Once you understand what is going on regarding your condition, you need to review and consider which behaviors and habits you need to drop, which helpful behaviors you have to re-adopt or expand, as well as whether any of your thinking patterns are holding you back and keeping you stuck.

The second aspect of acceptance can be made when you learn of some advice or treatment that can become easily incorporated into your day and that will help change your situation for the better. It should be evidence-based, helpful, and plausible (making sense), as well as be endorsed by your physician. This can improve your situation greatly. For example, hypertension and diabetes can be greatly improved by losing excess weight, even if you still need medication. Chronic conditions work this way.

It is not only what you are given (medication, injections, physical therapies) that helps, but also what you do, and the unhealthy habits you put on hold.

And then this brings us to the importance of and need for meaning. Meaning, as it applies not only to your condition, or what is going on in the body, but also what your condition means to you personally in the way that it impacts most areas of your life, as happens with chronic pain.

I will discuss the importance of meaning in a subsequent posting.

photo credit: Marcos Paulo Prado

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We then considered the importance of acceptance in chronic disease, which helps you recognize that you need to make certain lifestyle changes because of chronic disease. This can only be done once you know what you are agreeing to or accepting. Chronic pain is not merely the persistence of pain symptoms, it is a disease or disorder in its own right, and we can see brain changes on special imaging scans such as fMRI.

Why would meaning be so important?

For two reasons, because it is hard to plan when you do not know what you are up against, and, in order to know what you are to accept, you must have a clear idea of what you are buying into. As important as the above is that once we understand the “why’ of something, the ‘how to’ (or how to deal with it) becomes more obvious and easier to address. Meaning also affects our motivation level, and ultimately our resilience, and our ability to persist with our efforts. History is filled with people who did amazing things through their commitment against all odds, based on the meaning and value that they placed on their quest or goal.

Now the following challenges remain. 

What is chronic pain? 

And what does it mean to you?

This will be outlined in another posting.

photo credit: Erik Aquino

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Multimodal merely means that the treatment may include various modalities or types, such as physical interventions, medication, injection therapy, to name but a few. This is what we often see and can be said to be true in most cases.

Bio-psychosocial is merely a long-winded way of saying that the psychological and social issues of chronic pain should be addressed at the same time as the medical problems.

Experts then go on to say that it is unlikely for recovery to occur without including this approach, and yet, alarmingly this is what is most often missing from treatment programs.

How did this happen?

There are a number of reasons for this, such as poor undergraduate chronic pain training for physicians and present- day medical appointment times that are way too short, with about 15 minutes or so at one’s own physician, but often less than 10 minutes at a walk-in clinic, in order to do the required education and work.

But there is a less frequently discussed, even bigger problem behind it. It is a medical system that has somehow helped create the unrealistic expectation that we can always rely on rapid and effective ‘solutions’, mostly in the form of chemical compounds, even in the case of chronic conditions such as chronic pain. We still see the effects of this notion in the ongoing opioid crisis.

So clearly, that’s not how things work.

It is also why our treatment outcomes for chronic disorders are relatively poor compared to other diseases and conditions such as acute (recent onset) disease like pneumonia, surgical conditions like appendicitis, and the treatment of traumatic injuries.

photo credit: Rodrigo Curi Unsplash

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