Chronic Pain as a Disease: Why Does it Still Hurt?

People who suffer from severe, chronic back pain know how it can disrupt and damage one’s life.
Chronic back pain can be cruel, making it hard to enjoy even the simplest daily activities. The pain makes it a challenge to carry out an exercise routine and other healthy activities.

Moreover, chronic pain was not always all that well understood. Pain always has a cause, that used to be the believe in the medical profession. It was a manifestation of an underlying injury or disease.

As such, doctors focused on treating the underlying cause of the pain. A doctor cures the injury or disease and the chronic pain would then disappear.

In cases where no underlying cause could be found for the pain, the doctor told patient that very few treatments are available. Or worse, “the pain must be in your head”. Unfortunately, some doctors still practice in this manner. They have no appreciation for the unique problem of chronic pain. They don’t always consider newer theories about chronic pain. There are many factors that influence a chronic pain problem.

The medical community is coming to a new understanding. They no longer see pain as a function of a healthy nervous system, signaling that there is a disease or underlying injury. This means then that the chronic pain itself becomes the problem. The doctor  needs to treat your chronic pain as the primary pathology.

All pain is real

Contrary to popular belief, all pain is real.

This may seem like an obvious statement. People with chronic pain are sometimes treated as if they imagine the pain. Sometimes they are even told they are exaggerating.

In some cases, they feel like they have to prove their chronic pain to their friends, family and doctors.
Some patients are told by their doctor that there is no reason for the chronic pain and so “it cannot be that bad”.

Chronic pain is a personal experience. You cannot measure it like other problems in medicine.

For instance, a broken leg can be confirmed by an X-ray. An infection by a blood test measuring white blood cell count.

Unfortunately, there is no medical test to measure chronic pain levels.

For patients matters can be even more challenging. Many chronic pain problems have no evidence or physical findings to explain the pain.

As a result many chronic pain sufferers go from one doctor to the next searching for explanations.

This process can lead to unnecessary evaluations and treatments. This puts the patient at risk. The patient can actually be harmed or his conditions made worse by the healthcare profession.

The Experience of Chronic Pain

Everyone experiences and expresses pain differently. Two people with the exact same injury will feel and show their pain in unique ways. This all depends on a number of things such as:

• The situation in which the pain occurs
• Thoughts about the chronic pain. Thaughts like “this is nothing serious” versus “this pain could kill me”
• Emotions associated with the chronic pain. Emotions like depression and anxiety versus hopefulness and optimism
• Cultural influences. Determining whether a person is to be more stoic or more dramatic in showing pain to others

The newest theories of chronic pain can now explain, on a physiological level, how and why people experience pain differently.


By William W. Deardorff, PhD, ABPP