When we talk about recovery in chronic pain, this is not based on only one measure such as pain reduction or elimination, although this is something that is obviously in the forefront of the mind of someone suffering from chronic pain. If this were the case, the obvious problem would be that every time that a person experienced more pain than usual after a relatively pain-free period, they might well think that they were relapsing or even getting worse.
From a medical standpoint, we view pain reduction or elimination as only one of the parameters for recovery. A good deal of importance is also placed on increasing functionality, or the ability to do more than usual physically, with improvement of the activities of daily life, whatever the current level of pain. A further consideration is improvement in quality of life. These two factors are therefore also important metrics in order to assess recovery. This is all completely in keeping with the recommended bio-psychosocial approach to chronic pain, where the psychological and social issues also need to be factored into the overall health status.
So, we really need to evaluate all three. As we have seen in previous articles, what we focus on expands or grows in our life, and in the case of pain focus, this is also one of the early predictors and triggers of chronic pain. However, by rather focusing on increased functionality and quality of life, these two, rather than the pain is likely to expand with the increased awareness and attention.
The central nervous system has neuro- modulators, specific nerve cells and circuits that use various chemicals that can affect other circuits to change different types of nerve activity including pain levels. They act like ‘volume knobs’ for the pain, either increasing or decreasing the pain level. When your quality of life and/or functionality increases, these factors can actually reduce the level of pain experience, much like a good night’s sleep, an improved mood, or a more positive outlook may achieve.
Therefore, there is good reason to make every effort not to place too much focus on the pain level, even though pain itself is admittedly hard to ignore. These modifications may seem simple though challenging to adhere to, but their effect is profound.
Photo credit Yanapi Senaud