Who should you see for chronic pain?

You have a choice but which is the right one?

The short answer to this question is a clinician who truly understands pain. Such a clinician will work together with the person in a way that is solution focused and inspires change in a desired direction.

Many people will go to their doctor, so they immediately enter the medical model. Informed doctors will help the person understand their pain from the outset and initiate self-coaching practices. Others prescribe pain killers or anti-inflammatories, they may refer for investigations and could provide a tissue based explanation, thereby entrenching the biomedical thinking from the outset. Most of us have been brought up with this model so it is implicit. Our deepest beliefs about pain and injury tap into this because it is what we ‘know’ despite the fact it is actually wrong. Pain and injury are neither the same nor are they synonymous.

“Pain and injury are not the same and they are poorly related

Of course the same can be said for other clinicians and therapists who base their thinking on the biomedical model. Even those who claim to be ‘biopsychosocial’ will maintain a focus on the bio, perhaps with some psycho and rarely any socio. Pain as a public health issue necessitates that this be turned on its head. When a person is in pain, they don’t need to think about chemicals in their body or what their brain is doing. Instead they need a practice that they can use then and there to change their current course.

Is there an ideal clinician or therapist?

You may be surprised to know (or maybe not!) that pain education for healthcare professionals is minimal and falls short of the need. Those interested in pain may follow a further course of study such as the syllabus described by the International Association for the Study of Pain. Others may be examined upon the dimensions of pain, how they interrelate and their emergence in the person as a lived experience. Modern pain education requires input from the fields of neuroscience, cognitive science, studies of consciousness and philosophy as a bare minimum.

Briggs et al. (2015) looked at undergraduate pain education and concluded:

‘Documented pain teaching in many European medical schools falls far short of what might be expected given the prevalence and public health burden of pain’.

understand pain to change pain

What do we need?

Society needs dedicated clinicians for pain who can incorporate all dimensions of pain and how they blend in the context of the person and his or her life. Each moment is made up of cognition, action and perception within a sociocultural background and on the end of a lifetime of prior experience and learning. The clinician must understand that pain is part of such a moment and be able to lever the opportunity and potential that each person holds. In understanding pain, they know that the person can be successful in changing their life.

In essence when a person seeks help with their pain, they want change. No longer are they satisfied to maintain their current existence. They have decided to change and want to know how. Existing disempowering beliefs have thus far been in the way of successful change — e.g./ pain = damage; fear of pain; fear of change; fear of failure. These beliefs can be far reaching and deep, having existed since childhood. Each person also has empowering beliefs that can be used with their individual strengths, building their potency with practices, much like building muscle. We change by design, but often need the know-how. This is where coaching is a powerful approach. The person with chronic pain needs coaching to reach their potential.

“let’s focus on what you want and what you CAN do

The Pain Coach Programme focuses on the individual achieving results and success. With the foundation of understanding pain in place, the person can learn and develop practices that foster health and well-being whilst other practices maintain the course towards a desired outcome: what do I want in life?

When we need help in life we turn to a trusted advisor who can give us what we need to change our circumstances. The challenge of pain is no different. Only the individual can decide to take action, and it is the action that leads to results. However, he or she needs a clear vision of what they want, new understanding, actions to take and the know-how or practical knowledge of how to apply new thinking and skills. This is why coaching is ideal because it provides just that.