More than 100 million Americans suffer with chronic pain; it is the most common medical problem in the country today, surpassing cancer, heart disease, stroke and diabetes. The cost of treating pain exceeds half a trillion dollars annually, yet most people do not consider it a major health problem, according to Dr. Lynn Webster, author of “The Painful Truth: What Chronic Pain is Really Like and Why it Matters to Each of Us.” The painful truth is that millions are going untreated or undertreated for their debilitating pain, and it will take a societal attitude change amounting to a revolution to reverse this.
Webster has devoted his career to pain management, and his expertise is recognized globally as he works to develop safe and effective treatments for chronic pain. His Opioid Risk Tool is used by thousands of practitioners and his book “Avoiding Opioid Abuse While Managing Pain” is used for training physicians in the field of pain management.
With “The Painful Truth,” Webster gives readers the stories of some of his patients — Carolyn, a victim of a mall shooting that took the life of her 15-year-old daughter; Jason, a First Lieutenant in the Army who carried the pain of a basic training injury throughout his military career; Hal, an NFL linebacker whose career-ending spine injury set him on a downward spiral that ended in jail. These personal, harrowing stories of suffering and loss illustrate the issues those suffering chronic pain must deal with each day.
For many, their suffering is compounded by addiction problems (20 to 30 percent of people prescribed opiates become dependent on them) and lack of understanding from families, friends, employers, co-workers and the medical community. Webster’s narratives illustrate the necessity of a multi-modal approach to treatment. “Pain isn’t just biological,” Webster writes, “It’s also psychological, social and spiritual. It’s personal.” His success stories aren’t about cures. For those suffering months and years of chronic pain, it is something they have accepted as part of their lives, but it is possible, with support, to reduce pain so it is not debilitating.
Webster opens his book describing how companionship and community support can aid the healing process, yet those who suffer pain are often isolated. Pain cannot be seen, and it is measured by self-reporting, a subjective measure that health care providers may not take seriously. The problem of opioid abuse has cast a stigma over the use of these drugs for treatment.
Regulators scrutinize the prescription practices of doctors. Fearing litigation, many doctors are hesitant to prescribe appropriate medication. Insurance companies, to save money, often don’t cover costly, yet effective, medications. Webster believes the answer is a society-wide transformation in how we deal with chronic pain. In addition to leaving the practice of medicine to doctors rather than health insurance companies and DEA regulators, Webster would like to see more NIH research funds dedicated to finding new treatments. Research is effective, Webster writes, yet only 1 percent of NIH research goes towards pain treatment.
Webster’s book does offer some hope for sufferers. In his practice, he’s seen the power of the mind to lead one suffering pain towards healing. Those who resign themselves to pain and focus on their loss do not fare as well as those who accept their condition and resolve to live the best life possible despite their pain. He calls these modes of thought “acceptance with resignation” and acceptance with resilience.” Those who suffer must be proactive and positive. Being involved in your own treatment is good medicine.
Religion and spirituality also play an important role in the healing process. Webster’s deeply religious patients were all able to draw on an inner peace, a sense of connectedness and a process of meaning-making that comes with their beliefs to find some relief from their pain. For those who don’t prescribe to a religion or have a spiritual system of beliefs, Webster writes: “Love, compassion, giving and relationships are within the reach of all of us, whether we’re believers or doubters when it comes to pain. These are the ingredients in the elixir for pain.”