Rethink Chronic Pain

Relieve Suffering, Heal Your Body, Own Your Health

Gaétan Brouillard, David Warriner

• Publisher: Greystone Books
• Year: 2020
• ISBN:
  9781771644648
• Topic: Medicine
• Subtopic: Anesthesiology & Pain Management

"At last… a book about chronic pain that covers every aspect of this huge issue.A possible solution for nearly everyone who is suffering."
—Christiane Northrup, M.D., New York Times -bestselling author of Women's Bodies, Women's Wisdom.

Do you have arthritis, back pain, fibromyalgia, or another form of pain? This foundational book on chronic pain offers a holistic guide to living pain-free, which incorporates traditional medicine and natural solutions such as supplements, reflexology, meditation, cannabis, and more.

In Rethink Chronic Pain, medical doctor and proven chronic pain expert, Dr. Gaétan Brouillard, identifies the physical and psychological roots of pain and recommends not one single treatment (as the vast majority of pain books do) but many: he combines osteopathy, hypnotherapy, acupuncture, nutrition, mindfulness, and natural products (including cannabis and CBD) into his tried-and-tested approach, which he has used to heal patients in his own practice. Dr. Brouillard also draws on his years of experience as an emergency room doctor, clinician, and medical researcher to explain scientific breakthroughs in pain treatment and how to usetraditionalmedicine and surgery when necessary.

Throughout the book, Dr. Brouillard explores all aspects of pain. He explains the connection between pain and depression and anxiety; the biological and environmental causes of pain; the impact of pain on our finances; the importance of sleep for chronic pain recovery; and the relationship between pain and what we eat. Finally, he shares the benefits of meditation and creative thinking for living a pain-free life.

An illustrated Pain Guide covers an abundance of different pain types and their treatment options including:

• Arthritis and osteoarthritis
• Fibromyalgia
• Headaches
• Neck Pain
• Scoliosis
• Herniated discs
• Carpal tunnel syndrome
• Sciatica
• Plantar fasciitis
• And so much more

Readers will come away with new understandings of their pain and different treatment options—as well as renewed confidence for healing chronic pain at its source.

CHAPTER 1

Understanding Pain

________________

Man is a pupil, pain is his teacher.

ALFRED DE MUSSET

SINCE WE’RE GOING to be talking about pain throughout this book, let’s start by defining what it is. Pain is a manifestation of an imbalance in your body that you feel as an unpleasant sensation. Think of it as an alarm going off to warn you of a danger or a threat to your physical or emotional body. (That’s right: pain can be psychological, too.) It’s irritating, it’s unwanted, and it can affect your quality of life. Pain creates a sense of unease and discomfort. But worst of all, pain isn’t something you can see. It doesn’t show up in a blood test or on an X-ray. And you can’t show it to anyone else. Pain is something you feel and experience alone. That’s why it can be so challenging to try to explain it to someone.

The Merriam-Webster Dictionary defines pain as “the physical feeling caused by disease, injury, or something that hurts the body.” The definition also extends to psychological pain, citing “acute mental or emotional distress or suffering.”

According to the International Association for the Study of Pain, pain is “an unpleasant sensory and emotional experience associated with actual or potential tissue damage.”¹ Going by this particular definition, pain is never solely physical; the emotional aspect is always there, too. Pain, therefore, is a subjective thing, and we all feel it at different intensities depending on how sensitive we are.

Pain is considered to be acute if it is short-lived (though it can be very intense), or chronic if it recurs or persists for longer than three to six months (depending on who you ask). In many ways, pain can be a useful thing, because it essentially sounds the alarm and helps you to avoid doing any further damage to your body.

Keep reading, and you’ll find out how pain has a cause, a source, and even a meaning.

Pain is necessary

Pain stems from a change in tissue. Thanks to your nervous system, your brain registers any change your body undergoes, and pain is the mechanism your body uses to tell you that something is wrong or out of the ordinary. Without this mechanism to sound the alarm, you wouldn’t know something was happening that might pose a threat to your body or to one of your organs. Think of a burn as a simple example of this. If you put your hand on a hot stove, the searing pain you experience is your brain’s way of telling you about the risk of damage to your hand. Your hand doesn’t feel the pain; rather, receptors in your hand send signals to your brain, which decodes the sensation as pain. Before you even realize the stove is red-hot, you instinctively pull your hand away, because your nervous system immediately tells your bicep to contract.

