DR. MAX PEMBERTON: Pills aren’t always the answer to chronic pain… Talking can help, too

Of all the medical problems my patients have, chronic pain has to be one of the worst. People are often referred to me with this condition because their pain causes a devastating mood and it is heartbreaking to see them in agony, unable to sleep and never really resting.

They often rely on strong painkillers just to get through the day. Of course, the pills can also have debilitating side effects and often don’t really work.

The person cannot fully engage in life as the pain is always in the foreground and gets in the way. In fact, it can be so debilitating and isolating that it’s considered a major risk factor for suicide.

A woman in her 70s I saw recently had degeneration in her spine which meant she was never able to get comfortable. She spent the whole night in pain alone in a chair staring at the walls.

Someone suffering from chronic pain may find it difficult to get through the day and may feel crushingly depressed

She got up and tried to walk around, but was so unsteady on her feet that she suffered several falls. It was hell on earth for her – is it any wonder she felt miserable and wondered what the point was in moving on?

The causes of chronic pain are complex, and we’re still trying to fully understand how – and why – it manifests.

To complicate matters further, there are sometimes significant differences in the pain experienced by different people with a similar underlying cause, such as: B. a herniated disc, are felt. It’s not clear why some people experience pain so differently than others.

In addition, sometimes no underlying cause can be found. And yet the person is severely handicapped by it.

dr Max Pemberton (pictured) explains in detail how psychological steps could be taken to manage this pain and how they would work, including the five steps to solving the problem

People with chronic pain are often surprised to be offered psychotherapy instead of just more and more painkillers.

In fact, a study last week by the Stress Illness Recovery Practitioner’s Association showed that many chronic pain conditions can be triggered or aggravated by emotions.

Conditions like sciatica and fibromyalgia can be the result of a complex interaction between physical and mental conditions.

The researchers argued that emotional and physical issues are processed in the same part of the brain, and that chronic pain is likely in fact a “mind-body” condition in which emotions play an important role in triggering or exacerbating it.

One of the pioneers in this field, clinician and researcher Dr. Howard Schubiner, has studied how pain can be aggravated by the “Five Fs” – fear, focus on the pain, trying to fix it, frustration, and fighting.

Psychological steps to managing chronic pain often involve exploring and treating each of these elements in turn. This is consistent with what many clinicians know to be true – that our mental feelings can have a major impact on how we experience pain.

In fact, we’ve known this for many years, as it was first appreciated by anesthetist Henry K. Beecher during World War II, who observed that soldiers sent home to their families often did not need pain medication, even if they had suffered amputations or terrible injuries. This puzzled Beecher until he realized that, unlike the civilians he was used to treating, for the soldiers a serious injury was actually a good thing: it meant they were discharged from the army and returned home could.

Beecher’s breakthrough was that it is not necessarily the extent of the injury that determines how a person experiences pain, but the circumstances in which it occurs. It was one of the first studies to clearly document the power of the mind over the body.

However, I only know this story because an old, savvy anesthetist told me when I was a medical student—and bemoaned that advances in pharmacy had largely forgotten this aspect of pain management (except as a historical footnote in textbooks). in favor of exciting new pills and potions.

So I’m excited to see new studies that shed light on this complex and fascinating subject – we shouldn’t underestimate the power of the mind.

Unfortunately, it’s true that it’s far easier to prescribe painkillers and allow the patient to trudge out of surgery with a prescription in hand than it is to explore what might be going on in their life socially and emotionally, affecting their experience of pain could affect .

I often think that’s why complementary medicine—like homeopathy, naturopathy, and healing therapies like Reiki—is so popular with patients with these conditions, especially those for whom conventional medicine hasn’t worked.

It’s not just that people think it’s going to work, and that’s why it is – the placebo effect – that’s relevant, but the fact that the doctor sits down for a considerable amount of time beforehand and talks at length with the patient his life speaks . It is this interaction, I am convinced, that helps as much as anything else.

The real shame is that more psychological support for people with chronic pain isn’t readily available. Too many are dismissed with more pills.

The problem with painkillers is that they are not always as effective when used long-term and have a variety of side effects, especially in higher doses.

However, science is beginning to show that by providing emotional support to those affected, their lives can be vastly improved.

Today’s medical professionals would do well to follow in the footsteps of Dr. Kicking Beecher and remembering that what’s going on around the patient is just as important as what’s going on inside.

Too many people are being sent to A&E because the computer algorithm used by NHS 111 is “too risk averse”, said Dr. Adrian Boyle, President of the Royal College of Emergency Medicine, told MPs. I agree. Much in medicine is judgment based on experience and gut feeling. You can’t put that in a box.

We’re not all as lucky as Paris

dr Max Pemberton says although Paris Hilton (pictured) went public with the birth of her baby via a surrogate, we have to remember that this isn’t possible for everyone

Paris Hilton gave birth to a boy fathered by a surrogate mother. The 41-year-old made headlines around the world. Of course, she paid for it herself, and I don’t normally think that people’s reproductive choices are anyone’s business. But she’s just one of a growing number of women in the public eye who have resorted to surrogacy, and I marvel at the false expectations this inspires in young women’s minds about when they should start a family. Using a surrogate mother is a very expensive and complex way of conceiving. No one likes to talk about the limitations of things like IVF because there are many couples who are desperate to start a family and fertility treatment is their only option. But we also need to make young women realize that while their favorite celebrity may seem capable of delaying motherhood into their 40s or older, this is pipe dream for most.

• Britain is addicted to steroids according to the latest figures. Around 500,000 people now use it routinely – a tenfold increase in the last ten years. And no surprises as to what’s to blame — social media, of course. It seems strange that an image of a skinny, scantily clad woman is now frowned upon, given the recognition that such images inspire unrealistic expectations of women’s bodies. However, pictures of topless, ripped men are considered fine. My 13-year-old godson says that boys in his class are already wary of removing their tops when they switch to sports, fearing they don’t look muscular enough. Until we address the detrimental effects that reality shows like Love Island, advertising, and social media are having on impressionable minds, more young men will feel ashamed of their bodies and turn to things like steroids, which have potentially disastrous effects on their health .

dr Max prescribes…

orienteering

dr Max Pemberton argues that orientation is good for memory and may prevent cognitive decline

This used to be all the rage but seems to have gone out of style in recent years. But new research shows that orienteering could help prevent dementia. The researchers argued that in the age of GPS, critical areas of the brain responsible for navigation and memory are underutilized and this can accelerate cognitive decline. So get out your maps and compasses and hit the road!