Pain is so much more complicated than most of us realize. First, pain is so much more than just pain. There are countless terms, learnings, treatments, ideas, and practices to manage it with new ones seeming to be birthed nearly daily. A major distinction in classification is whether the pain is considered acute or chronic. Here, I’m talking about chronic pain, which is generally considered pain persisting for a minimum amount of time (I’ve read six weeks, three months, and six months).
Chronic pain is currently modeled as falling into three big categories. There’s no need to take notes, just know it’s complicated: nociceptive, nociplastic, and neuropathic. Each one of these can grow stronger or weaker over time and affect the other pain types to a greater or lesser degree. Of course, this is just a model, but models are useful until they’re not.
Looking at chronic pain from a different standpoint, other models consider three distinct lenses to look through: biological, sociological, and psychological. Once again, each one affects the others. Biological makes sense. Psychological, if you sit with it for a little bit, makes a lot of sense as well. Even sociological, which for me is much less obvious, is considered to be an important parameter to evaluate. Multi-faceted multi-dimensional relationships wrapped in complexity. I guess this shouldn’t be surprising.
Then there are the different entry points into the pain complex: emotions, thoughts, and behaviors. Each one, once again, is connected. And once again, for me at least, some are more obvious than others and some interconnections more apparent, as well the directionality of those relationships also being more or less familiar. Pain does not have to equal tissue damage. Remember phantom leg pain for example.
And, bringing in some Eastern thought since that generally has been verified over and over again for millennia, the surest way to never reach enlightenment is to try to reach enlightenment. The goal in having a meaningful pain journey if that is what life seems to be offering at the moment is first to accept this reality. Acceptance is so powerful. Next is to try to develop a soft curious open-hearted relationship with the pain. The more we try to minimize or eliminate the pain the more persistent and loud the pain will become in our lives. This does not mean that we should not seek help, not use prescribed medications, not eat and sleep and socialize healthily, but it means the goal is not elimination of the pain. The goal is elimination of the resistance to the pain. This is still a work in progress for me and I assume will be for years to come if not always. Living my values fully and bravely despite chronic pain is the goal, is the journey, the fabric of existence, not the destination. Generally the more we try to make the pain go away the stronger it gets. It is not until we practice relaxation, movement, connection,mindfulness, purpose, and kindness instinctively and regularly will we make peace with and turn the corner on our pain. The pain doesn’t have to hurt.