Pain plays an essential role in alerting you to danger. Because of damage to sensitive nerve fibers, some people with chronic diabetes experience a decreased sensitivity to pain in their feet. As such, they might easily walk on hot coals or step on a nail without realizing the damage they’re causing to their foot. This means they must be very careful to avoid hurting themselves. Ultimately, pain is a protection mechanism and a survival-instinct tool for your body, and you have your nervous system to thank for it.

The pain circuit

Pain is personal

Most people’s reaction to touching a hot stove would be to pull their hand away. However, in some situations, tolerance to pain can vary dramatically from one person to another. Think of a visit to the dentist’s office, where it’s easy to see the two extremes. Some people can have dental work done without any anesthetic at all, while others need to be heavily medicated to undergo the same procedure—and can find the pain so unbearable they might even pass out, especially once fear comes into play. Meanwhile, others may undergo a similar procedure that would usually require anesthetic with the help of hypnosis or acupuncture alone. Pain perception can vary tremendously depending on the person, their age, how accustomed they are to the feeling, how tired they are, and even their emotional state. Pain is therefore a very personal thing, and we can all experience different intensities of pain at different times.

Giving birth is another interesting example of how pain can vary radically from one person to another. While there are many factors involved in giving birth and some women no doubt have a more difficult experience than others, even given similar situations some women will find the pain unbearable, while others give birth seemingly easily and almost painlessly.

It seems there may also be a sociocultural dimension to the perception of pain. One thing that struck me when I went to work with the Innu in the northern Quebec town of Schefferville was the high pain resilience exhibited by some Indigenous people. I recall being able to perform some surgery—on adults and children alike—using only minimal local anesthetic, all very successfully. I found myself treating children who had ear infections with ruptured eardrums, but who complained of very little or no pain.

My few weeks as a locum in the far north soon came to an end, and before I left to catch my plane home to Montreal, I did the rounds one last time. All inpatients were receiving proper care and the emergency room was empty. All was calm as I prepared to thank the nurses and bid them farewell. Considering that, at that time, there was only one doctor for nearly four thousand people in the Schefferville area, the nurses there did a remarkable job and were highly talented. They would often diagnose patients and begin treatment in the middle of the night, saving the doctor precious hours of sleep. There are no roads to speak of into or out of this remote town, and back then it was only accessible by plane once a week, and sometimes only every two weeks.

Therefore I knew I had to leave in the next hour, on the same plane my replacement was flying in on. I was quite sad to be leaving, since I had enjoyed working there with the keen staff and friendly people in the town. It was at this point that Jade Shu Lee walked into the outpatient clinic at the Schefferville hospital. This young woman of Asian descent was expecting her first baby and presented with uterine contractions. She calmly told me her contractions were close together and that she was probably very close to giving birth. As I carried out a pelvic examination, I was astounded to see her cervix was already significantly dilated. I figured that she would be giving birth in a few hours and that the nurses, together with my replacement, would take care of her.

I performed another examination and realized that her cervix was fully dilated and that the uterine contractions were doing their job very well indeed. Yet my patient was remarkably cool, calm, and collected, displaying no signs of concern or suffering, even though this was her first child. She was alone, with no one to help her through the birth. I asked her how she was feeling and how severe the pain was. She told me she was fine and wasn’t in any pain. It looked like she was carrying a big baby for such a petite frame. And so I administered an injection to anesthetize the perineum and performed an episiotomy—a small incision—to help ease the way for the baby and minimize tearing. Jade remained perfectly calm throughout all of this, never displaying any discomfort.

