Quick and Dirty
Pain Science
(from the BEST resources in the world)
WARNING: They, we, honestly don’t understand how pain works entirely yet. Pain is a perception and as such, I figure it’s kinda of like how I view life - it’s what you make out it.
Right, so I lecture on this stuff but frankly there are some brilliant experts out there with the stage presence and stamina I would only possess if gin and chocolate were permanently on tap. So, I’m turning you over to them. If you don’t understand why no one understands your pain yet (including your doctor, your physio and the fancy consultant) please go to these websites. They are awesome myth busters and one of the videos or explanations will hopefully click for you.
I recommend starting with retrainPain.org. Visual + words makes for easy learning and damn if they don’t go about it really well. One minute lessons that cover topics that have taken me years to suss.
Then, move down the list to find what makes sense to you. I have not included ANYTHING which is not evidence-based or could possibly pass for snake oil. For magic tricks that work for some but not for everyone, feel free to explore the posting on placebos (coming soon). Yes, the mind is more Jedi than we ever thought, only with the caveat that it doesn’t listen to my weight loss pleas or to stop the pain enough so I can get my life back when a flare-up hits.
Again, it has taken me almost 20 years to figure out how things work. And then only to realise that pain management is different for everyone. Including your response to drugs. FYI individual response rates to NSAIDS (your anti-inflammatories or whatever you call it, ibuprofen, etc…) are on par with your star sign sometimes. Ok, it may sound a little extreme but if only 40% of the population responds to NSAIDS wouldn’t you want to know?? It’s as if being a Scorpio really was more predictive of my pain experience than my pain catastrophizing score…. Wait, not to diss the pain catastrophizing scores though as they can do a brilliant job of bringing about awareness to the specific fears you might have about pain destroying your life (what you don't know or understand, CAN hurt you).
Thoughts are powerful. My favourite cartoon below demonstrates this beautifully… it’s all about where we’re at and where we’ve been, not just some standard pain rating.
xkcd.com
Yup, I think the above sums up measuring pain in general. Now do you get why clinicians are screwed when trying to assess your pain?
TRANSLATION: This is really messy and everyone is doing the best they
can with figuring it out.
In the meanwhile, here’s my fancy list of totally trusted, decent, humane and intelligent resources to
learn about pain for when you’re sitting around, the meds have kicked in, it’s a decent day
and you don’t want to kill anyone.
Websites to flirt with...
(this is just the beginning)
1. Retrain Pain Foundation - Start here and if you can’t handle the 1 minute lessons about pain, take another dose of whatever pain medicine works for you and try again. This is not a suggestion, understanding pain is fundamental to living with it. If you already know this stuff, you are brilliant and I beg of you, please get your fellow pain patients to at least click on the link…
2. PainScience.com - Absolute favourite, excellent explanations but maybe more for the evidence-based worshipers as there are actual references involved!
2. Joletta Belton blog and pain resource website - Seriously cool. Firefighter chick whose life changed when she became a pain patient and now she advocates hardcore on behalf of patients, speaks science, writes about genuine and honest stuff and all without the cussing that I do. Not going to mention the beauuuuutiful photos on her website. Too jealous.
3. Neil Pearson website offering self-management AND loads of other support - Cool guy who’s a physio and a yoga dude so excellent blend of some of the best movement stuff. This is another way to learn about pain and how to self-manage which may be right for you! Worth a shot...
4. Pain BC, non-profit for pain patients (and others too) - Ok, I stumbled upon this because I’m originally from BC, Canada but damn, it seems to have a lot of good stuff and this little province is genuinely trying to get its sh*t together for persistent pain patients.
5. painHEALTH - I haven’t looked at this much but a physio friend recommended it and as it’s backed by the Department of Health in Oz & has a mix of clinically supported info alongside patient stories, I think this is another winner. Ooh, and I just noticed it has a pain self-check option for all you newbies out there or if you still don’t trust what you’ve been told. And then a training module as well, not too shabby!
6. Pain Chats - Website aiming to bridge the knowledge gap for pain patients, they say "The right advice is your best pain medicine". I think this is good. It didn’t irritate me right away so that’s a positive sign. Go through it and get what you can out of it, the team of advisors behind it are some of the best!
