"I just want my life back." This is what I hear from almost every one of my chronic pain patients. Not only do they feel trapped by their pain, they've lost hope. They're stuck. There seems to be no solution. No one believes the depth of their suffering. Their doctors haven't helped but, nonetheless, they go from one to the next – trying one treatment after another.
It doesn't have to be this way. I've developed a chronic pain treatment program called the DOCC (for "Defined, Organized, Comprehensive Care") project that you can do yourself. My book, Back in Control: A Spine Surgeon's Roadmap Out of Chronic Pain, outlines it in detail, but here is a simplified version.
Three Principles for Understanding and Eradicating Pain
Pain is complicated and affected by several variables (outlined below). The solution, however, is relatively simple. There are three basic principles:
- You need to gain an understanding of pain, in general, and your situation in particular.
- You then need to commit to using this knowledge to take complete control of your care – and eventually your life.
- You must put in place a plan to simultaneously – all at once – address each and every one of the variables that (as you've learned) affect your perception of pain.
Surprisingly, this process isn't complicated or difficult – in fact, most of my patients really enjoy it! Not only do they begin to feel in control of their lives but, as they see results, they begin to once again experience their lives as pleasant and rewarding.
Let's get started.
Variables That Affect Pain
The following "variables" affect how much pain you feel:
The Source of Your Pain
There are three separate, potential sources of pain – your pain may result from one, two or all three:
- Structural: There is an identifiable problem (your doctor can usually see it with an imaging test such as an X-ray, CT scan or MRI) and you have symptoms that match the problem.
- Soft-Tissue Inflammation: You've experienced an injury to your muscles, ligaments or other supportive tissues leading to inflammation in that area. This is a very common source of pain and it often cannot be visualized on an imaging test.
- Mind-Body Syndrome: The sensation that you experience as "pain" is actually neurological feedback loop. Sometimes, over time, the nervous system can "short circuit" and get, effectively, stuck repeating the same signals over and over again.
How to take control: Understand whether your pain involves one, two or all three of these components. It's important to realize one key bit of information: Surgery is often only helpful for structural problems. If you have soft tissue inflammation and/or mind-body syndrome (and many people with chronic pain have both) surgery is unlikely to make your pain go away.