Chronic Pain
by Evelyn Cole
When I was nine years old my father suffered a “nervous
breakdown”, whatever that was. The term is no longer in
vogue. Too vague. He was sick in every part of his body.
When one part healed another part hurt. He thought he was
dying.
We moved from the city to a country farm. We didn’t have a
telephone because he couldn’t stand the ringing of a phone.
His doctor finally told him he needed to see a
psychiatrist. That shocked him into reading everything he
could to heal himself. It took him seven years.
During that difficult time my mother suffered chronic back
pain.
I suffered chronic shoulder pain relieved by daily use of a
Chi machine until I had both shoulders replaced.
I’m sure you know someone who suffers chronic pain. It’s
no fun.
Here are excerpts from a fascinating lecture presented at
the 14th annual meeting of the AmericanAssociation of
Orthopaedic Medicine, Tempe Arizona Feb.21, 1997
Psychological Factors in Chronic Pain: An Introduction to
Psychosomatic Pain Management by Dr. Dietrich Klinghardt,
M.D., Ph.D.
“Most pain treating physicians have a vague notion that
there may be a psychological component contributing to the
severity of chronic pain. The International Association for
the Study of Pain defined pain as ‘an unpleasant sensory
and emotional experience associated with the actual or
potential tissue damage’.
“The well respected British neurologist and researcher
Barry Wyke demonstrated that the neurological signal from
a painful stimulus travels from the receptors in the
periphery to the thalamus, where the message is split: one
pathway goes up to the sensory cortex, telling the patient
where the pain is and what particular sensation it causes
(warm, pulling, pressing etc.). The other pathway goes to
the frontal lobe, which is now accepted as being partially
part of the limbic system. Stimulation of this area gives
the patient the emotional experience that goes along with
having pain (”it makes me sick, hopeless… I feel terrible…
I am afraid… etc.).
“Patients that had their frontal lobes removed can still
tell pain, but there is no suffering whatsoever that goes
along with the experience. It is really the “psychological”
component that has earned chronic pain the attention it is
given in modern medicine. Why then are we not focusing our
attention on the ways in which we can help patients in this
area? Why are most of us still trying to “fix” pain with
all the invasive procedural approaches available today? Why
not develop a psychological intervention that treats the
emotional part of chronic pain and leave the rest alone?
“One of the main reasons I found for this dilemma can be
explained quite simply: Medicine is a science that has
clearly come into it’s adulthood. Many safe injection
procedures and other technical approaches are available
today. These are teachable, learnable and reproducible.
Psychology however is a young science with many diverting
opinions ,each exploring different personality models,
being based in often contradictory philosophies.
“In 1992 the San Francisco Spine Institute published a
paper in Spine Magazine. 100 adults with MRI proven severe
lumbar disc herniations were preoperatively interviewed
regarding five possible traumatic situations in their
respective childhood:
1. Physical abuse
2. Sexual abuse
3. Emotional neglect/ abandonment
4. Loss of one or both parents (divorce, death etc.)
5. drug abuse at home (alcohol, prescription drugs etc.)
The patients were assigned to 3 different groups:
1. None of these risk factors
2. One or two risk factors
3. Three or more
The long term postoperative success was as follows:
1. 95% excellent improvement
2. 73% improvement
3. 15%improvement
“What does this mean? The result of surgery and
postoperative pain have little to do with the surgical
procedure itself but largely depend on factors that date
back to the childhood of the patient. It can be easily
extrapolated from this study that the same is true for
many or all of the other procedures used in pain
management, including osteopathic manipulation,
prolotherapy and others. A follow-up study demonstrated,
that brief targeted psychotherapy that addresses these
specific issues, could improve the postsurgical results
dramatically in groups B and C. Pelletier showed that
patients, who had a”severe”childhood, but matured through
the process of good psychotherapy, ended up having a higher
life-expectancy than people that had a “happy” childhood.
“Another study, conducted by several AAOM affiliated
physicians (Klein, Eek, Dorman et al) pointed indirectly in
the same direction as the Spine Institute study: Patients
were examined regarding the severity of their MRI findings
before undergoing prolotherapy treatment. There was no
correlation between outcome and the severity of the lesion:
patients with severe pathology had the same success rate as
the group with no demonstrable pathology, i.e. some
patients with no demonstrable pathology did not improve
with prolotherapy, others with severe pathology did
improve. This study did not look at the probable underlying
psychological problems even though I would dare to say,
that just as in spinal surgery the outcome of the treatment
was determined by the same 5 psychological factors, not by
the severity of the lesion.”
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With recognition of psychological factors in chronic pain
and illness that travels the body, medical doctors now
studying the neurological pathways of chronic pain are
recommending treatment rather than prescription drugs. No
longer is there shame that the subconscious mind can be the
source of pain.
Don’t take seven years to get well.
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Evelyn Cole, MA, MFA, The Whole-mind Writer,
http://www.write-for-wealth.com
evycole@hughes.net
Cole’s chief aim in life is to convince everyone to
understand the power of the subconscious mind and
synchronize it with goals of the conscious mind.
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Add comment December 5th, 2006