Kill All Pain

Picture a dark, grey, rainy day. Almost 200,000 physical therapists in the US drag themselves to work, with one mission: Kill all pain!

As patients enter the clinic, the therapists try as hard as they can to rid the patients of their pain, which would mean success. Now, its the end of the day. The same therapists find themselves slumped forward and exhausted - heading home after a day in the trenches. The scenario repeats day-by-day for weeks, months and years. Depressing, right?

This describes a lot of clinicians I meet on weekend seminars. This describes my colleagues and me in the early days of clinical practice. We know now: pain is a lot more complex and warrants a more comprehensive approach to make meaningful changes in our patients.

The day I found out that pain is a normal biological process aimed to protect us, it set me free. Pain is normal. Without the ability to experience pain, you wouldnt survive very long. Now I feel much less pressure to kill all pain in my clinical practice. I became interested in the issues that keep the normal pain going longer than it biologically should, in coping skills and in teaching people that pain is a normal human experience. Guess what? My patients started having epiphanies and seeing pain as an informant rather than an enemy.

For example, their perception of low back pain (LBP) could shift from "Cold air is toxic to the human body!" to "An ion channel (sensor) is telling me its cold out and a sweater would be a wise choice." Let's reflect on this. If we convinced the world that LBP is a normal experience that most of us get, and its not really a big deal, we would instantly rectify the health care deficit in the US. LBP is simply the common cold of the musculoskeletal system.

Pain is normal, but suffering and disability neednt be. Accepting pain as normal has transformed my clinical practice from dragging myself to work trying to fix pain to helping people deal with pain and move them to a better place - through pacing, graded exposure, and goal-setting. Countless patients have transformed their pain right after understanding this simple concept. Pain is normal, but living in pain isnt and thereare a lot of ways we can helpthose in pain.