By Richard P. Holm, MD
The word “chronic” means persistent and unrelenting; something that doesn’t go away quickly. When you preface that word with “pain”, you have a potentially crippling condition which affects too many people in too many guises.
Chronic pain can develop in a variety of conditions: headaches, lower back pain, herpetic pain following shingles, neuropathic foot pain resulting from diabetes, and the body-wide muscle pain of fibromyalgia, to name a few. The bad news is that it is often very difficult to get rid of chronic pain, like an unwanted guest who never wants to leave.
Surgery or medicines (especially opioids) are often minimally effective at treating chronic pain and sometimes make things worse. Even injections of steroids, which is an invasive, expensive and overused procedure, is typically useless for chronic pain. In the end, too many people continue to suffer. The pain can eventually take control and cause the person to become helpless, inactive, and shut down completely.
It is important to understand that immobility often makes the situation worse. If a joint or muscle is not used regularly, it barks and bites when called upon to be moved, the pain of which can dissuade further use. This cycle, if unbroken, can result in an increasing level of immobility, severe disability, and more time to dwell on the pain. This is exactly the reason they say “use it or lose it!”
Paradoxically, one of the most effective ways of breaking people out of this cycle is for them to change negative habits and to become more active. Again, the best answer for CHRONIC pain is usually not surgery or more pain medicines. Regular stretching, good posture, adequate sleep, a good diet, and regular exercise can work wonders where modern medicines fail. Of course, each case is different, and sometimes a trapped nerve needs release or severe inflammation needs to be turned down and rested. However, carefully moving through stiffness and discomfort can give us considerable relief. It will be tough in the beginning, and results may not be instantaneous, but the struggle of starting healthier habits in the face of chronic pain can be well worth the long-term benefits.
Studies show that return to function, although not easy, is the key to rehabilitation. Chronic pain doesn’t have to mean progressive immobility, disability, and hopelessness. We should remember to accept the pain when we have to, and, when advised by the doctor, to move those muscles.
Use it or lose it.
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