We all need pain. Pain is a signal that tells us that something is wrong. If we didn't have pain we wouldn't know when we had injured ourselves.  When we have had pain longer than six months, and we know what is wrong, that pain has lost its value as a signal. Such pain is called chronic pain, and at that point the pain itself is the problem.

When something hurts we usually try fight the pain. This is a normal, natural reaction. With chronic pain the fighting itself causes problems. Not only are we in pain, we are also in a battle with the pain.  Since the pain is unlikely to go away, fighting it just makes things worse.

When pain signals reach the brain they go to more than one part of the brain. Pain signals go to sensory areas in the brain where all sensations go. Pain signals also immediately go to emotional parts of the brain. These emotional areas in the brain are responsible for the emotional distress that accompanies pain. Then we often think about the pain. This thinking about the pain gets the cortex involved, the higher part of the brain.  We think thoughts like "How much longer is this going to hurt?  Why can't the doctor do more about this?  Is it going to hurt as badly today as it did yesterday?  Will I get any sleep tonight?"  Now we have three distinct areas of the brain involved.

People who have chronic pain can often learn ways to turn off the cortex and the emotional parts of the brain.  This eliminates two-thirds of the distress involved with the pain.  They still have pain, but it has become simply a sensation - not a sensation and an emotion and a collection of thoughts.

One way to do this is to "make friends with the pain."  Chronic pain is like a roommate that you don't like.  You are stuck with it, and it doesn't do any good to fight it.  Don't allow the pain to keep you from doing things that you enjoy. If you are employed, keep your job.  Be sure to have activities in your life that you enjoy.  Allow the pain to take a back seat to other things.

There are certainly ways to reduce many people's chronic pain.  Medications, even narcotic analgesics are often used.  Treatments such as anesthetic and steroid injections, TENS, biofeedback, acupuncture, meditation, and hypnosis can all be helpful.  Even with all these tools available - it helps to make friends with the pain.  

Pain Links:

• Pain.com - A comprehensive site for patients and providers
• Creating a New World of Understanding Concerning Chronic Pain Management Utilizing Behavior Modification (enough said)
• Chronic Pain - Hope Through Research - an excellent article from NIH
• Partners Against Pain - A drug company sponsored site that has some good information
• Institute for the Study and Treatment of Pain - studying soft tissue pain.
• Opioid Therapy for Chronic Pain - from Dr. William Hurwitz
• What do you think?