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3 Must-Haves for a Different Approach to Chronic Pain Care

Chronic pain is chronically mistreated in America.

Key points

  • Many people suffering from chronic pain conditions receive ineffective, unnecessary, and costly interventions that leave them in continued pain.
  • Understanding and acting upon the neuroscience behind chronic pain is key to better outcomes.
  • The most effective treatment for chronic pain is a whole-person approach incorporating education, exercise, and behavioral support.

Musculoskeletal (MSK) pain is widespread in the United States. Experts estimate that the annual costs of MSK conditions, including healthcare costs and lost worker productivity, are in the range of $600 billion. This astounding number far exceeds the yearly costs associated with heart disease, cancer, and diabetes.

Yet, the unfortunate truth is that many people suffering from chronic MSK conditions receive ineffective, unnecessary, and costly interventions that leave them in continued pain. Why are so many surgeries and other treatments unsuccessful? One reason is that treating chronic and acute pain in the same way simply doesn’t work. Understanding and acting upon the neuroscience behind chronic MSK pain is key to better outcomes.

Your Brain Controls Your Chronic Pain

With acute pain, the body’s process for generating pain is quite straightforward. The brain receives a signal, realizes that there is danger, and then makes the body feel pain. This occurs when people experience musculoskeletal pain caused by damaged bones, muscles, tendons, and disks.

The story of chronic pain, however, is more complex. Research has shown that chronic pain is poorly correlated to tissue damage. So, what’s going on? The nervous system–nerves, the spinal cord, and the brain–becomes overprotective and oversensitive in people suffering from chronic pain. In essence, the nervous system becomes too good at generating pain.

This is why individuals with chronic pain experience symptoms that persist even after their injuries have physically healed. Clinicians often fail to treat chronic MSK pain effectively because they focus on fixing tissue damage rather than treating the over-sensitized nervous system. This approach doesn’t relieve pain.

Chronic pain correlates with lifestyle, behavioral, and emotional health factors like insufficient sleep, depression, stress, obesity, and a poor diet. Studies have found that nearly two in five people with chronic pain also have associated depression.

Treating Chronic Pain Requires a Different Approach

Effective treatment plans for chronic MSK pain treat the individual’s overactive nervous system by incorporating three components:

  1. Education about the neuroscience of pain. Simply changing a person’s understanding of pain can change how their brain perceives pain. If patients know that their pain is real but not associated with physical damage, they are often more willing to engage in physical activity. Breaking the pain cycle of fear and depression is an essential step on the path to recovery.
  2. Exercise. Low-intensity movement reduces pain signals from the body and is beneficial in many other ways. Exercise stretches muscles which facilitates movement. It also lubricates joints, strengthens bones, and helps to build cartilage. When done correctly, exercise can desensitize the nervous system and reduce chronic pain. From a mental health perspective, movement enhances a sense of well-being by releasing endorphins and other chemicals.
  3. Behavioral support. Treatment plans based solely on physical therapy aren’t the answer for chronic MSK pain. Encouraging healthy lifestyles and behaviors that can desensitize the nervous system is essential. Emotional health is critical to reducing pain since the regions of the brain responsible for depression also process pain. Changing behaviors and habits, however, is challenging. As a result, when evaluating chronic MSK pain treatment plans, it’s important to look for programs that include specialists with lifestyle modification skills and behavioral health training.

Knocking Down Barriers to Chronic Pain Care

Reducing chronic MSK pain is possible, but it requires a different approach. We’ve found that individuals now living pain-free lives share several characteristics. To address the psychological, social, and biological contributors to chronic pain, they worked with an integrated care team which typically includes physical therapists, health coaches, and physicians.

These care teams lower the psychological barriers to addressing chronic pain by setting attainable goals and expectations, identifying everyday events that trigger pain, and prescribing movement to calm nerves and anxiety.

Another key to success is lowering the physical barriers to care. Care teams that leverage technology, such as digital apps, motion sensors, and computer vision, can offer at-home coaching and physical therapy for individuals. If it’s convenient to participate in care, people are much more likely to engage regularly and see positive results.

Chronic MSK pain is complex and can’t be addressed solely with surgery, injections, or physical therapy. The most effective treatment is a whole-person approach that focuses on a combination of education, exercise, behavioral and lifestyle support, and digital tools that can be used conveniently.

If you’re suffering from chronic pain, ask yourself if you’re getting the comprehensive care you need.

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