Why Some Cope Better with Chronic Pain

Why Some Patients Appear to Cope Better with Chronic Pain

NOTE: The science in this article is based upon a review of, “The Brain” by Carl Zimmer, Award Winning Biology writer, June 2011 issue of DISCOVER Magazine. It is highly recommended that you read this great article.

There are no medical tools, stethoscopes or thermometers, to measure or determine objectively if a neuropathy patient has chronic pain.

While measurable, observable, objectivity is the hallmark of modern science, too many times what drives treatment, testing and payment approvals by medical insurance is the observable.   The neuropathy patient lives in a world of subjective symptoms until measurable damage is done to the axon (nerve) or the covering to the nerve (myelin).

Neuropathic pain can occur for years or even decades before there is measurable damage to the peripheral nerves. (Read One Man’s Journey with Neuropathy).   The reality as recently confirmed by the medical experts in the  Journal of the Peripheral Nervous System – such measurable nerve damage can take years to happen.  Meanwhile the neuropathy patient suffers alone from some unknown underlying pain from a disease or condition, too often dismissed by doctors.

Patients are trying their best to cope with the problems moving limbs in a motor neuropathy or the chronic pain that accompanies many sensory or disturbance to many internal systems as in autonomic neuropathies and sometimes all three.  It is easy for the doctors no having the necessary tools for diagnosis and faced with the demands of objective information, to dismiss the patient or diagnose with the diagnosis of somatization.

Now you may have heard the brag. “I have better pain tolerance than you!” Or, “You must have little tolerance for pain.” Or worse, “You have a low tolerance for pain and I deal better with pain than you do.”

The implications are that there is something wrong with you and something superior about them. Such comments hurt and all too often afflict more psychological pain on top of the physical pain and damage that is being done to the brain by chronic pain.

The truth is there is something right with you, but it is not what these braggers think or imply with such unhelpful insensitive comments.

True, the experience of pain is personal and complex. Each of us for a variety of reasons experience pain differently.

Yet science knows that the person with “tightly linked neurons” experience more pain. So you can always say that you are more tightly wrapped, but this will probably go over their heads.

There are physical and psychological reasons why each of us reacts differently to pain and pain medications. This is why partnering with the doctor to find what works for you is so important.  (Read Partnering with the Doctor).

That being said, there is something right with you as research of the brain reveals high levels of the enzyme AC1 increases chronic pain.

To any patient living with chronic pain, you do not need to explain what neuroscientist researchers now know about chronic (lasts more than 60 days) pain and how over time, under treated pain actually causes concrete psychological changes in the brain. We now know that patients actually begin to lose gray matter and some of us do not have a lot of it to give away!

Yet the exciting promise behind this discovery of enzyme AC1 is the related testing of NB001 in animals, a compound which attaches itself to AC1 preventing the “neuronal activity that makes chronic pain possible.”

The results are so promising that human trials are planned in the near future.

Whether this compound will continue to show promise in the more complex world of humans remains to be seen, but the road to “where chronic pain lives” has been unveiled.

The promise that science will eventually find a solution for the many patients suffering with chronic neuropathic pain, pain that is beyond the understanding of anyone except the patient experiencing such pain, has moved ever closer.

This is why we must support neuropathy research and more training in the clinical diagnosis and treatment of all neuropathies.

About the Author

LtCol Eugene B Richardson, USA (Retired) BA, MDiv, EdM, MS

Col Richardson has suffered with severe neuropathy for over 45 years. A 27 year military veteran and veteran of the Vietnam War, he was diagnosed with a progressive chronic peripheral neuropathy resulting in severe disability. This diagnosis has been confirmed as due to exposure to Agent Orange. It was not until 2010, 42 years after his exposure to Agent Orange, that his diagnosis was recognized by Veterans Affairs as service connected.

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  1. I have neruopathy and they don’t know know why. I’m taking pain meds and have had the spine stimulator put in, nbut not much helps. When I woke up from the surgery the Dr must have cut a nerve to the right leg and now I deal with a constant itch or ache. Can’t take Lyrica had a terrible reaction from it ! This is terrible stuff and to top it off I have arthritis. Good luck everybody who has to deal with this!??

    1. Gail: I am so sorry for your experience with the surgery. Would recommend that you speak to your doctor about trying Nortriptyline as it has worked for many patients and is an older proven drug that stops or reduces neuropathic pain from damaged nerves. It also helps you sleep when taken at night. The important thing is that a doctor just can not give you a drug like Lyrica and walk away. The doctor must work closely with you to find out what drug or combination thereof will help reduce the neuropathic pain. There are other things to try outside of drugs that might work. Yet it is important to find out what is behind your neuropathy while treating the symptoms. Have other ideas but will send them in an e mail to you.

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