Pain management is a multi-billion dollar business and experts predict this number will rise dramatically in the next twenty years some predicting exponential increases. Over 100 million people in the United States according to the Institute of Medicine (2012) are living in pain. In addition this same study claims that nearly 30-40 percent of the population of the United States is currently living in chronic pain. Chronic pain, for many people, is a daily reality. Yet with all the research and studies that have been conducted to track and decrease pain, those who study pain are often puzzled by the elusiveness of pain. Chronic pain, pain that lasts for more than six months is not a choice and is often debilitating. People living with pain have to find ways to cope day to day with chronic pain. This is not an easy task. For these millions of individuals, people just like you and me, making healthy choices to cope with the pain is, at times, the single most important factor in their lives. This is no joke. Chronic pain for too many is a daily struggle, which ultimately dictates life quality. For many chronic pain is too difficult to manage and impossible to control.
Everyone, at one time or another, is going to experience pain. As a young child, we might fall off a bicycle or misstep a skateboard and then we get banged up—it hurts. When in pain our body sends the brain pain signals. These sensations tell the brain something is wrong. This is normal. When these pain signals don’t stop, even when the body has healed, then the brain continues to receive signals of pain. This makes the body “hurt”. Whether pain is categorized as acute, temporary, or chronic there are many factors determining how a particular individual responds to different types of pain. We have all stumped a toe, or have experienced a hang nail or splinter. How would you cope if you felt the intensity of a stumped toe 24 hours a day, seven days a week as do so many who suffer with a kind of neuropathy (nerve damage)? Some people suffer with headaches 2 to 3 times a week and describe these conditions as excruciating, debilitating and unbearable. Others describe facial pain, neurological pain, vaginal pain, arthritis, fibromyalgia, angina and chronic fatigue as kinds of painful experiences. As humans we go through many developmental steps throughout our lifetimes and yet at any point on the path of living we are not immune to having our bodies radiate pain signals to the brain.
Conversations about Pain
Many people don’t believe they have the right to identity, talk about, engage in discussion, or express their experiences around pain. No one person or agency has the right to deny the pain that another is experiencing. Pain is in part a subjective and an objective experience and the concept of pain management must occur in the context of real life experiences. People who suffer with pain still have to work, they still have to care for their children. They have to grocery shop and pay their bills. These concepts surrounding pain and pain management are dependent upon the intersections within an individual’s life and inform future life experiences. Some pain sources can be explained: a failed surgery, an old injury, a natural consequence of aging, or a result of disease. Other pain sources are mysterious in their origins; their etiology cannot be traced to any originating cause. This kind of pain experience is frustrating and complicates pain management.
Factors that Influence Pain Perception
Issues like gender, family status, adverse childhood experiences, cultural practices, religious teachings, educational achievement, all of these elements –in their own way –influence an individual’s experience of pain. Women and men experience pain differently. And not surprisingly are treated differently by health care professionals. Women overall receive less treatment for pain than men and the kind of medicine women receive are qualitatively dissimilar to the medical interventions men receive. For some men, pain is not an acceptable subject to discuss and is simply not talked about. For those with chronic pain the experience of pain may, over time, become more intense and less likely to be tolerated. In many scenarios chronic pain is difficult to navigate, hard to manage and can lead, in some instances, to despair. Progressive thinkers believe chronic pain to be a condition in its own category and classified as such. Even with the best medical interventions, chronic pain is only relieved with pharmacological interventions only 58 percent of the time. This is not a good situation either for individuals, or for the medical community which they depend on.
Pain and Addiction
Some people equate pain with addiction. Many individuals see pain as a close relative to addiction and will avoid talking about pain or engaging in conversations about pain—medical personnel included. Some may even equate pain and pain medicine with a weak or undeveloped underlying character structure. There is no evidence to support this attitude toward people with pain. Some equate pain with sacrifice, repentance and heavenly gains. Others equate the inability to adequately cope with pain as a moral or religious issue. Extreme perspectives on pain exist across a variety of cultures, classes and abilities. Many refuse to take pain medicine and do not realize how much pain signals tax the body’s system. For some taking any form of pain medicine makes them “addicted.” For others, the ability to secure pain medicine forces them to interface with many pain medicine sources in an effort to obtain the pain mediating substance they believe they need simply to survive. Some professionals call this the “pain monkey ride”. Many health care providers are consumed with distinguishing legitimate from non-legitimate pain experiences. This includes doctors too. Some doctors refuse to give out any pain medicine due to fear and insecurities about treating those in pain. The process of experiencing and managing pain whether mostly subjective or objective is a complicated and multi-leveled experience.
Untangling the Knot
Healthy pain management is the process of accessing and implementing successful ways to cope with experiences of pain. The successful management of pain means managing physical and emotional pain signals where the quality of an individual’s life is maintained and not jeopardized. Coping with pain can be challenging. Many progressive thinkers believe that there is a significant connection between physical and emotional pain. When a person is in physical pain there are most often emotional elements feeding into this pain cycle; and where there is emotional pain there can be elements of physical involvement so much so that sometimes these two tracks merge together in the brain and fortunately or unfortunately, one track cannot be distinguished from the other. Some studies suggest that those who cope with pain more successfully are generally happier people. Other studies suggest that pain experiences are related to psychological health and well-being. Progressive thinkers relate there is a definite connection between biological health and emotional health and treating the wounds of past psychological hurts to alleviate current incidences of pain. It makes sense that when people are already stressed either emotionally or physically that causing them additional pain or suffering on either side only exacerbates the originating condition.
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Pain Management Screening
Pain Management Assessment
2 - 4 hours