There are two fundamental aspects to the perception of pain:
The source: Three Sources of Chronic Pain
- Possible structural problem
- Inflammation of soft tissues
- Neurophysiological Disorder – “short circuits”
The receptor—your brain
Three additional variables affect your perception of pain:
- Sensitization
- Memorization
- The “Modifiers” –1) anxiety 2) anger 3) sleep
Chronic pain is a complex problem and even more so, as each person is unique. It won’t respond to isolated simplistic treatments. The approach that is successful in solving pain is similar to that of fighting a forest fire.
“I Can Only Fix What I Can See”
These concepts apply to pain in any part of the body regardless of the source. I will discuss low back pain as one example. The exact source of your LBP is usually unclear. Many assume if you are pursuing a diagnosis with your doctor then there must be an indentifiable problem that is solvable with surgery. Surgery is felt to be the “definitive” solution.
- It is only definitive if you can see the problem.
- Even then the potential benefits must outweigh the risks.
- I often compare spine surgery to dentistry. (Back Pain vs. Mouth Pain)
A high percent of spine surgery should never be performed.
- What many surgeons are defining as “structural” is simply normal aging anatomy.
- Degenerative disc disease is not a disease.
- All intervertebral discs lose water content with age.
- They have been shown not to be the source of your chronic LBP.
- A fusion for a degenerated disc has a success rate of < 30%.
Video: “Get it Right the First Time”