Saturday, March 27, 2010

Chronic Pain - Largest Investigation Ever

In 2000, the Workers Compensation Board of Ontario (now the Workplace Safety & Insurance Board) released a set of final reports under the project title of Chronic Pain Initiative. This was a huge investigation and to my knowledge, the largest ever done.

Over 11,500 scientific studies were reviewed. This, on its own, tells you the scope of chronic pain as a serious health problem. Ten years ago, there were already over 11 thousands investigations done. Today, with the increasing awareness in public and scientific circles, that number has mushroomed. There are still many scientific questions regarding the exact mechanisms underlying chronic or long-term pain. But, no one can credibly deny its existence. (Sadly some still try, however).

The Chronic Pain Initiative resulted in 3 final reports. I believe that they are still available from the Workplace Safety & Insurance Board ( One report summarized the overall findings. A second report reviewed conclusions from the expert scientific panel. A third report emphasized policy recommendations.

As a psychologist, I was especially interested in the expert panels review of potential psychological causes of chronic pain. My personal views were, and still are, that any psychological causes, if they exist at all, are very rare. After reducing the 11,500 studies to only those with credible methodology, the panel was unable to find any clear evidence for psychological causes. It is clear that chronic pain can cause additional psychological injuries, such as depression and anxiety. But, these psychological injuries are caused by the patients long-term pain and widespread losses. Not the other way around. This is not only true for chronic pain, but for any long-term medical problem.

There is a long history of psychological and psychiatric theories, which try to explain the origins of chronic pain. There are theories of long-term migraine pain, back pain, neck pain and even multiple schlerosis. Understandably, these serious medical problems can cause depression and anxiety. There is no evidence that they have any psychological causes, however. The Chronic Pain Initiative has provided evidence to support this view and made an important contribution to this field. Congratulations.

There is a whole chapter, on these studies, in my book, Unbelievable Pain Control: How to Heal and Recover from Chronic Pain & Fibromyalgia (see details at ). Go have a look.

Thursday, March 18, 2010

Chronic Pain - Seven Simple Truths

Living every day in pain is a battle - a battle with injury, pain and the many ways that pain interferes with your daily life. If you have been hurt in a car or work accident, you may also have to do battle with insurers, employers and lawyers. At the same time, you are trying to keep your head above water and not drown in all of this stress.

Here are some simple ways to cope with these battles and to keep your chronic pains from completely taking over your life.

1. Chronic pain is real, not imagined. It is never “all in your head.”

2. You can’t get better until you stop getting worse. The first step is to recognize this pattern. Even by itself, this step can make a big difference.

3. When you go to war with pain, pain always wins. There are much better ways to gain control over your pain.

4. A simple flare-up formula: pain causes stress, which then causes more pain. If not stopped, the flare-up keeps building to a mountain of pain. The best way to decrease a flare-up is by reducing the aggravations that are feeding the fire.

5. For some people, coping with constant background pain is the easier part. Repeated flare-ups are what bring you down. Reducing flare-ups (and learning to avoid as many as you can) are the best ways to gain pain control and a speedy recovery.

6. If your benefits are cut off, recovery is over. When your losses escalate, it is almost impossible to gain the energy, strength, and pain tolerances necessary to move forward in your life. Make sure you work with your doctors and lawyers to protect your benefits.

7. Helplessness and anger can give pain the power to defeat you. They add fuel to the fire. But not all types of anger are harmful. Anger directed toward simple, achievable goals can give you a powerful boost toward recovery.

These ideas are expanded and detailed in Book Two of Unbelievable Pain Control: How to Heal and Recover from Chronic Pain and Fibromyalgia. You can find out more information and helpful advice from

Saturday, March 13, 2010

Chronic Pain - $100 Billion Validation

Recent estimates have put the costs of chronic pain to society at $100 billion in the United States alone. These costs are related to lost work days, as well as disability and health care expenses. That’s huge. And this doesn’t even count the tremendous costs (and suffering) to individuals and their families.

Health, disability, worker’s compensation insurers, as well as personal injury lawyers, complain that these costs are uncalled for. To me, such statistics demonstrate the reality of chronic pain and its costs to individuals and society. It takes big numbers for this serious health problem to be given the recognition it deserves.

In my experience, insurance companies are not in the habit of giving away money unless they have to. Chronic pain is now being recognized (if begrudgingly) by health, disability, and workers compensation insurers, as well as by the courts and government agencies.

It is still very difficult for individuals with long-term pain to get the level of care that they need. They still have to fight for income protection, when they cannot work. I believe that we are making progress, however. Chronic pain is a real, physical and in many cases disabling, health problem that deserves our recognition and attention - just like any other serious health problem.