Pain and society — Pain is an issue in society, and for society. Why pain has become the number one global health burden is a question that we must consider and answer using on-going study of what pain really is, how it influences us, how we influence pain, how pain emerges from individuals who form society and how society views pain. No mean task, however we must envision where we want to be as a society and focus on getting there.
One of the biggest problems with pain is that it is misunderstood. The predominant thinking remains in the pathological and body structure camp as an explanation for pain. This thinking needs to develop across the whole of society, in fact beginning in schools where I believe children should be taught about pain.
Fear is a huge factor in pain — what does this mean? Will it get better? Will this pain ever go away? Etc etc. Of course those who understand pain will know that these very thoughts are ample to fuel further protection and hence pain. We need people to understand that pain emerges in them as an individual, very much flavoured the situation in which the pain is noted, influenced by past experiences, beliefs about pain and immediate thoughts and emotions. There are reams of papers examining these factors. The early messages are vital when someone has injured themselves or suffer an acute episode of pain. The right thinking from the outset creates a way forward with effective behaviours and actions to allow the body systems to co-ordinate healing and recovery. Unnecessary fear and worry simply divert resources away from these processes and hence affect the outcomes. We do not need to fear pain but rather, take action and deal with pain.
When someone has more persisting pain, and this is likely due to certain vulnerabilities that we are understanding more and more, again the messages must be clear and accurate. The notions of management and coping are just not good enough. We can deliver much better care, advice, coaching and treatment than ‘management’ implies. This is beneficial for the individual, the funder and hence society as a whole. Society needs to be purporting the right messages about pain and therefore we need to develop thinking on a large scale.
When I studied the Pain MSc at Kings College London under Dr Mick Thacker, I used to wonder why it was called ‘Pain: science and society’. Whilst I do not know the exact reasons for KCL’s entitling of the course, now it is obvious to me that we have a huge societal problem that needs urgent attention. There is a responsibility for all of us to come together and develop so that change occurs in the wake of new thinking based on the huge amount of research into pain. We need the support of the policy makers, businesses and individuals. Why policy makers and business? Because we can change what is happening now including the vast cost of chronic pain — this huge pot of money could become available for many other areas of life. So let’s move forward together.