FEATURE RECORD KEEPING Reframing pain I Developing a healthy narrative BY DAWN ARMSTRONG was young and spring had sprung. Our back lane was finally clear of snow. It was time for a very first ride on my new birthday bike. Those were the days of no train-ing wheels, no helmet and parents who trusted that kids could figure it out for themselves. Gravity is an unforgiving teacher – three times in a row my little bare knee knocked up against the hard-pack gravel road. When my mother saw the bloody mess, she stated the obvious. “Well, that’s gotta’ hurt!” She cleaned it up, applied a band-aid and reassured me: “It’ll be all better in just a few days.” And it was – if not for the scar on my knee, I may have eventually forgotten about the entire event. Fast forward to now. A young relative – a rambunctious 5-year-old boy – tripped and fell while chasing his sister upstairs. He banged his shin pretty good; there was a small abrasion and an even smaller bruise. It was an altogether bloodless scene but he was howling. His mother’s response was to imme-diately administer two children’s Tyle-nol and have him rest on the couch. Her message was crystal clear – pain is unacceptable and drugs are good. I was stunned to realize the extent of the transformation of our culture’s atti-tudes about pain medication, and it only took two generations. The pharmaceutical industry has been unimaginably successful in the service of selling more analgesics, but the consequences of this mass-market-ing of powerful drugs are now raging like wildfires through our communi-ties, destroying lives and families in every neighbourhood. In the service of humanity, DCs need Remember that most body pain is to step up and loudly promote a more associated with inflammation, and helpful narrative around pain. never forget that inflammation is our Envisioning our path to accomplish first-line, non-specific immune re-this, we should first consider the gen-sponse to tissue injury and invasion by eral (and wildly successful) strategy of foreign agents. It follows a strict play-the pharmaceutical industry: book, evolving and resolving in a pre-1. Discover/develop a drug which dictable way. addresses a serious problem If there has been obvious trauma to 2. Because there are relatively few tissues – whether the skin over the pa-patients who have this serious tella is ripped open by sharp stones or problem, do a massive, ongoing, the deltoid ligament shreds and bleeds insidious and duplicitous public when you twist your ankle coming off relations campaign to reframe the the edge of an unseen curb – we expect “problem” as the “enemy of every-that with a little TLC (an ice pack, a one, all the time” (inflammation, bandage, a kiss) and some time, the cholesterol and pain are prime pain will stop. But if it doesn’t resolve examples) along a predictable timeline or there’s 3. Watch the profits roll in on the no obvious traumatic event, then some-superstar, blockbuster thing’s not right. drugs like NSAIDS, What’s the possible nature statins and pain-killers. of what’s wrong? What are the As chiropractors, we have chances that there is an under-As the tools and the understand-chiropractors, lying pathology, as compared ing to “re-reframe” pain. To to the chance that we’re look-we have the ing at a functional problem? do this we must first un-blur the lines: Not all pain is the tools and the The statistics are stark: pa-understanding thology= 10 per cent, func-same. For a person who is suffer-to “re-frame” tional problem= 90 per cent. pain. ing the agony of untreatable I’ve noticed that a number multiple myeloma gnawing of unconventional medical away at their bones, opiates doctors, especially those who can be a godsend. Pain is the are presenting themselves as enemy. experts in nutritional issues, are using For a person who has sprained their the label “functional medicine.” There ankle or “put their back out,” those are no guidelines on the use of the same drugs can mark the beginning of word, but as chiropractors, we are the end of life as they know it – and the clearly positioned to use the term be-start of what will surely be a hellish cause “functional” is what we do. journey of recovery from addiction. We perform comprehensive physical Un-resolving musculoskeletal pain examinations that are laser-focused on isn’t the enemy, it is a flashing red light how the neuro-musculoskeletal system – something is wrong and it needs to works. We are perfectly positioned to be fixed. help those who are suffering with body pain that won’t go away. No doubt, DR. DAWN ARMSTRONG is a graduate of CMCC and has been in practice for over 30 years. She is currently more high quality clinical studies focused on promoting life-long learning and professional development and has created a continuing education would be a very good thing. But, I course – Clinical Record Keeping: A Hands-On Approach. Learn more at auroraeducationservices.ca. suggest we need to make more noise 10 Canadian Chiropractor May 2019 www.canadianchiropractor.ca
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