#007: “Why Do I Still Have Pain,” the $655 Billion Dollar Question
Hi friends, family, and extended internet family!
I just started an online writing class, and it’s been so much fun. I’ll be posting my work so my newsletters for the next 5 issues are going to look a little different. Please enjoy!
Update: Due to concerns about patient privacy, I wanted to confirm that Mr. Seto is a fictional character. I do not share any Protected Health Information that would identify my patients. If Mr. Seto seems very real, it’s because he totally can be! Your uncle, cousin, neighbor, or mailman, Mr. Seto is a conglomerated character pulled together from one of the most common patient profiles that I see in practice.
In front of me is Mr. Seto, a thirty-three year old Asian-American male who has been hurting for a while now. After ignoring a nagging lower back pain for over a decade, doing some light chores around the house had turned this into a full-blown interruption to his life.
Now he can’t eat, can’t sleep, can’t work, and can’t even sit down to poop. The past few months have been a roulette of NSAIDs, muscle relaxers, nerve blockers, physical therapy, acupuncture, injections and visits to both the orthopedist and neurologist with no clear winner. Today, he’s here because the neurologist wants a chiropractic consultation.
“Can you cure my pain?” He asks.
I tell him frankly that I don’t have a cure, but nothing else stops the pain better than completely obliterating the nerves that feel pain. But, that’s like using the Death Star to fix an ant problem - overkill. A simpler and less destructive solution would be to follow the ant trail to that half-eaten banana at the bottom of a backpack.
Like the ant trail, chronic pain can be framed as a tool instead of a nuisance. It’s my job to follow the ant trail. To find what in life is out-of-alignment as much as it is to find what in the spine is out-of-alignment. I reckon that chronic pain is one of the human body’s most useful biofeedback mechanisms to get us back on track to living a meaningful life.
In Mr. Seto’s case, he was overweight, Pre-diabetic, smoked a half pack of cigarettes daily, skipped breakfast, hated vegetables, lifted weights but skipped cardio, worked the night shift, didn’t have very many friends, and watched Netflix in his spare time.
To say it straight, Mr. Seto did not have chronic pain because he was missing chiropractic adjustments (although that certainly would help). Unfortunately, he is not an anomaly. Most cases of chronic pain do not have a singular solution because there is no single cause.
If it were that simple, we wouldn’t have a$655 billion dollar problem that affects millions of lives in the USA. It follows the paradoxical nature of cancer, depression, and Alzheimer’s in that there can be “Many causes, one condition. One cause, many conditions.”
For instance, with chronic lower back pain, some of the key risk factors are impaired fasting glucose, depression, smoking, and increased BMI. This is why taking a multi-pronged approach to look at the whole person can be so helpful.
Personally, I like to use Maslow’s Hierarchy of Needs. While initially presented in the world of psychology to explain human motivation, I like to use this framework in the health context in conjunction with the paradigm that everything in the body is of intelligent design, including pain. This is how the brilliant architecture of the body and nervous system is meant to bring us in tune with our needs and to fulfill on our human experience.
In fact, there is no better showstopper in life than pain. It’s quick, it’s effective, it immediately cuts through the noise to get your attention. In the chronic state, pain is on loud-speaker and there’s hardly a way to get a word in. And the message is loud and clear, “Cut the shit and get on with life.”
It’s a tough thing to hear.
Today, Mr. Seto gets to hear it. In front of me is a human being waiting to be transformed! I’m so excited I want to send him off with a full range of tools to address his basic, psychological and self-fulfillment needs.
But it’s our first visit, and I don’t want to scare him off. So instead, I get him adjusted, ask him to eat 6-9 servings of vegetables, and schedule him to come back.
Thanks for hopping aboard my train of thought! Over and out.
Was this interesting to you? If you have something to add about what I’ve written or feedback about how to improve my writing. I’d love to hear from you!
The best way to get a hold of me is to reply directly to this email (or if you are Boyfriend - come visit me in “The Studio”). I read all your responses.
Until next time - have a happy healthy and fulfilling evolution!
Maymie