Where is the pain?

If you were bruised or cut and somebody told you your pain was all in your head, you might well feel indignant. Even if your pain was from a headache or strained muscle that no one else could see, you would probably be certain your pain was not a figment of your imagination. But what […]

Real and Imaginary Pain

Many people believe that pain is either real or imaginary. They might say that real pain should be treated medically while imaginary pain should be left to the psychiatrists. But how can we tell real from imaginary pain? Pain is a sensation, not something that can be seen on a MRI or detected with a […]

Pain as a Symptom

Almost everyone views pain as a symptom. Since the time of Hippocrates it has been widely accepted that the task of medicine is to find the cause of symptoms and treat that cause. If only the symptom is treated then the problem causing it remains. However, there are problems with this seemingly self-evident truth. Take […]

Pain as a Disease

I wrote earlier that the feeling of pain is produced in the brain after it processes nerve signals from the rest of the body. Interestingly, the brain itself has no pain receptors. Cutting the brain during surgery in awake patients does not hurt them although cutting the scalp does. However, if certain parts of the […]

The Complexity of Pain

Pain can be a symptom. Pain can be a disease. Pain can be mysterious and hard to figure out. In fact, we still don’t completely understand what happens in the brain when you stub your toe although we know it’s complicated. How complicated? Take the example of the soldier shot in battle who rescues his […]

The Complexity of Treatment

Chronic mechanical neck/back pain, whiplash associated disorders, complex regional pain, headache, chronic post-traumatic pain, neuropathic pain and fibromyalgia constitute the bulk of my specialized practice. These categories of pain may overlap, are all incompletely understood and difficult to treat. While marketers make claims and medical studies show rates of success, no sure-fire cures have ever […]

Multidisciplinary Treatment

There is research-based evidence that chiropractic, acupuncture, meditation, psychotherapy and some drugs can relieve chronic back pain. What enthusiasts for one kind of treatment over another may forget is this. In clinical studies, not everyone gets relief and any one treatment rarely gives anyone 100% relief. Furthermore, the success of one kind of treatment does […]

Surgery

When pain is a symptom, surgery may relieve pain and save lives. Appendectomy, hip replacement, heart bypass surgery, removal of a tumor and trauma surgery are but a few well-known examples of beneficial surgical procedures. In each case a clearly identifiable source of pain (more precisely a source of pain signals going to the brain) […]

Drug Therapy

In this post I am defining a drug as anything that is taken into the body, by any route (swallowed, absorbed through the skin, injected etc.) that is meant to enhance or change a bodily or mental function. This is a very broad definition that includes pharmaceuticals, herbal products, supplements and homeopathic remedies. Drugs do […]

Side Effects

Just because a drug is known to have side effects doesn’t mean everyone who takes the drug will experience any or all of them. The severity of side effects may also differ from person to person. Most people, most of the time, do not have to stop taking a drug because of side effects. For […]