Everything progressed much quicker than I had expected. Jade’s contractions were very efficient, and a little head soon appeared. We carried on a conversation the whole time and at no point did Jade show any sign of suffering. I was flabbergasted by such restraint in the face of pain, to the point where I wondered whether her neurons were wired differently from most people’s! Before I knew it, Jade was holding her beautiful baby boy, full of life, in her arms.

I hadn’t finished stitching up the episiotomy when a nurse ran over to tell me I had to leave right away, as the plane wouldn’t wait. Obviously, I didn’t want to leave my patient with a tear that I hadn’t closed, but there was no arguing with the nurse, who was adamant that if I missed this plane, there wouldn’t be another one for another week or two. I knew my colleague would be arriving at the hospital less than ten minutes later, since he was aboard the plane that had just landed.

Reluctantly, I explained to Jade that if it was all right with her, I would have to leave her to catch my plane, and that my colleague would be with her shortly to finish her stitches. She smiled and told me not to worry, joking that she was in good hands with the nurses anyway. As I left, to my great surprise there was no taxi waiting for me at the hospital entrance, but a police cruiser, which promptly raced off to the airport with lights blazing and sirens blaring. This was quite a surreal experience for me, since I was so used to seeing ambulances and police cars arriving at the emergency room, not leaving it. I boarded the plane just in time, my head spinning with thoughts of all the kind, generous people I had been able to help during my short time there.

Differences in individual pain tolerance are difficult to explain. Could it be that our perception of pain, which isn’t purely physiological, also depends on our state of mind?

Do we learn to feel pain?

Many researchers have examined the question of pain perception. One notable example is Dr. Ronald Melzack,² whose work includes a study on dogs that were bred in an environment that had never exposed them to pain. Once they were fully grown, they reacted differently to injections than other animals, as if they didn’t recognize the sensation of pain because they had never learned what it was. According to Dr. Melzack, pain depends as much on our experiences as on our instincts. This is interesting, because it suggests we also have the capacity to unlearn how to feel pain. Hypnosis has demonstrated how we can manipulate the sensation of pain by feeding our brain a different program than the one it knows. We’ll look at the benefits of hypnosis in greater depth in Chapter 6, which is all about treating pain.

DO WE FEEL FEAR MORE THAN PAIN?

One important realization that research has brought to light is that the apprehension of pain can augment the sensation—it can even make it feel twice as intense. However, the opposite is also true. One of my patients used to faint whenever I injected his medication, so I started administering a drug that would prevent his blood pressure from dropping so that he could confront the pain. After two more of his shots, he was no longer afraid of fainting and realized the needles didn’t actually hurt as much as he had remembered. In fact, his “needle pain” completely disappeared from then on.

I often have to be careful when someone accompanies a patient into my office for an injection. They sometimes have to leave because they feel faint at the sight of their friend getting an injection, even when the patient experiences no pain from the shot and keeps smiling the whole time!

The level of pain we feel—or the apprehension of that pain—bears no relation to the size of the person.

A patient of mine, a police officer who’s six foot four and weighs nearly two hundred pounds, asked me to slot him in one day between two appointments because he was on duty and was in a hurry to get a shot to relieve himself from severe shoulder pain. I took my time administering the injection, only to see this giant of a man turn as white as a sheet and promptly pass out. He was in such a hurry when he walked into my office, but it took him nearly forty minutes to come to his senses and walk out again.

SOMETIMES WE FORGET IT HURTS

After a traffic accident, it’s not uncommon for parents who have withstood fractures to keep moving long enough to help their children get out of the car—they’re so focused on helping their injured children that they barely sense their own pain. The same phenomenon has be...

Table of contents

• Cover
• Title Page
• Contents
• Introduction
• Chapter 1: Understanding Pain
• Chapter 2: The Meaning of Pain
• Chapter 3: Why am I in Pain?
• Chapter 4: Pain Treatment Starts on your Plate
• Chapter 5: Natural Pain-Relief Solutions
• Chapter 6: Ways to Treat Pain
• Chapter 7: The Psychology of Pain
• Chapter 8: Making Pain Easier to Live With
• Conclusion
• Appendix: Pain Guide
• Acknowledgments
• Notes
• Index
• About the Author
• Copyright Page