Dr. Mark Kestner (crop)


One of the fastest growing segments of healthcare is pain management.

As a past member of the American Academy of Pain Medicine (AAPM), I have received many articles and research papers regarding pain treatment. 

A few years ago, I was in attendance at a huge AAPM conference for doctors that work with patients suffering from chronic pain. This conference is known for including attendees from all professions involved with treatment for pain. There were surgeons, medical physicians, chiropractors, osteopaths, acupuncturists, physical therapists, psychiatrists, psychologists, massage therapists, researchers and other professionals that are working to solve chronic pain problems.

This type of conference is a great way to gain insight into fields of expertise other than my own. I had the opportunity while there to speak with providers that work with helping patients deal with emotional and psychological issues related to chronic pain.

I asked questions about the effects that emotions have on chronic pain. These questions sparked spirited discussions among the experts.

I won’t try to relay all of the details of the conversations, but I will share the high points that I took away from the conference.

Have you ever noticed that some individuals are very sensitive to minor physical pressure or bumps, while others seem to not even notice severe trauma? The experience of pain is unique to every individual. Sensitivity to pain can vary in each of us at different times in our life. Illness, stress, adverse physical conditions such as being too cold, and emotional state can all affect how we feel pain.

It works the other way as well.  Chronic physical pain can adversely affect our emotions and mental state.

Which came first, the chicken or the egg?

People with chronic pain often have some degree of depression as well. The question is often in the back of the mind of the provider: “Is the person more sensitive to pain because of the depressed emotional state, or is the patient depressed as a result of chronic pain?” As one professional explained to me at the conference, the answer to that question is usually, “Yes.”

“In many cases,” she explained, “by the time a patient has been diagnosed with either chronic pain or depression, the other condition is present as well. The conditions become intertwined and it is nearly impossible to treat one successfully without addressing the other.”

At this point, another doctor jumped into the conversation. He related that he often encountered resistance when he suggested counseling, medication or therapy for depression for his pain patients. He expressed frustration that when he brought the subject up, patients often felt that he was diminishing the importance of their complaint of pain and thought he was suggesting that their pain “was all in their head.” 

This doctor’s intent was to acknowledge that the patient was experiencing real pain and to attempt to address their emotional issues as well as a way to reduce the severity of the chronic pain. 

All of the participants in this discussion recommended that patients intentionally engage in activities that they enjoy. They also recommend that patients try to increase their level of physical activity and limit time spent in front of the television. They agreed that people with many contacts with friends and associates do better than people that spent more time alone. Sometimes even having a pet brought improvement

They also offered opinions that patients in chronic pain often were avoiding facing certain situations.  Several mentioned that if they were successful in guiding a patient through dealing with a difficult personal situation, often the pain disappeared abruptly.

One consistent theme throughout the conference was that chronic pain is a very difficult issue to address. Each participant was attending in an effort to learn from others.  Many were keenly interested in the surprising success of approaches such as acupuncture.

Because of the vast diversity in clinical and personal situations of the people that experience chronic pain, it is impossible to recommend a one-size-fits-all solution. Often a patient will have to try several different approaches before finding success.

Over the years I have noted that as we are successful in alleviating a patient’s physical condition, their emotional condition improves significantly. 

Earlier this week I had a patient tell me that her coworkers had begun to comment on how happy she seemed. She told them she was happy because she no longer had to deal with chronic pain or the daily medications that had been prescribed since she had been to our office. Over the years we have heard countless similar stories. 

Our physical wellbeing affects our emotional and mental wellbeing. As we help solve physical complaints, we frequently hear personal stories of improved sleep, mood, attention, alertness, energy and other signs of improved mental and emotional function.

Dr. Mark Kestner is a licensed chiropractic physician in Murfreesboro. His office is at 1435 NW Broad St. Contact him at mkestner@DrKestner.com.

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