Murray J. McAllister, PsyD
Murray J. McAllister, PsyD, is the editor and founder of the Institute for Chronic Pain (ICP). The ICP is an educational and public policy think tank. Its mission is to lead the field in making pain management more empirically supported. Additionally, the ICP provides Academic quality information on chronic pain that is approachable to patients and their families. Dr. McAllister is also the clinical director of pain services for Courage Kenny Rehabilitation Institute (CKRI), part of Allina Health, in Minneapolis, MN. Among other services, CKRI provides chronic pain rehabilitation services on a residential and outpatient basis.
People outside the healthcare industry, such as the typical consumers of healthcare, are often surprised to find out that some of the most common healthcare procedures and therapies are largely ineffective on average. It can sometimes even border on disbelief. When seeking healthcare, most people assume that the treatments healthcare providers recommend are effective. This assumption forms a basic trust in our healthcare providers – that they know what they are doing and that they wouldn’t recommend something that they know is ineffective. So, it seems hard to believe that a provider might ever recommend treatments that have been shown to be ineffective on average.
When it comes to the management of chronic pain, good coping is quite possibly the most powerful intervention we have to be able to reduce pain and improve function. It’s typically what accounts for the ability to manage pain without opioid medications or remain at work full-time despite having pain. In short, it can make tolerable what was once intolerable pain.
Oftentimes, however, people won’t believe it.
The meaning of "chronic" and why the healthcare system refuses to accept the chronicity of chronic pain
We live in an age of chronic illness. Conditions like heart disease, diabetes, asthma and chronic pain are common. All these health conditions are chronic. The term chronic means that a condition has no cure and so will last indefinitely.
It’s common to complain about healthcare and our healthcare system. We complain about our health insurance and we also complain about reforms to the health insurance industry. We complain about the long wait times to see a provider. We also complain about the short amount of time that we actually get once we see a provider. We complain about how much money we pay for healthcare. We also complain about how much money certain providers and insurance executives get paid. With our healthcare system so large and complex, most anyone can find something to complain about.
Opioid, or narcotic, pain medications are beneficial in a number of ways. Terminal cancer patients, for instance, benefit from their use. The short-term use of opioid pain medications is beneficial, especially while recovering from an acute injury or a surgery. However, the long-term use of opioid medications for chronic, noncancer, pain remains controversial. While a number of issues contribute to this controversy, the main reason for the controversy is addiction. Opioid pain medications are addictive.
This controversy makes opioid pain medications a highly sensitive issue for patients who take them.
What is trauma?
Trauma is the psychological and bodily response to experiencing an overwhelmingly terrible event. Some examples of events that can lead to trauma are the following:
What is a sleep disturbance?
Patients with chronic pain frequently experience sleep disturbances. Sleep disturbance is a catchall phrase for any type of problem in sleeping. The most common forms of sleep disturbances in patients with chronic pain are the following:
What is depression?
From time to time, most people feel down, blue, unhappy, or irritable. These kinds of depressed moods come and go in response to the normal problems of life.
What is anxiety?
Anxiety is a normal emotion. Everyone has anxiety on occasion. It is the emotion that people have when something dangerous might happen. Anxiety is closely related to fear. Fear occurs when something dangerous is happening. Anxiety, though, occurs when something dangerous is pending, and hasn’t happened yet, though it could.