Richmond Stace 2
Richmond Stace...
Select an answer to get started
What is chronic pain?
That's a big question. There's been a lot of research and a lot of thinking over the years, a number of models to try and explain what it is. But I think where we are now, what we can say is that chronic pain is a pain that has persisted perhaps beyond the time that you expect, which creates a lot of confusion and misunderstanding. Generally speaking, there's a lot of misunderstanding about what pain is in society, which means that people often go down the wrong path. So essentially, chronic pain is a lived experience. It's something that you are experiencing and it's the best explanation that your body systems can come up with for your circumstances, which includes your biology, your past experiences, what's going on in your world in that moment. I think there are often issues with the notion of chronic pain and what it is, and what does the word chronic mean to you? How's it been explained to you? Some people are told, this is something you're going to have to manage. This is something you're going to have to live with. But the reality is you don't know that because nobody knows the future. The future is always imagined. So the way that you think about your pain plays a big role in how it is for you, and research shows that our beliefs and our understanding plays a big role and actually what it's like, but also the trajectory that you go on. So there's something about chronic pain and a timeline, but if you can understand that there's only this moment, the present moment, and the path that you are going to follow, there are certain things you can do and control to be on a particular path, then I think you're starting to get a better grip and understanding on what chronic pain is. It's inherently very complex and influenced by many, many different things, including past experiences and emotional state and where you are and who you are with and your expectations, where your attention is, what you're anticipating. All of that stuff plays a role. So it's a very complex question to answer.
Why is my pain persisting?
Pain persists for a number of reasons. A lot of it can come down to past experiences. So what we're experiencing right now is a large part due to how our body systems have learned to create experiences over the years. So with a sort of chronic pain or persistent pain, there's a kind of stuckness. Sometimes it's tempting to use the word same, of the same pain, or I'm in the same situation, but fundamentally, there's a bit of an issue there because no moment's ever the same. So each time you experience pain's, actually a different experience, even thinking that starts to change it. So the question maybe is why do we get stuck? Well, some of the contemporary thinking about that is that when you first have a pain experience, maybe an injury or something happens, or quite often there isn't actually an injury or an obvious thing, you just start to feel pain. There's an expectation consciously and subconsciously that, well, this will get better. I'll be all right. But then it doesn't. You might go and seek treatment, or you might try a few things yourself, and it doesn't get better. I know that will help. And then you go and try something else, and that doesn't, so you have these repeated situations where you're expecting to get better, but the reality is you don't. There's this kind of mismatch. So what seems to happen, or what could be happening according to more recent thinking and research is that your body systems then start thinking, well, maybe this is it. Maybe this pain experience is the way things are. So that seems to be the lens that then we come through. So there's this sort of stickiness, this sticky belief in the systems that pain is the best explanation for what's going on right now. Now, I'm totally aware that these kinds of explanations sound very different from what we've been brought up in our culture and healthcare system to think. But the old ways of thinking, the biomedical ways of thinking, that pain is very well related to tissue state or structure or anatomy. That model doesn't work. That does not explain the entirety of pain experiences. So it is much more complex, but people do seem to get stuck. But excitingly, we've also got ways of thinking about how we can help people to get unstuck as well.
How do I know I have chronic pain?
That's a good question. The textbook answer to chronic pain is at three months. So if you still have pain after it started at three months, that's chronic pain. But that's not the reality of the situation because there are so many factors involved in the trajectory that you go on. So really it's thinking about your personal situation, your unique situation, and the pain you're experiencing in relation to all of your circumstances. And when you understand the bigger picture, rather than perhaps zooming in on the bit that hurts, which is what the classic way of thinking is. So if it was my back, for example, I might be thinking about what's going on in my back, not realising that the experience of my back pain is actually being generated top down as a best guess of what's going on in my body, which takes into account all my past experiences, where my attention is, how I'm feeling, where I am, my mood, all of those things. So there's loads of things going on which are influencing whether you are in pain or not. And it may be that you've had pain for five or six months, but actually unpleasant as it is, it is part of that experience. It's something that's just part of that situation that you are in, but you need to learn ways to move forward on a better path.