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Do you have one of those things that really gets under your skin so much that it kind of drives you a bit potty about how helpless you are to do anything about it?  (for instance- why can’t Honda deliver a decent power unit to McLaren – who have actually produced a great chassis,  and...oh, sorry – wrong audience...). 

Well, here’s mine. 

It’s now pretty well accepted in the world of understanding pain that it is our sensitive nervous system that produces pain.  On top of that, pain depends on a whole host of stuff going on within our brains to actually experience it.  Pain is an output of our brain, not an input from our body.  If this is tricky to digest ask yourself: how does phantom limb pain happen?

Anyway.  We also know that stress plays a big part in the story of why someone develops pain and why increased anxiety and stress about what is wrong with you amplifies the feelings of pain.  This means that people in pain need to be reassured that there is nothing structurally wrong with them and that they can and should get better.  It’s also a great idea to draw attention to why their nervous system got this way in the first place and to explore ways in which they could be healthier.

But here’s what I hear all the time:

“My back hurt like crazy, I just woke up with it and I couldn’t move.  I got an emergency appointment at the surgery and two minutes later I was given some really strong drugs which completely zonked me out.  I was told to stay off work and they referred me for an X-ray.  Now I was really scared, because they don’t X-ray you unless they think something’s really wrong – right?  Anyway, the appointment took weeks and by now I’m scared to move, stuck on the sofa, and everything’s aching now.  The boss is on at me about coming back in or being let go and that.  So the X-ray results come back and I struggle in to get to the appointment because I can't drive now. They tell me that there’s nothing wrong with my back.  I was not happy.  Not at all.  I’m there saying ‘how can you tell me that when I’m sitting here in agony – do something!’  So after it all getting a bit heated (and by now my back is killing me) he tells me I can have an MRI scan done.  Good.  ‘At last’ I’m thinking – now I can prove that my back is damaged and I need the disc out, or whatever.  So, I’m signed off work again and told to take it easy as the last person they saw like this ended up in a wheelchair and had the back of a 70 year old.  So now I’m thinking ‘well that’s work stuffed isn’t it?’  I tell the wife that I’ll probably be off long term sick and she gets really upset at me like it’s my fault.  She’s crying about what we will do about the mortgage and the kids and all the stuff they need for school and holidays and all that.  By now I’m moody and my fuse is getting shorter. Probably because I’m hardly sleeping now- must be the mattress’ fault.  So a few weeks go by then I’m going for my scan and man, I’m scared now – thinking this is serious.  Things don’t hurt like this for this long unless it’s a tumour or something – right?  So the scan takes weeks to come through.  Actually, it was me that phoned the surgery asking if they’d had the results and they say ‘yeah, we’ve had them a couple of weeks ago’.   That didn’t go down well, I can tell you. There’s me freaking out and they’re just like ‘yeah, whatever’.  So I go in and the doc says ‘how can I help you?’ and I’m like ‘YOU SENT ME FOR A SCAN MATE, REMEMBER???’ Anyway, he’s looking at his screen and says – ‘That scan’s normal, so there’s not a lot we can do for you’.  I was gutted.  And I could tell he didn’t believe me.  Started doubting myself to be honest – thinking this might all be in my head.  But whatever, now I’m completely lost.  I’ve been seeing some guy who tells me my pelvis is out, or twisted or something and my back needs realigning because it’s unstable.  But all that treatment does is hurt.  I’ve been a few times but I don’t think I’ll go back...”

Now, granted that is not a direct quote from one person.  But it is snippets from conversations put together from different people I see every day and it forms the gist of so many conversations we have about pain.  I bet if you’re a pain sufferer you have identified strongly with some, if not all, of that.

How much simpler would that story have been had the first health professional understood that here in front of them was somebody calling out for help and reassurance?  How about a situation where they were listened to and told:

“You’re sore, but you’re safe”

“Hurt does not mean harm”

“Pain is the defender, not the offender”

“Motion is Lotion!”

Because what I see all the time are people whose pain is amplified by being put on the conveyor belt of catastrophisation.  And when they get to the end of it they are being dismissed as being loopy. 

Well, what’s loopy is the system that gets them into that state in the first place then washes their hands of that poor sod.

How about we recognise that pain is what our body will produce to protect itself when it is threatened, and that that threat exists from any source – not just physical. 

In fact, rarely physical and mainly emotional:

Stressed.  Under pressure.  Feeling run down.  Not sleeping. Freaking out.

We as health care providers need to get our house in order and stop adding fuel to the flames.

Or as Louis Gifford would have said:  Reassurance is a bloody good painkiller.

 Thanks for reading.

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