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 been demonstrated. Chronic pain is especially resistant. No matter how well you or someone you know responded to your surgeon, G.P., specialist, chiropractor, naturopath, acupuncturist etc., many others fail to get adequate relief.

A way to improve our efforts lies in the knowledge that pain is the result of several related neurological processes stimulated by emotional, cognitive, sensory and environmental factors. If we investigate the possible role of all of these factors in any individual we can come to a better understanding of that person’s pain. Keeping in mind the complexity of pain, it would be a mistake to ignore any of them.

The implication of this for treatment is obvious. All the factors involved need to be addressed. Reducing back pain with massage, drugs and acupuncture is good, but adding instruction in body mechanics, strengthening muscles and reducing distress would seem more complete.

This kind of treatment is called multi modal or multi disciplinary. It has intuitive appeal if one accepts the complex view of pain I’ve been presenting in these posts. Even more important is the fact that medical studies have repeatedly demonstrated the superiority of multi disciplinary approaches to the management of chronic pain. Simply put, combining different kinds of treatment gives better results than any single therapy alone.

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