A clinical update published by the International Association of Pain in January 2011 observed that “specialty training in pain medicine has become increasingly technical.” but also noted, “ despite a steady increase in the number of surgeries and interventional therapies for chronic pain, many individuals with this condition report little noticeable improvement in overall health status.”

Although more doctors are being trained to prescribe drugs and perform procedures (e.g. nerve blocks and operations), this has not translated into large benefits for most chronic pain patients according to Dr. R. N. Jamison, a psychologist at Brigham and Women’s Hospital affiliated with Harvard Medical School. The article indicates that surgery, injections and drugs are not the same thing as “helping patients cope and deal with the suffering associated with having a chronic medical condition”.

Dr. Jamison suggests that factors such as attention from caregivers, motivation, reduction of anxiety, attitude change and improved coping are as important as the specific effects of a drug or an injection when it comes to improving outcome of pain treatment. He cites a significant amount of evidence from the medical literature showing the benefits of addressing these factors in treatment.

This clinical update is yet another way of highlighting the multi-factorial nature of pain and the importance of a multi-disciplinary approach to treatment that has already been mentioned in these posts (see The Complexity of Pain (#5-What is Pain) and The Complexity of Treatment (#6-What is Pain?)). Furthermore it is this idea that lies underneath the surface of what we do in our pain group sessions. We are attempting to address those factors contributing to chronic pain that drugs and procedures don’t.

We believe that providing a group where there is no pressure to perform or participate beyond one’s capabilities gives participants a safe place to go where they will not feel as if they are being judged. We feel this is an important step in addition to meditation and relaxation training toward reducing anxiety. We invite participants to voice their concerns and ask questions about what we do or about any pain related topic. Feedback is welcomed. As relaxed as our sessions are, respect for each person is always maintained.

Learning to move the body without strain or apprehension is one way of coping with pain. Learning to work with the mind to gain control over oneself is another. With explicit instructions we teach participants to do both. In every session we acknowledge the reality of everyone’s pain but focus on how to deal with it.

Dr. Jamison’s article points out that technological advances have led to only modest successes for some patients. We hope our sessions are one way of increasing success for most patients by paying attention to the physical, emotional and cognitive factors that are part of chronic pain.

A much simpler way of summarizing all of the above comes to mind: we need to treat the person as well as the pain in order to make the biggest possible difference in someone’s life. All of us, patient and doctor alike would do well to keep this in mind.