Sufferers of chronic pain have long been told it’s all in their head. We now know that’s wrong

[Northerner]

It started with headaches and neck pain, but no sooner had Tricia Kalinowski’s physiotherapist come up with a strategy to tackle these problems, then another area of her body would start to hurt: her lower back, her hip or her jaw.

“The physio was chasing the pain up and down my body,” says Kalinowski, 60, from Minneapolis, US. Eventually, she was referred to an oral surgeon, who believed the root cause of these issues was a problem with one of the joints in her jaw, so she underwent surgery to replace a thumbnail-sized disc.

Unfortunately, the replacement was defective, triggering an immune reaction that resulted in the loss of several inches of jawbone. It took 13 rounds of surgery to fix the damage – the last of which was performed in 2015. “The irony to all the surgeries is that I still have headaches, I still have neck pain, and nobody really knows quite what to do about it,” she says.

Sufferers of chronic pain have long been told it’s all in their head. We now know that’s wrong

There’s a growing realisation that pain can be a disease in and of itself – and the pandemic could be making it worse

www.theguardian.com

 

[mikeyB]

Pain is all in the mind. That’s how opiates work, whatever the source of the pain. Other painkillers like paracetamol or NSAIDs like Brufen treat the source of the pain. Pain relievers in neuropathies, such as the old antidepressant Amitryptiline, and the anti epileptic Pregabalin work by increasing the threshold at which neurones signal pain.

The gold standard of pain relief is diamorphine, still used in end of life situations. No need to fear it - it’s not as addictive as some regularly prescribed opiates like Oxycodone. But if diamorphine doesn’t relieve pain, then give more diamorphine. It always works eventually. Doses tend to be lower if you let the patient self control via a pump.

In this case specifically, the pain is clearly something dreamt up by her body, given the pain’s period of roving round her body. No analgesic will work against that. A shedload of CBT might well help.

 

[Drummer]

My daughter in law had an operation on a knee which went wrong and the pain was dreadful.
One expert wanted to treat it by lightly tapping the joint - something which would have caused agonising jolts of pain at every tap.
When she was told 'no' the expert threw a paddy and removed her patient from the pain clinic and she was left without any help for some time - during which her leg became deformed and it took a lot of physiotherapy to even be able to stand up without support.
Over the years there have been accusations of addiction, misuse of prescriptions, attention seeking and it is now almost a decade since the operation and the family is living on benefits - fortunately my daughter in law was just about to start work at a solicitors office, and she is highly qualified with a photographic memory so they have managed to survive fairly well - though at one time they had to repay money which they were told they had been overpaid even though their claims had been done correctly.

 

[Nayshiftin]

Unless it is a headache no pain is in your head but in pain it is never out of your mind either. I suffer from pain and believe you me it is not attention seeking nor is it to gain anything. I would like to get rid of it. I am sorry for others in pain because it does take over you. Hopefully something will help one day.

 

[mikeyB]

Well, if your mind is inside your head, then the pain is being experienced in your head - or brain. It’s the brain that reports your pain. The brain itself has no pain receptors - that’s how brain surgery can be carried out while patients are conscious.

All pain is experienced in the brain. So is sound and vision, and the sense of touch. General anaesthetics affect your brain, they don’t numb the pain receptors in your body.

None of that suggests that reporting pain is attention seeking, pain is your body telling you something is wrong. As I said earlier, if you have pain that is not relieved by pain killers, get a better pain killer. Three days out of the last 10, breakfast has been a double espresso, a vape, and two Tramadol just to get out of bed and interact with the world. Works for me, so I’m content.