If your back pain or neck pain has persisted despite a variety of treatments - and maybe even after spine surgery - you may understandably feel frustrated and miserable. Pain can be very cruel - making it hard for you to undertake or enjoy even the simplest daily activities.
To help you better understand how pain works, and treatment approaches, here are a few pointers that your physician may or may not have explained to you.
All pain is real
Saying that “pain is real” may seem like a painfully obvious statement (pardon the pun), but people with chronic back pain or neck pain are often treated as if their pain is actually made up or greatly exaggerated. Some people are even told by their doctor that since no anatomical reason for their pain can be found the pain must be “all in your head”.
Fortunately, the medical community is now starting to establish and accept that pain is a personal experience and cannot be diagnosed like other medical problems (such as a broken bone that can be diagnosed by an X-ray). Increasingly, spine specialists are starting to accept that pain is real and needs to be treated and managed. See also Chronic Pain as a Disease: Why Does it Still Hurt? and Modern Theories on Chronic Pain.
Pain needs to be treated
Traditionally, if no underlying injury has been found, or if it is believed that the original injury has been treated, most patients have been told that few treatments are available or basically that not much can be done. For spinal problems, however, it is not uncommon that no objective evidence or physical findings can explain the patient’s painful symptoms.
The medical community is now starting to understand that if pain does not signal that there is a disease or underlying injury, then the pain itself becomes the problem and needs to be treated as the primary pathology. See Pain Management for Back and Neck Pain.
Pain is a unique, personal experience
Everyone experiences and expresses pain differently. Two people with the exact same injury will feel and show their back pain in unique ways depending on a number of factors. The newest theories of pain can now explain, on a physiological level, how and why people experience pain differently.
Chronic pain is different than acute pain
Chronic pain does not serve a biologic or protective function like acute pain does.
- With acute pain, the severity of pain directly correlates to the amount of damage, thus providing you with a protective reflex (e.g. to immediately remove your hand if you touch a hot iron). Acute pain is a symptom of injured or diseased tissue, and after the underlying injury is healed then your pain goes away.
- With chronic pain, the pain does not serve a protective or other biological function. Instead, even though there is no tissue damage, the nerves just continue to send pain signals to your brain.
As back pain or neck pain moves from the acute phase to the chronic stage, factors other than tissue damage and injury come more into play. These include such things as ongoing “pain” signals in the nervous system even though there is no tissue damage, as well as thoughts and emotions. See also Understanding Low Back Pain.
Multiple treatment options are available for spine pain
There are many new treatments available to treat ongoing back pain or neck pain, including conservative (non-surgical) medical and alternative treatments, surgical treatment options, and pain management/pain medicine. If your pain is severe and has become chronic (e.g. lasting more than 6 weeks), it may be time to seek an evaluation by an experienced spine surgeon. If your pain is not amenable to surgical treatment, then it may be time to see a physician who specializes in pain medicine for spine problems or to seek out an integrated, multi-specialty treatment approach. See also Spine Specialists Who Treat Back Pain.
Whenever your back pain or neck pain is ongoing, consider trying a different approach to managing your condition. While it is unfortunate, finding relief from back pain is often a process of trial and error, and it may take an enduring effort to find the best approach to adequately manage your pain so you can get back to enjoying life.