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Peter Abaci, M.D.

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The Lesson We Can All Take Away From Chronic Pain

Posted: 08/24/11 10:05 AM ET

First off, I must disclose that I have never taken a business class, always reach for the sports page over the financial section of the paper, and when I look at a spreadsheet I tend to go straight to the bottom number on the far right. This may make me sound like an unlikely source for advice on how to better our economic health, but I believe my many years spent in the field of treating pain -- where I have witnessed so many personal transformations and triumphs -- has taught me some really cool life lessons about growth and healing that many politicians, business leaders and consumers seem to have missed.

Treating chronic pain is often about creating change. In order to help someone feel better and function better, you have to help them change the way they move, think and even breathe. Overcoming chronic pain is a game of control. Is the pain in control of the patient or is the patient in control of the pain? It is the job of someone like me to help tip this scale in the direction of the patient.

Here are some key ingredients that have helped me create positive change for those overcome by pain and how these same concepts can be used to treat what ails our economy:

Fear: There is a concept in pain management known as the fear-of-re-injury, or fear-avoidance model, where the individual in pain stops moving or using certain injured body parts out of fear. That can mean avoiding using a hand or refusing to stand on one particular leg well beyond the acute injury phase. This is a tricky situation for patients to understand because fear is often seen as a natural defense mechanism and initial attempts at using an overprotected body part can feel uncomfortable. They often need help understanding how the new fear they have developed is holding them back from getting better. Fear can put people in a very small box, but patients overcome their fears very gradually, step-by-step, by building confidence in what they can do.

It seems like there is a pervasive feeling of fear throughout the U.S. and around the world affecting decisions on a bigger scale. This would account for the wide fluctuations in our investment markets each day. You hear talk every day now about the "fear of going back to a recession" and everyone cringes whenever a new economic statistic -- like unemployment -- is going to be released. I know that my patients stay stagnate and fail to progress when they are controlled by their fears. We need all of our parts moving freely, in both the public and private sectors. Please inspire me with courage, build my confidence and don't hold me back with fear-mongering.

Independence: An important concept in chronic disease management has to do with returning the locus of control to the patient. When patients initially seek medical care, they are dependent on their health care providers for getting tests, diagnoses and treatments. Successful disease management occurs when the patients start to take on more and more of the responsibility for managing their own conditions.

In the case of diabetes, for example, blood sugar control improves when proper dietary changes happen at home. When my patients develop effective tools to better manage their pain, then they feel better about becoming less dependent on needing my help. This means they have gotten past some of their fears and are more self-confident, which is a sign of sustainable progress.

I would suggest that our leaders put more emphasis on returning the locus of our economic control back home. This always gets discussed during election campaigns but never seems to gain enough traction to get off of the ground. This means tackling problems like our dependence on foreign oil and using our technological innovations to promote a better balance between hiring at home and outsourcing jobs abroad.

Avoid Quick Fixes: Patients often spend years looking for the magical treatment that will eliminate all of their chronic pain and never find it. Those who learn to accept their injuries and focus their energy more on healthy management tools, are more likely to feel happier and fulfilled.

When businesses and governments focus on quarterly profit reports and re-elections, they often fail to achieve meaningful change. There seems to be a general lack of accountability on long-term outcomes.

Environment Matters: Experience has taught me that nothing inspires a patient more than another patient who has successfully overcome similar challenges.

We need to see, hear and read more about what is working and who is having economic success from our media, and read less about whining, complaining and finger pointing. If there is a business doing well on Main Street right now, then we should all learn about it.

Be Careful What You Believe: When patients misinterpret the medical terms that get thrown at them, then they are much more likely to make poor decisions. Degenerating discs on a MRI of the lower back in a middle-aged person can be a typical age-related change of little significance, yet I see many folks interpret this to mean something is "broken" or "cracked" in their backs. Medical information is always more useful when we can put it in the right context and do something with it that is good for our health.

Is it possible that the economic reports that get released have a similar impact on the public as a whole? Do we really understand what these terms and numbers mean and how to use them appropriately? When I vote, buy a house or invest in mutual funds, I do so, not as an expert, but as a regular guy who has come to some sort of emotional decision, based on less than an ideal understanding of whatever I am evaluating. Really being in danger and just thinking you are in danger can have the exact same outcome. In other words, my advice to patients who are concerned about MRI results but can still walk, is to not stop walking.

Growth occurs when we aren't afraid to fail. Change happens when we are open to it. Sometimes you just have to lead with your heart.