The Problem with Pain

The Problem with Pain

Pain is a universal human experience, a visceral and undeniable reality that strikes at the core of our existence. It’s an affliction that knows no bias, affecting people from all walks of life; it doesn’t matter who you are, the CEO of a large company or someone living in a remote village. While some individuals might possess a remarkable resilience to pain, there’s a simple truth: pain is as real as it gets. Regardless of how skeptical or stoic one might be, pain is the common ground where belief is unanimous.

Our contemporary approach to managing chronic pain has fallen short of the mark, and the issue at hand is that many must endure persistent pain, specifically chronic pain. Pain stands as one of the most enigmatic challenges of the human body, a complex riddle with no shortage of purported solutions. Many people who grapple with chronic pain become desperate, resorting to daily medications for survival, only to eventually suffer the secondary effects. Pharmaceutical companies have excelled in creating medications that offer momentary respite from pain, but these drugs do little to address the underlying causes of pain. Worse, they’ve formulated powerfully addictive painkillers that millions of lives are lost to overdoses (Abramson, 2022). Despite significant advancements in medical science, the scourge of chronic pain remains, leaving a trail of devastation.

In our world today, pain casts a heavier burden than ever before. Almost half of the global population grapples with chronic illnesses (Zelaya, 2019), encompassing conditions like arthritis, frozen shoulder, back pain, neck pain, degenerative disc disease, sciatica, knee pain, hip pain, migraines, and TMJ, to name just a few. The magnitude of this statistic is chilling, primarily because the most distressing aspect of chronic pain is the overwhelming isolation it imposes. When a chronic illness diagnosis is received, it fundamentally alters one’s life, causing the world to contract, and isolation to become an insufferable companion, a factor that can lead to despair and even suicide (Edwards, 2023). There are hundreds of thousands who understand your emotional journey; you are not alone. Those living with chronic diseases or pain encounter distinctive challenges, including the perplexity and isolation that accompany being “differently-abled.” Chronic disease doesn’t happen by chance.

What’s fueling the chronic pain epidemic?

Few ask why. And when doctors pop their heads up for just a second, and start asking questions, one quickly realizes what they don’t want you to do in healthcare. What’s causing the rise of these diseases? Every time we take care of a patient with diabetes or autoimmune disease, there’s a voice inside of us whispering and then a little louder, and finally, with a deafening call that something was wrong with the American health system. The rise in these diseases is not just a coincidence, but a result of systemic issues within the American health system.

Presently, suffering with chronic pain is accepted as a normal human condition. We’re living in a hyperfast world, and we throw ourselves into a healthcare system that offers numerous treatment options, but all too often, relief is marginal and sporadic. Surgery, especially for back pain, frequently worsens the problem in the long run. Our contemporary lifestyle encourages poor posture, with regular physical activity becoming a relic of the past, as desks, video games, phones, and computers dominate our lives. Humans are meant to move, yet we’re moving less, not more. Our access to food is unparalleled in history, but we’re consuming addictive foods designed for overconsumption and leaving us unsatisfied. This, in turn, leads to obesity, afflicting over half of America, which is deeply intertwined to the chronic pain epidemic.

Until recent times, most people with chronic pain had to live with the condition or face surgery. The common conservative treatments are activity modification, bracing, medications, psychiatric medications, physical therapy, steroid injections, and weight loss (West, 2020). Once these modalities prove ineffective, pain medications and surgery are the mainstay of treatment. This explains the nearly million shoulder, hip, and knee replacements that are performed annually in the United States (Williams, 2015). These surgeries also leave patients with the specter of needing another joint replacement within 10 to 20 years.

One answer to chronic pain is regenerative medicine. This is a rapidly growing field that aims to treat acute and chronic pain conditions by harnessing the body’s natural healing properties to improve function and pain after injury. We’ve forgotten that our bodies possess an internal resilience to heal. Instead, every problem requires a pill, surgery, or an expert. Miracles happen every day, our bodies heal and perform the many functions essential for life. In modern times, we’ve ignored this wisdom.

Every healthcare provider has stories of healing that truly amazed them and defies logic. Regenerative injection techniques have existed nearly for a century and are applied locally at the site of injury and work through various mechanisms. They include prolotherapy, platelet -rich plasma (PRP), stem cells, perineural superficial injections (PSI), and saline injections (Yelland, 2004; Linnanmäki, 2020; Simental-Mendía, 2020; Abate, 2018; West, 2020; Shipley, 2013). Chronic diseases like osteoarthritis are particularly amenable to regenerative approaches since patients often fail conservative treatments, ultimately requiring joint replacement to achieve pain relief and improve function and quality of life.

However, some things have changed, for instance, it was once standard of care to prescribe non-steroidal anti-inflammatory drugs (NSAIDs) like Ibuprofen for any type of pain or broken bones. After extensive research, we’ve circled back to understand that inflammation is a natural part of the healing process and NSAIDs may not be the best thing for acute orthopedic injuries (Marquez-Lara, 2016). Another example of this shift in medical understanding is arthroscopic knee surgeries. Historically, the knee meniscus was considered a vestigial remnant and having no significant impact on knee biomechanics. Consequently, thousands of patients underwent total or near-total removal of their knee meniscus. However, today, the decision to remove the knee meniscus is carefully considered because it can accelerate cartilage damage and result in the premature need for a knee replacement (Simonetta, 2023).