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Pat Oreilly

The following is a series of articles by Pat Oreilly

We will be adding new articles on a regular basis

About the Author

Chronic pain is not just pain that lasts a long time...
Doctor, PLEASE...
Oxycontin
Multidisciplinary Pain Management...Why?
Pain Relief? You need to read this!
Addiction, Tolerance, and Other Nasty Wives Tales
More articles coming soon...

Multidisciplinary Pain Management...Why?

Pat Oreilly

With the acceptance of the gate theory a new and better form of pain management was inevitable. Scientists began to realize that pain is not just a result of nerve damage; it also had an emotional component. You don't just have the pain to deal with, but also how you feel about the pain because these and other factors have a direct effect on the type, severity, and duration of the pain.

While doing research into finding new and better pain relievers, scientists noticed something they did not expect. This was that the volunteers that were in a relaxed state, were expecting some pain as a result of the test, and were not afraid of the pain, had much higher pain thresholds than volunteers that were stressed, anxious, and had expressed some apprehension. In addition they found that in the test subjects that had expressed fear, the brain was sending out more inappropriate signals, and stronger signals than what was seen in the relaxed test group.

What does this mean to people living with chronic pain? Simply that by creating a "supportive" environment, with as little stress as possible, practicing ways to consciously relax, we can work to reduce the number and severity of pain signals the brain sends out.

People living with chronic pain, regardless of the originating factors, are experiencing an overload of inappropriate pain signals. For example, I have a disease that can cause pain. Because my pain was not addressed early and aggressively it has "taken a life of it's own," and now has become inappropriate for the type of disease I have. I have much more pain than I should with this disease.

This is why it is so important to treat early, and to re-invent our lives so that we can retain some control over the signals the brain sends out. We must learn not to deny the pain, but to embrace it and live the best life we can under the circumstances. This is one time in life where "hanging tough" can really work against us. We must embrace a multidisciplinary program to treat our pain. By learning and using different modalities we give ourselves the best chance of regaining a full life.

And where do I start?

Of course anything I say here is a suggestion. Only you and your doctor can design a program for you. Your doctor will try to start you with basic diet/exercise/relaxation techniques, and rightly so. If it is possible for you to start with these areas I encourage you to do so. But for many of us, until we get the pain under some control these things are impossible for us to consider.

Medication is a controversial subject for most chronic pain patients and physicians. When you understand the gate theory you understand that you must get the pain under control by any means possible before it makes permanent changes in the nervous system. However, medication is not effective for everyone, and for some the side effects are worse than the disease.

My philosophy is this; try the medication or any other aspect of the program. If adding the new ingredient contributes to your improved function, then add it to your regime. If it does not help to make you more functional, don't continue it unless your doctor has a special reason for you to add it. Some treatments or programs need time to work. Allow yourself sufficient time to receive the full benefit from the treatment. For most treatment options one month is sufficient.

Exercise

I think that next to medication exercise is the most important and also the most difficult portion of a multidisciplinary pain program. How can you exercise when you have so much pain?

I answer that question this way: If you don't find a way to exercise now, very soon it will be out of the question for you to exercise at all. As I have stated in numerous articles in this site, When pain is allowed to run rampant it will change your body in many ways, and none of them are positive. You will begin to send more pain messages, you will become hypersensitive to pain, you will decrease endorphin output, your connective tissue in your body will begin to harden so you will have decreased flexibility. This list is just the beginning. I have worked with many people that have Fibromyalgia, a diagnosis that I share. Some of these people are in wheelchairs, or confined to bed because the pain has become so intense and the tissue is so hard that they no longer have the choice. Had they pushed themselves in the beginning to keep moving, they would not be in this state today. This is not to judge them. For a long time no one knew how important it was to exercise. Almost every ailment that strikes us will be helped in some way by exercising.

It is very important if you are restricted with your pain that you begin at an appropriate level of difficulty, and increase very slowly. I had seen many people, myself included, that have gone head first into an exercise program only to find that it backfired and caused us to feel worse than when we started. This of course starts the internal dialogue that says, "See? I told you that I was in too much pain to exercise!" From this moment on that argument is to be disregarded. If you do find your pain increasing just back down a bit and keep trying. You will find the balance point where you can exercise without paying for it in ways that none of us want to pay.

Remember that exercising is a good way to fight depression and to increase endorphin levels in your body, so it will help the pain .

Relaxation exercises

Relaxation does not mean lying on the couch watching television. And it does not mean a day at the beach, although that can be beneficial also. Relaxation means a structured program of meditative, hypnotic, stress reducing quietness. There are many ways you can practice relaxation therapy. Meditation, Biofeedback, Prayer, Self-hypnosis to name a few.

When the body is in pain, it begins to tighten the muscles in the body in response to that pain. These chronically tense muscles cause more pain signals to be sent to the body. Over time this becomes the permanent cycle that destroys the quality of your life. When muscles are tense the blood cannot circulate properly and the muscles are not warmed. Pretty soon the muscles cause inflammation, which triggers more spasms, and angry nerves.

Relaxation exercises can break this destructive cycle and allow the body to rest a while. Over time these rest periods build up and allow the body time to heal. Common sense tells us that the more relaxation periods we can provide the body, the more likely the body will slow down the release of pain messages. And, once again relaxation is a good way to release those ultra important endorphins, and help your body fight pain the natural way.

Counseling and Depression

The question of which comes first, depression or pain will likely be fought over from here to eternity. Who cares? Depression and chronic pain go hand in hand and you can't treat one and leave the other and expect to have any lasting relief. Pain messages are pain messages, regardless of whether the pain is physical or emotional. Pain messages travel the same pathways as emotional aspects of who you are, and both send messages to and from the body about the current state of affairs. So when the brain is sending out inappropriate pain messages, it is likely that it is also sending information about your psychic pain.

Treating depression can teach you new ways to cope with the stress chronic pain has brought to your life. A professional therapist trained in pain management can help you to organize your priorities surrounding the pain, and also teach you new relaxation exercises. By using a professional you will reach your destination much faster and with fewer complications. It is a good investment.

Diet and Nutrition

I admit this is the area that I fall down most often. I want to eat what I want, when I want, and how much I want. This is an immature attitude, and one that does not work well for me. I know that I feel better when I don't overeat, and stay away from too much sugar and fat.

This body is the only one we will be given this time around. And if we want it to last a long time we had better take care of it and nurture it so it can support our desires. A balanced diet makes so much difference in how our body functions, that to ignore the rules about what we know is good for our body and what is bad is to insult God and the Universe who gave us this body.

Some chronic pain conditions are so sensitive to dietary adjustments that eating a small amount of the wrong food can send them into a tailspin that can actually result in death. Diabetes is an example. We all know that eating sugar when you are diabetic is like eating poison and can have far reaching and dramatic repercussions. Fibromyalgia, Myofascial Pain Syndrome, Chronic Fatigue Syndrome are also conditions that are made worse by too much sugar.

So the lesson here is that our body is what we feed it, and if we want it to last we had better get on the nutritional bandwagon, find out what is most beneficial to the condition(s) we have, and give our body what it needs to thrive.

All chronic pain must be treated with a multidisciplinary pain management program because it involves so many different parts of what makes us who we are. Chronic pain invades every corner of your life and to find the best chance of living a full and vital life we must examine and care for our self in as many ways as possible.

Pat Oreilly, 2000

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