and services please reach out to hello@thefeelgoodlab.com anytime!
