{"id":2154,"date":"2024-03-16T07:08:04","date_gmt":"2024-03-16T11:08:04","guid":{"rendered":"https:\/\/earthmoves.vassarspaces.net\/?p=2154"},"modified":"2024-03-19T13:21:09","modified_gmt":"2024-03-19T17:21:09","slug":"broke-your-leg-go-to-therapy-a-new-approach-to-pain-treatment","status":"publish","type":"post","link":"https:\/\/earthmoves.vassarspaces.net\/?p=2154","title":{"rendered":"Broke your leg? Go to therapy:\u00a0 A new approach to pain treatment"},"content":{"rendered":"\n

A Newletter by Stuart Heintz<\/p>\n\n\n\n

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Pain is a sensation, an emotion, and can be entirely consuming. While nearly all of us experience pain, we have different relationships to it. Some folks live relatively pain-free lives, while others spend thousands of dollars a month for a few moments of relief. Some people even seem to seek pain out. But what is pain? How can we quantify and understand a universal experience with so much variance? <\/p>\n\n\n\n

The basic purpose of pain is to act as a warning signal to alert and prevent your body from further harm. Pain can be helpful and necessary for detecting issues like a broken leg or open wound and understanding where we are in the healing process. In these cases, there is acute harm that has happened to the body, and pain is its screaming, “Hold up! Something is wrong here!!”. But pain can persist and become chronic, like in the case of an osteoarthritis patient (when the cartilage that acts as “cushioning” between joints wears away, resulting in bones grinding against each other). Here, the body has been alerted that something is wrong, but the pain itself is more of an issue than the lack of cartilage on the bone. With chromic pain, treatment shifts to dealing with the pain that has surpassed the injury. Sometimes, our bodies tell us we are in pain when, in reality, it is just a malfunction occurring somewhere along the pain pathway. <\/p>\n\n\n\n

New studies have shown that the prevalence of chronic pain has significantly increased for all US demographics (especially for those of lower socioeconomic status) and, with it, the use and prescription of opioids. Medication is a powerful and important tool for pain management, and for some people, it is the key to resolving pain. However, it does not work for everyone, and excessive medication use can lead to addiction and further harm. The number of chronic pain sufferers is increasing in part because of the narrow approaches our healthcare system provides for pain management and the emotional exhaustion that comes with years of ineffective treatment. Recent studies have found that treating pain through a biopsychosocial approach (I know that’s a big word; don’t worry, we will break it down!) can be the key to pain management, but to understand how it works, you must first understand pain.<\/p>\n\n\n\n

Pain is constructed in the brain based on input from the body. When someone tells you, “It’s all in your head,” they are not wrong. However, this does not mean your pain is not real. Since our brains create pain, all the other stuff up there impacts how your body feels pain. Environmental factors like genetics, sleep, diet, and exercise will all affect our perception of pain, but so will emotions, memories, and other components dictated by the brain. Pain and emotion circuits in the brain overlap, creating a shared neural network known as the “economy route, ” allowing the brain to process more efficiently. We simultaneously process pain and emotion in the same structures, meaning they constantly impact each other. So if you skin your knee while diving for a home base to win a baseball game while your team screams your name, it’s still going to hurt, but probably not as much as skinning your knee falling off your bike after having a fight with your friend and failing a math test. Essentially, how we are feeling emotionally determines how severe we feel physical pain. <\/p>\n\n\n\n

When we feel pain, we tend to focus purely on the biological component. We have constructed a healthcare system around fixing the signaling that sets off our pain warning alarms. But that is only one angle of pain. Let’s go back to that big word- Biopsychosocial. Right now, we are only looking at the Bio component of pain and ignoring the psychological and social components that play just as big of a role in our experience with pain. This model is especially relevant for folks with chronic pain. After all, no matter how good of a day you are having, a broken leg will always hurt! But when it comes to dealing with long-term pain, it is critical to address our psychological and social well-being. And this is challenging because physical pain makes us feel bad. It causes us to isolate ourselves, stay inside, and deprioritize things that make us feel physically and socially good. Don’t get me wrong, sometimes this is needed! If you have the flu or a migraine, staying home and sleeping is critical to getting well. When it becomes a pattern, the brain becomes overwhelmed with physical pain and lacks positive input from nonphysical things that we enjoy. Neural networks are like muscles; when you use them or “work them out,” they become stronger. So when we focus solely on pain, not only are we deprioritizing other things that make us feel good, but we are also strengthening these pathways that do not make us feel good, resulting in hypersensitizing our brains to pain. <\/p>\n\n\n\n

