“A person who sees a problem is a human being; a person who finds a solution is a visionary; BUT, the person who goes out and DOES SOMETHING about it is an entrepreneur.” – Naveen Jain
The Pain Problem
So much has been written and discussed in the news and media about the opioid addiction epidemic and about the 100 million people, $600 billion dollars a year problem of chronic pain that underlies it here in the US. The number of people who suffer from chronic pain is greater than those who have cancer, diabetes, and cardiovascular disease combined. Without question, both the size and severity of the opioid addiction epidemic and the chronic pain problem affect nearly every one of us directly or indirectly. Both are shattering lives, destroying families and disrupting society.
It is time for better solutions, which start with a better understanding.
Recently, I had the privilege of attending my friend, JJ Virgin’s Mindshare Summit in San Diego. There, on the opening night, Mark Hyman, MD of the Cleveland Clinic and Congressman Tim Ryan of Ohio held a discussion on health care, food science, nutritional guidelines, and governmental policies. It was mentioned how industry has informed the science of nutrition, which has informed guidelines and policies. The result has been misinformation about nutritional guidelines and education, which have contributed in no small part to a high rate of obesity and lifestyle diseases in our country.
When it comes to pain and pain science, a similar phenomenon has occurred, which is a significant reason that we find ourselves with such an overwhelming amount of chronic pain in the population, and this devastating opioid addiction epidemic on top of it.
Pain Is Very Human, But How Well Do We Understand It?
Pain is a very human experience. Not one of us goes through life without feeling pain. Therefore, we feel like we have a fairly clear understanding of it. Generally, that understanding is very “cause and effect”: a hammer to the thumb, a broken wrist, a sprained ankle; it seems very clear.
Pain means something is wrong. But does it?
Indeed pain, in the short term such as in the examples above is a protective and productive function. It alerts us of a problem by getting our attention. And it teaches us – stop doing that, avoid doing that and let it heal before more damage can be done. Pain in this acute phase is very appropriate. Its presence, though uncomfortable, is serving a clear purpose. But, we don’t like it.
Pain is uncomfortable, even when, like in these examples above, it is good for us. So we try to avoid it, diminish it, mask it in just about any way we can. Going back to our primitive ancestors, we realized that if we do things like drink alcohol or take opium, that our pain can be diminished, at least in the short term.
The pain management industry was born out of this analgesic approach via chemical means and has changed very little in the years, decades and centuries since we first started using them. In fact, because these chemical and later pharmaceutical approaches with a similar mechanism of action work in the short team, they have been adopted in mass, promoted by professionals, and pursued by consumers.
However, maybe their very nature is part of the reason that the population of pain sufferers continues to grow and has become the primary reason that the opioid addiction mess has grown as large as it has. Their efficacy to relieve pain in the short term has hindered our ability to really understand pain, particularly chronic pain on a more accurate and real level.
The latest pain science is clear, but not widely understood by either consumers or professionals. All pain is neurogenic; it comes from the brain, not from the tissue. We don’t experience it that way. When we whack our thumb with the hammer the thumb hurts, or maybe it’s a sprained ankle or broken wrist – it is those areas that hurt and the reason they hurt seems clear, tissue damage, inflammation, trauma. But the tissue actually has no ability to feel pain.
The tissue simply has sensors that gather information and transmit it back to the brain via the nervous system. The brain interprets and assigns meaning (i.e. this hurts, it hurts a little, it hurts a lot, etc.), and the brain via the nervous system drives the physiological response such as swelling, stiffness, and increased sensitivity.
So when we understand that pain is a product of the brain, we can begin to better understand that chronic pain is a problem of the brain. When pain becomes chronic, which means it has been present longer than is appropriate (typically 3-6 months or longer) or is growing disproportionate to the cause, or in some cases, without a clear cause, this is chronic pain. It has less to do with the tissue and more to do with the brain, which has created a new expectation of pain and is causing it to grow regardless of the tissue.
Industry, Tradition and Personal Experience Influence The Evolution of Care
Most professional clinicians have been trained in old pain science; something called The Gate Control Theory of Pain, which was published in the 1960s. And because pain, at least by itself is not typically terminal, it receives significantly less attention, funding dollars and research attention than a more terminal illness. The industry players often inform what ongoing education most clinical professionals receive and tend to have the most influence, especially the drug companies. Medical professionals would have to go out of their way to seek out and learn the most recent pain science. Most have and do not.
Those professionals that have studied the most recent neuroscience of pain, that do understand that pain is a product of the brain and that chronic pain is really a problem of the brain are faced with another challenge. What to do about it?
Most consumers haven’t been taught that pain comes from the brain and not the tissue. It’s not how they’re experiencing it and at the end of the day, they just want to feel better, as quickly as possible. Pop a pill. Mask the pain. Hope it gets better.
The other aspect of this that cannot be overlooked is economics. Without question, there is an economic disincentive to migrate away from what is being used now to manage pain because it gets paid for. Physicians and clinicians who treat pain and consumers dealing with pain often choose therapies that have insurance coverage, even if those therapies are known to be limited in their efficacy, or even risky, dangerous or addictive. Economics drive care decision to a significant degree.
Better Pain Management Solutions Start with Better Understanding
Indeed if we’re going to arrive a place where we can advance safe, more effective therapies for chronic pain management, we have to have a better understanding of pain. To this end, I have written a book, Radiant Relief, A Case For A Better Solution To Chronic Pain.
Like the Naveen Jain quote above, we all recognize that we have a problem. Many people are talking about this. Some have a vision for better solutions, and few, myself included, are taking action towards something better. But better solutions to chronic pain start with better understanding. A better understanding of both the most recent pain science and the industry drivers that affect the evolution of pain education and treatment are the first places to start.
I have spent the last four and a half years of my life, building a disruptive new approach to pain management, with my company Radiant Pain Relief Centres. Rather than masking the pain with a drug, or pursuing therapies that address the tissue, we use technologies that allow us to retain the brain and restore it back to a more normal perception of pain, through the principles neuroplasticity. Relief is profound, often total, and lasting for nearly all types of choric pain without drugs, needles surgery or side effects.
I invite you to read the book. It is my hope that its message can expand the conversation, not just for the sake of doing so, but also to move us closer to therapies like those we’re offering and building through my company Radiant Pain Relief Centres.
The world needs less suffering, but it also needs more joy, more connection, and more productivity in the lives of the many millions that suffer. It is my belief that begins with better understanding first.