Pain: Why does it hurt?

I have encountered med seeking behavior in hospitals and clinics; and also seen family members benefit and/or struggle with their use of opioids for real pain.  My grandmother died of cancer, on morphine managed by her nurse daughter, so her transition would be peaceful.  Opioids and other addictive medications certainly have their time and place. 

But, as patients we must better understand pain so we can better advocate for ourselves.  This will help us make better choices and know when we need to press our physicians to do more, or find a second opinion.  Our family caregivers will also benefit from a better understanding of why we hurt, so they can support and advocate for use when the are needed most.

The last book I read did just that for me.  I've always had a high pain tolerance, but struggle to know how to help others.  Also, perhaps there will come a time when I need to seek care sooner  instead of tolerating pain. Dr. Aneesh Singula's new book Why It Hurts: A physician's insights on the purpose of pain did help me to better understand.  

The scientific explanations were written so even and administrator like me could understand and the numerous examples helped put it into perspective.  The short of it is that pain is vitally important. The body is sending a message to the brain to get our attention.  Just like a child, if we don't pay attention the body will scream at us using even more painful sensations.

I marked my book up with some notes, and share a few highlights below.  If you or a love one struggles with pain, this book will help you be a more engaged patient who will hopefully find a way to stop the pain.

1. Not all pain can be stopped and this is unfortunate.  But, too many people live with pain that can be stopped, or needs to stop before irreversible damage is done.  This is why you need to learn and advocate.
2. If the pain can not be "fixed", physicians leveraging the art and science of medicine can help relieve suffering without causing more harm.  This requires a delicate balance, perhaps finding  the point where you can live with less pain or listening to our body and knowing when it is time to stop and rest.  Think of a thermostat and your own balance of comfort with the cost of electricity or heating oil/gas.
3. Pain helps reveal the root cause of what ails us.  It is a highly developed alarm system the body uses to prevent further injury and properly attend to our underlying conditions.  Think of a fire alarm! Should we shut it off with pain medication, or look for the fire?
4. Pain provides your brain with constant feedback for adjustment, both consciously and subconsciously, every minute of the day.  Those with insensitivity or delayed reactions to pain are at risk of serious injury.
5. Psychological pain, suffering, can contribute to how we each experience physical pain.
6. Pain is a tool for growth.  Think of sports or fitness.  The story of WWII prisoner of war, Louis Zamperini, offers a wonderful example of how pain can make us grow stronger.
7. Stress makes pain worse! And, pain can cause stress.  We the patient must take control here and practice the art and science of stress relief - with support from our physician.
8. There is also a great review of a multidimensional model -perception of pain.  It includes sensory, affective and cognitive.

As a society, this is an important issue.  Why?  Because, pain represents an equivalent of 1 out of 5 dollars spent on the entire US health care system per year.  Perhaps if patients and their physicians could collaborate to better manage pain, we could make a real impact on the cost of healthcare in the US.

I really do recommend reading the book and reflecting on your own experience with pain.  If you do, help support others by sharing what you learned in a comment.