It has recently been in the news that the National Institute for Health and Care Excellence (NICE) has issued a new draft guidance, which is open for review until 14th August, reviewing the assessment and management of Chronic Pain.
They are recommending that medications such as Paracetamol, NSAIDs (including aspirin and ibuprofen), benzodiazepines, and opioids, should not be offered for chronic primary pain in over-16s!
They have found that many studies are now showing that taking medication for the treatment of chronic pain does not work, and indeed can cause other problems, one of which is addiction to the pain medication.
So what is chronic pain?
Chronic pain is pain that has been there longer than what we would normally expect given the situation, and that lasts longer that 12 weeks.
We have known for a long time that taking medication only masks a lot of problems – yes it keeps you alive and maybe out of pain for a short period, but it never addresses the real question – why and how is this happening in this person?
We are all different, and have traveled different paths to get where we are today – no one is the same, for we are all unique.
We also know that pain is not just about tissues – ie a cut or a broken bone etc. We know that pain is in fact also an emotion – which means that pain experienced in the body can be emotional – psychosomatic – psycho referring to the mind and somatic referring to the body. You can also get viscerosomatic pain which is referred pain from the viscera – your organs.
The questions that we always consider here at the clinic are these. Why/how is this individual person before me suffering with what they are? How has it come about? What particular combination of life events have contributed? What is their lifestyle, home and work life, their diet and sleeping patterns? All of these factors are intricately woven in each individual, resulting in how they are presenting to our clinic today.
NICE is realising this and are recommending looking at how we think about how our body works, and working on the emotional side of things. This has come out of old ways of thinking and explaining things -such as ‘slipped disc’ and degeneration, osteoarthritis – my spine is crumbling, I have a weak back etc.
Thinking and believing this usually causes fear and means that one then usually stops moving and exercising which results in lack of fitness, reduced mobility, stiffness, etc. which then feeds and further supports the beliefs – this results in a downward spiral and and increased fear of doing anything, spiralling down and down.
One can end up saying that one is always in pain, and indeed that may be the case – but in many cases it is not. If you were to stop now and ask yourself the question – am I in pain? What would the answer be? If the answer if no, leave it there. Unfortunately if we are used to being in pain, when we get the answer no – we then go looking for it! And surprise surprise, we eventually find what we are looking for – reinforcing the belief patterning.
As you can see, pain is a complicated subject, but one that we have huge knowledge about and are experienced in dealing with – it is after all the main reason why someone comes to see us.
A last bit of advice would be to come and see us as soon as you start to have pain – you are not wasting our time and it does not need to be excruciating – remember it is your body trying to get your attention about something! Do not let it become chronic! If you have been suffering with pain for some time, seen lots of specialists but not an osteopath, then please do book a session – we may well have another way of working with you and supporting you as we work out together why and how you are where you are today.
This article is written by Karen Robinson, our Clinical Director.