Validate Your Pain! Exposing the Chronic Pain Cover-Up

From: Helen Dynda (
Thu Jan 3 10:49:41 2002

Title: Validate Your Pain! Exposing the Chronic Pain Cover-Up

Author: Allan F. Chino, Ph.D. & Corrine Dille Davis, M.D.

Publisher: Health Access Press

Price: $19.95

ISBN number: 0967343925

Published Date: 2000

There are some 50 million people throughout the U.S. suffering from chronic pain at any given time, according to a national survey. The total figure worldwide is estimated to be a staggering 800 million! By definition, chronic pain is pain that persists after the body has had time to heal. It is pervasive and unrelenting. Because it does not go away, it impairs one's ability to function and can impact one's entire outlook on life. The future seems bleak and hopeless to many. Chronic pain devastates both body and mind. Research on back pain alone reveals facts that underscore the scope of the entire problem, not only to individuals, but also to society at large:

* 80% of the U.S. population will experience significant back pain at some point.

* One percent of the U.S. population will become disabled due to chronic back pain.

* Chronic back pain is the leading cause of disability in men under 45.

* Back pain is the second most frequent reason for visits to a physician.

* It is the fifth most common reason for hospitalization.

* It is the third most common reason for surgery.

* No "objective" medical cause can be found in 50% of chronic back pain cases.

* Chronic pain costs Americans some $80 billion in healthcare costs and lost productivity each year. ~ ~ ~ ~

And these figures relate just to back pain. Here are some facts relating to the most frequent type of chronic pain: Headaches.

* More than 40 million Americans suffer from headaches severe enough to require medical attention.

* Fully 65% of migraine sufferers have never been properly diagnosed and treated.

* Lost annual productivity in the U.S. due to headaches alone is estimated to be as high as $17 billion.

In addition to chronic headaches and back pain, countless others suffer from debilitation caused by, arthritis, post-herpetic neuralgia (pain from shingles), reflex sympathetic dystrophy (RSD), and, perhaps the most widely ignored, wide-spread, and misunderstood pain condition, fibromyalgia. Unlike other books, Validate Your Pain!: Exposing the Chronic Pain Cover-Up speaks to all sufferers, regardless of pain type.

The fact that no "objective" medical cause can be identified in 50 percent of chronic pain cases speaks to one of the biggest challenges facing those with such disorders. Our medical tradition has relied heavily on new technologies, such as CT and MRI scans, to document "structural" causes of pain. Those unfortunate enough to suffer from pain that cannot be documented by such "objective" methods are relegated to second-class membership in the chronic pain club. In other words, they are given short shrift. The attention they deserve is withheld due to ignorance, misunderstanding, and, often, greed. At best, they are seen as chronic complainers and given pain pills and tranquilizers. At worst, they are regarded as malingerers, trying to cheat the system in order to gain sympathy and/or to collect financial compensation.

Many of these individuals report undergoing surveillance by insurance company private investigators armed with video cameras, in hopes of "catching" them engaging in some kind of healthy activity. And while we work hard to help the individual increase such activity, they are afraid that their healthy behavior will be used against them. In essence, the overwhelming majority of these unfortunate individuals know that their circumstances are tragically misunderstood and that they are being treated unfairly. They are told There's nothing wrong with you — it's all in your head or you'll just have to learn to live with it. Yet they are given nowhere to turn for help. They are never told how to live with it.

As part of our interdisciplinary chronic pain management program, hundreds of patients have participated in our group sessions in which relevant topics — most of which are included in this book — are discussed. By far, the topic most frequently raised by patients is that their pain experience has been invalidated or disregarded as they have moved through the medical system and they are searching for someone (especially healthcare professionals) to understand and to help them. It is an issue charged with emotion.

Currently in vogue these days is an approach that actively dissuades patients from talking about their suffering. The idea is that pain behavior will go away if it is not reinforced. The unfortunate result, however, is that patients may begin to doubt their own experience and to feel alienated from their treatment team. Pain behavior may be reduced, but it is often only a temporary effect. Alternatively, we have seen, time and again, that more solid and lasting success comes when patients are first given an opportunity to fully express the ways in which pain has disrupted their lives. When combined with opportunities to function in ways that reinforce their efforts, emotional suffering is weakened. It is this process that leads to changes in beliefs and perceptions, not the differential reinforcement of using the "correct" (often referred to as rational) language.

Validation is only the first, though the most important, step toward recovery from chronic pain. And while we have the utmost respect for our patients and their experience of chronic pain, we do not advocate the making of victims. We do however, advocate telling it like it is and then moving forward to help those afflicted to achieve a greater sense of empowerment, self-reliance, and fulfillment as human beings.

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