Stuff to watch...
1. Explain Pain - As Nike says, just do it. This is beginning of Pain 101 and the US updated version of the original explain in 5 minutes, AWESOME. Again, if you are a pain newbie, this is where to start.
2. Explain Pain (the original) - Legendary original which explains pain in 5 minutes, straight from Oz. They nailed it.
3. Low Back Pain by Dr Mike Evans - Explains lower back pain. Yes, this is the best of what we’re working with regardless of politics, insurance and money. Just watch and absorb.
4. Why things hurt - Aussie Lorimer Mosely doing what he does best, explaining pain in a Tedx Talk. Fun and pain, who knew!?
5. The myth of a slipped disc - More endearing aussie accent Lorimer myth busting SLIPPED DISCS!!!!! You can't slip a disc. Mic drop. End of story.
6. Pain and me - Bit of a mentor and hero of mine, Prof Tamar Pincus explaining pain with some props. Love it. Thank you Tamar.
7. The mystery of chronic pain - This is for those who are stuck with the extra mysterious stuff… nicely put Elliot, love a bit of humour with my pain education.
8. How does your brain respond to pain? - Awesome. Keeping in mind this doesn’t talk as much about pain without injury. For those with pesky persistent pain with no stimulus or nociception involved, this won’t explain as much but all part of the education process eh? Can’t hurt more, promise.
9. How do pain relievers work? - If you don’t understand my dramatics about pain medication, start with this.
10. The mysterious science of pain - Another Ted Talk and a good start, just the tip of the iceberg but love the animated educational stuff!
Mostly all between
3 to15min long so no stress and no need for hardcore
attention span!
Books (if you can focus or hold something with your hands for more than 10 minutes)...
1. "The Pain Chronicles: cures, myths, mysteries, prayers, diaries, brain scans, healing, and the science of suffering" - By Melanie Thernstrom. Journalist and pain patient, just awesome. This book is not a light read but she covers loads very personally but also with a great injection of the latest science so one of my absolute favourites.
2. "CROOKED, Outwitting the Back Pain Industry and Getting On the Road to Recovery" - By Cathryn Jakobson Ramin. Seriously, she is not wrong and I swear the medical industry she’s talking about is the reason I may have work as a behavioural scientist for a very long time. I’m not blaming anyone, I just think that now that we know better, we need to do a hellava lot better.
3. "Explain Pain" - By David S. Butler and Lorimer Moseley – pictures and everyday language. This is an excellent foundation in understanding pain. See the videos of Moseley explaining this in person if you can’t hack the reading or have the money to buy a new book!
Articles to read...
(don't worry, not the academic ones yet!)
1. Pain really is in the mind but not the way you think - This is just good stuff. Lorimer at it again and explaining how pain is different from nociception. I can not stress enough how much I have to talk about how these are two separate things. Pain is NOT nociception and nociception is NOT pain. This confuses pretty much every class or audience I have given lectures to. It has taken me years to sort my own understanding of this out and another two years before I was confident enough to explain it to an audience.
2. Five everyday myths that make it hard to understand pain - An excellent article by a mega ruler of pain in the world of academia, Amanda C de C Williams. A chick who seriously knows her stuff and is brave enough to dabble in the world of torture survivors.
3. The opioid crisis is not about pain - Something to chew on. This topic is like peace in the Middle East or how talking about Northern Ireland used to be. Anyone who claims that it's simple probably knows the least. I have loads of strong opinions on this but my best advice is to seek out the real numbers, the real issues and the real context behind the headlines if you can.
4. Understanding and Treating the Emotional and Physical Roots of Chronic Pain & Change Your Mind-Set, Reduce Your Chronic Pain - last, and in no universe ever least, a word from Beth Darnall. This is one of my pain scientist mentors (even though she doesn't know it) and this pain guru chick has been there done that. Even before I could dream up what I'd want the best of the best to be studying, implementing and advocating, she's on it. I've picked her two least sciencey articles, as she regularly writes and talks to the big kids in academia and government, so please don't be put off if it gets technical. She's had her own extensive experience with chronic pain and having met her in person at a course, she's the real deal. Job done. No question.
