Myth 1: I have been to several doctors but nobody can cure me of this chronic back pain. Will I have to live with pain all my life?
Reality: No, pain need not be a lifelong condition. You may need to find the right doctor who can, besides treating you, also understand your emotional needs. Pain specialists are especially trained to diagnose and treat pain from a ‘biopsychosocial’ point of view. A multidisciplinary strategy for pain management would especially be useful in chronic pain conditions not responding to conventional treatment. With very few exceptions, pain, however chronic and severe it may be, can be treated. But at the same time, it is important to have realistic expectations and short-term functional goals for recovery, especially for certain chronic pain syndromes.
Myth 2: Psychogenic pain is nothing but faking pain.
Reality: The person is not faking pain. The pain is real. However, the reason for the pain is not physical but psychological. Mind and body are not different entities but two sides of the same coin. If there is trouble in one, say physical, it creates problems in the other, which is psychological, and the converse is also true.
Myth 3: If a person has psychogenic pain, is she/he mad? Are we dealing with a mad person?
Reality: No, the person is not mad. The person is distressed. Distress could show in the form of depression or anxiety. Neurochemicals like serotonin and GABA play an important role in how the body responds to stress. With decrease in serotonin levels in the brain, the person develops depression. GABA functions as a ‘calming down’ chemical in the brain. Low GABA levels render it unable to inhibit or calm down overexcited neurons, and this leads to anxious behaviour.
Myth 4: Everyone has stress but not everyone develops pain. Is it only the mentally feeble and weak-willed persons who develop psychogenic pain?
Reality: Different people react differently to stress. Some people are oversensitive and feel stressed over trivial issues. They may not have developed an adequate coping repertoire to alleviate their stress levels. Perception of stress depends upon many factors, including the personality, social network, attitudes, motivation, expectations and mindsets. Particularly in psychogenic pain, the person may have learnt pain behaviour from parents or have had adverse childhood experiences.
Myth 5: Post-operative pain is inevitable and has to be borne.
Reality: Advances in medicine and medical technology have made post-operative pain more amenable to treatment. Providing relief from pain is not only humanitarian and the duty of all healthcare professionals but also addresses the issue of untreated or inadequately treated post-operative pain, which can prove harmful to the body. Besides preventing early ambulation and physiotherapy, postoperative pain can cause serious side-effects such as heart attacks or increase the risk of blood clots in the veins. These clots can get dislodged and find their way into the lungs, which can be lifethreatening.
Post-operative pain can also cause insomnia and emotional distress, leading to various psychological disorders such as depression, anxiety, stress and so on. In some patients, inadequately treated post-operative pain can lead to chronic pain conditions, which persist beyond the expected time of healing and can last for weeks, months and even years. For all these various reasons, it is important that post-operative pain be treated.
Myth 6: Bed rest is necessary following an episode of acute back pain.
Reality: Acute back pain can occur in 90 percent of people at least once in their lifetime. Following such an episode, bed rest should not be taken for more than one or two days. Prolonged bed rest can lead to weakening of the muscles due to lack of use (disuse atrophy), blood clot formation in the lower limbs, bone mineral loss and it can even cause psychological problems like ‘illness behaviour’.
Excerpts from the book, ‘Conquering Pain: How to Prevent It, Treat It and Lead a Better Life’ (HarperCollins India).
