Pain is a symptom. Symptoms are the feedback that the body generates when it faces problems with its delicate internal balance (homeostasis). Without symptoms like pain, thirst, nausea and fevers, it would be very difficult for us to maintain a healthy body in the same way that it would be hard to drive a car safely with no dashboard display.
The Family Doctor Myth
There is nothing wrong whatsoever with seeking pharmaceutical pain relief to tide you over until real healing of your chronic pain starts to take effect. But in most instances, seeking real answers to chronic pain from your family doctor is a highly questionable endeavour. Doctors are trained and equipped to treat medical issues. And there can be grat value in drawing a distinction between medical issues and fundamentally non-medical issues. Value for us individually but also value for an overloaded healthcare system.
Is a tight hamstring a medical issue or something that you just need to stretch out?
Is the common cold really something medical, or is it between you and your immune system?
Is a weak pectoral muscle something medical? Or is it between you, your willpower, and the humble press-up?
At what point do sickness, weakness, tightness, and soreness become medical issues?
These are not easy questions to answer necessarily in some cases, and yet in other cases, they are extremely easy to answer. Like those above.
There is no question that if the struggles faced by our musculoskeletal system become severe enough that they can become medical issues. Major injuries and auto-immune disorders qualify. Yet, perhaps surprisingly, chronic pain seldom qualifies. Despite the severe impact it can have on our lives.
I meet people on a daily basis who have been back and forth to their family doctor for years, asking for help with their pain. They are often quite frustrated with the way their issues have been handled.
The list of solutions explored tends to follow the same basic patterns. Pain killers, non-steroidal anti-inflammatories, blood tests, x-rays, surgical specialist referrals, steroid injections and, sadly, on occasion, opioid medications, which have been conclusively shown to be far more lethal than chronic pain itself. All of which approach pain as if it was a disease rather than a fundamentally healthy form of biofeedback.
In an attempt to loosely measure how well we manage pain in the elderly, a group of researchers measured the duration of pain consults in doctors’ offices.
Many elderly patients consult their doctor about multiple issues at the same time, so it was a little tricky to design the study. Getting specific about the duration of pain
consults meant it was necessary to start a timer the moment a patient mentioned pain and stop the timer again once that part of the conversation concluded. They did this across hundreds of doctor visits.
The average duration of a pain consult for an elderly patient at their doctor’s was less than 3 minutes, which is close to constituting a complete dismissal of a very serious health issue.
To put that in context. In my clinic, we often spill over the 60-minute mark in initial pain consults with older patients. And trust me, I am every bit as time-poor as any of those doctors.
The time spent on specific issues reveals a great deal about practitioners. It’s a direct flow from the amount of honest training, thought and focus we have placed on that topic. If you asked me or your dentist for some advice about diabetes, this would be apparent. That would be a very short conversation, mostly about who you should actually be talking to.
Now, I’m not claiming any insight into what your doctor has or has not done for you. Nor am I seeking to diminish the good work family physicians do.
I am merely seeking to highlight the undeniable truth of this matter; the average family doctor’s education does not encompass the rehabilitation of chronic pain: any more than it does the management of tooth decay. It’s just not their field of expertise.
The fact that so many of us still rattle on year after year, Endlessly consulting doctors who know next to nothing about rehabilitation, biomechanics or pain management, is just another symptom of a society that struggles with pain.
Cut your family doctor some slack; they do a hard job. If you are peeing blood one day, they might save your life. But if you have knee pain, consider leaving them in peace.
Our problems become medical once they are so bad that the body cannot heal itself any more, like a badly broken bone or an infection that exceeds the immune system’s capacity. Less than .001% of chronic pains qualify. The body has the ability to resolve chronic pains in the same way that it has the ability to resolve obesity or a general lack of fitness.
Work with professionals who are actually trained to diagnose, treat, and rehabilitate pain. Just make sure they are primary healthcare providers. You might have something serious going on, so they need to be fully qualified! If you do it this way, with the right people, everyone wins, but mostly you.
But of course, there is nothing wrong whatsoever with seeking pharmaceutical pain relief to tide you over until some real healing takes effect.
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John is one of those rare gentlemen who has continued to play competitive soccer well into his late 50s. He is in really good shape, which you need to be to play football at that age—good shape except for his left leg. His left leg is not in good condition at all. In fact, once you get to know his left leg a bit better, it becomes apparent that it’s miraculous that he’s able to run at all, Let alone the type of running required to play competitive soccer against younger men.