Pills for Chronic Pain

Updated: Aug 11, 2020

image Kat J for Unsplash

Recent headlines caught my eye about the recommendation to use anti-depressants instead of paracetamol and ibuprofen for chronic pain; which, without further investigation, looks like: OK, those ones aren't great, let's chuck these ones at it - job done. And unfortunately, people do often just read the headline and not the whole article.

As anyone with chronic pain will likely have learned, when it's so bad you’re driven to taking painkillers several times a day, the benefits start diminishing pretty quickly - after just a few days, or even less. Long-term use can also do irreparable damage to the liver, kidneys and heart. So, the horrible choice you face again and again is weighing up vital organ damage against getting through today in any way you can, because you just have to.

Pain is a huge minefield, and such an individual business. I don’t like to use the word ‘subjective’, because that word is often used euphemistically to imply that while some people are ‘sensible’ or even heroic, others are just wusses. My blood boils when people who don't know what it's like helpfully suggest some or other herb or alternative therapy, secretly hoping it will 'do the trick' - mainly so that they themselves don't have to feel uncomfortable hearing about it anymore!

Chronic pain sufferers know all about the shame this can bring on, about all the repeatedly dashed hopes and deep disappointment of trying things that don't work, and the isolation of trying to put a brave face on it and not moan too much. It really isn't for wimps. Debiliitating, energy-sapping, morale-destroying, constant pain makes you feel ancient and humiliated. Anti-depressants may indeed help when pain becomes persistent and relentless; lowering the level of despair to some degree can be a truly merciful service when things get really bad. But neither painkillers nor anti-depressants can ever address the causes of the pain.

Pain is made in the brain and can worsen or ease according to the meaning we subscribe to it. Panicking and despairing about it, though quite understandable, really does make it worse. So, the response mechanism designed to protect you from harm can end up making your life hell. Ironic or what? I often recommend that my students watch pain scientist Prof. Lorimer Moseley's excellent and funny explanation of this in his TEDx talk, Why Things Hurt. https://youtu.be/gwd-wLdIHjs.

If there is any degree to which at least some of the pain is being caused either by something you are doing yourself, or by some ideas you may have about what's going on, or by your emotional response to your pain, wouldn’t you absolutely want to look into that and do whatever you can to help yourself in any way possible?

No over-promises, here; there's rarely one single solution. The modality I work in, the Alexander Technique, while incredibly helpful and highly recommended for everyone, hasn’t proved the whole answer for me. But doing everything possible to ameliorate chronic pain restores a degree of agency and self-respect that no pill can ever provide.

Yet isn't it tempting to fall for the idea that there’s one marvellous pill that will fix everything? Wouldn't that be wonderful! A happy-ever-after fairytale.

Meanwhile, back in the real world, let's never stop looking at every possible non-toxic avenue. Do keep trying different things. What didn't work for someone else might just work for you. They won't all offer a 100% cure, but some of them might help a bit. If you can possibly afford it, try: CBT, chiropractic, osteopathy, massage, acupuncture, hypnotherapy. Seek help for your mind and body which are, after all, one whole miraculous organism.

Sadly, few people have the money to try everything out there - and pressure from some pushy practitioners can be off-putting. But there are things you can also try that are cheaper or even free to do at home: daily yoga, Alexander Technique, Pilates (once you’ve learned from a good teacher), meditation, gentle walking, cycling, gardening. If any of them help, even just to some extent, they still hands-down beat pharmaceuticals and can restore to you some control over your circumstances; including coming to terms with unavoidable pain if necessary and reframing your relationship with it. It's your journey. You can own it. Stay curious.

#pain #chronicpain #chronicpainrelief #painmanagement

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