/uploadedImages/Bios/Blatman_Hal.jpgPain is one of the most common complaints that bring people to seek medical care. And for how common it is, treatment options and outcomes remain unsatisfactory. The sciences of physiology and biology are teaching us about how the nervous system changes with chronic and even acute pain…Read More>>

By Hal Blatman, MD 

Pain is one of the most common complaints that bring people to seek medical care. And for how common it is, treatment options and outcomes remain unsatisfactory. The sciences of physiology and biology are teaching us about how the nervous system changes with chronic and even acute pain. The pharmaceutical industry is teaching us how medications block or modify various aspects of the nervous system pathways that fire pain sensations to the brain. Pain doctors kill nerves, inject steroids to reduce swelling or inflammation, and implant electrodes next to the spinal cord that they know will cause scar tissue. Surgeons tell us that surgery is a last resort, and yet for many people it seems that all roads lead in the direction of trying to “fix” something. Pain clinics add a chiropractor or an acupuncturist and market themselves as an “integrative” or “holistic” clinic. Some pain clinics may work to “detoxify” patients and taper to discontinue “dangerous” narcotic medications and encourage a life of pain while taking NSAIDs (anti-inflammatory medications) and doing meditation and other therapies for relief. Other pain clinics prescribe high doses of opioid medications, and find that several patients are able to return to work, and most continue to have significant pain symptoms anyway. Other clinics add a component of “mind-body-spirit” to the more conventional techniques and medications. All of these understandings and treatments have their place, and none work as well as treatment providers and patients wish they would. 

What is a person to do? How is one to make sense of all this? And is there another path (in the middle of this soup where nothing seems to work) that patients might take? 

In a word, YES, and there are lots of things to explore and do. 

During the past 30 years, I have learned a lot about how to successfully treat pain. It is not what I was initially taught in orthopedic surgery, neurosurgery, or even pain medicine. Indeed, most of the things we have been taught that didn’t work and didn’t make sense, actually don’t work and don’t make sense. Fortunately, there is much we can do to help our patients, and there is so much that they can do to help themselves. We, as healthcare providers, should be learning a different way to treat pain. 

Most of the pain in the body comes from muscle and fascia, not from bone, disc, or nerve. Most of what gets in our way and keeps us sick and in pain, is our food, and much of what well meaning doctors and therapists do to us with medication and procedures. 

Wow! And True! 

Diagnosis of pain is a difficult process. We are taught to differentiate the cause of pain by the quality of symptoms. Indeed, there is no sensation of pain that anyone can describe that can’t come from muscle and fascia. It does not matter whether the pain is burning, numbing, tingling, aching, stabbing, cramping, or radiating….and these sensations can all occur at the same time. 

There are foods we eat that fire up the genetic structure in each of us that increases pain and inflammation in our bodies, and it takes 3-4 weeks for these systems to settle down after an exposure. Food choices can reduce the effectiveness of pain medications and various therapies. 

Commonly prescribed medicines stop our bodies from healing. 

Sleep is important, and people in pain often have difficulty sleeping. Without sleep, our bodies do not restore. 

Hormones are important. Some are needed to decrease anxiety, and some are needed to carry pain medications to the brain. Others are needed to promote the physiology of healing. 

When we injure our bodies, there is an internal mechanism that works to heal the injury. Part of healing from pain is making this same mechanism work again and again to continue the healing process years after the injury. 

A “Comprehensive Treatment Plan” for pain takes all of this into account.  

Successful treatment will involve diet and nutrition, muscle and fascia, mind-body-spirit, innovative ways to use medications, hormones, environmental detoxification, and many other nuances of how we can help our bodies heal.