Our lives are constantly moving, demanding, and full of stress. Pain can take over, and usually, the first thing to succumb to it is our free and social time. However, catering our lives to pain only makes things worse. Pain treatment is like a recipe. Multiple components come together in specific ways that can prevent or relieve it. Medication may be one ingredient. But what good is a cup of flour without the butter and sugar to make it into a cookie? Whether you struggle with pain every day or once a month, if its root cause is physical or emotional, if you have sought relief or not- consider the things (especially the small things) that bring you joy each day. A little dose of that may be all the medication you are missing. <\/p>\n\n\n\n

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References <\/p>\n\n\n\n

\u201cBiopsychosocial Model – an Overview | ScienceDirect Topics.\u201d Www.sciencedirect.com<\/em>, www.sciencedirect.com\/topics\/medicine-and-dentistry\/biopsychosocial-model.<\/p>\n\n\n\n

\u201cDolorology (PAIN) with Dr. Rachel Zoffness.\u201d Alie Ward<\/em>, 10 Nov. 2021, www.alieward.com\/ologies\/dolorology.<\/p>\n\n\n\n

Dowdle, Logan T., et al. \u201cSensitized Brain Response to Acute Pain in Patients Using Prescription Opiates for Chronic Pain: A Pilot Study.\u201d Drug and Alcohol Dependence<\/em>, vol. 200, July 2019, pp. 6\u201313, https:\/\/doi.org\/10.1016\/j.drugalcdep.2019.02.024. Accessed 10 June 2021.<\/p>\n\n\n\n

Editors. \u201cWhy Human Beings Secretly Want to Feel Pain, according to a Psychologist.\u201d Next Big Idea Club<\/em>, nextbigideaclub.com\/magazine\/human-beings-secretly-want-feel-pain-according-psychologist-podcast\/32973\/#:~:text=Some%20people%20think%20humans%20are%20natural%20pleasure%20seekers. Accessed 19 Feb. 2024.<\/p>\n\n\n\n

Edwards, Robert R., et al. \u201cElevated Pain Sensitivity in Chronic Pain Patients at Risk for Opioid Misuse.\u201d The Journal of Pain<\/em>, vol. 12, no. 9, Sept. 2011, pp. 953\u2013963, https:\/\/doi.org\/10.1016\/j.jpain.2011.02.357.<\/p>\n\n\n\n

\u201cEmotional and Physical Pain Activate Similar Brain Regions.\u201d Psychology Today<\/em>, 2012, www.psychologytoday.com\/us\/blog\/body-sense\/201204\/emotional-and-physical-pain-activate-similar-brain-regions.<\/p>\n\n\n\n

Meints, S.M., and R.R. Edwards. \u201cEvaluating Psychosocial Contributions to Chronic Pain Outcomes.\u201d Progress in Neuro-Psychopharmacology and Biological Psychiatry<\/em>, vol. 87, Dec. 2018, pp. 168\u2013182, www.ncbi.nlm.nih.gov\/pmc\/articles\/PMC6067990\/, https:\/\/doi.org\/10.1016\/j.pnpbp.2018.01.017.<\/p>\n","protected":false},"excerpt":{"rendered":"

A Newletter by Stuart Heintz Pain is a sensation, an emotion, and can be entirely consuming. While nearly all of us experience pain, we have different relationships to it. Some folks live relatively pain-free lives, while others spend thousands of dollars a month for a few moments of relief. Some people even seem to seek…<\/p>\n

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