As the pain management community embraces a holistic approach to care, it's also beginning to view pain itself in a whole new light. Increasingly, pain is seen less as a physical affliction and more as the result of an injury that permanently changes the brain and leaves a lingering fear. "When someone hurts you as a kid, you remember it really well," explains Min Zhou, a pain researcher at the University of Toronto. "The idea is that the injury leaves a mark that doesn't go away, which can trigger pain long after the initial symptoms have subsided." Zhou's research focuses on the part of the brain that may be responsible for that – the anterior cingulate cortex, located in the prefrontal cortex. It's an area that "lights up" in diagnostic tests, such as a functional MRI, when a person is exposed to painful stimuli.
Zhou has developed a genetically mutant mouse that feels pain such as a needle prick, but not chronic pain. He's optimistic that this model will lead the way to the development of a drug that reduces chronic pain but preserves other sensations like hot and cold in humans – something that current pain medicines can't do. (Many patients who take drugs like oxycodone lose sensation of hot and cold.) But Zhou acknowledges that such a drug could take at least 10 years to develop.
Kelly certainly hopes that day will come a lot sooner. Dosed up on oxycodone and still suffering from chronic inflammation, she says even short trips to Tim Hortons can be gruelling and are a regular reminder of her reduced quality of life. But she's determined nonetheless. "You've got to keep going," she says.
Managing
Dealing with long-term pain can be exhausting and emotionally draining. Here are some tips for coping.
• Chronicle the pain. Day-to-day tracking of pain and paying attention to the variations in intensity can provide clues as to the nature and severity of the condition, while providing a scale on which to grade the pain, says David A. Bray, a doctor of Chinese medicine in Toronto.
• Get a referral to a pain clinic. Such a referral may be key since some family doctors don't feel comfortable managing chronic pain, says Dr. Zohar Waisman, a neurologist in Toronto. Beware: You may have a long wait ahead of you.
• Learn the stages of pain. By doing so, you'll understand the different treatment approaches, including the physical and cognitive techniques such as meditation, says Marlene Noble, a physiotherapist in Vancouver.
• Keep moving. With help from a pain clinic specialist or doctor, develop an exercise routine, such as yoga, that keeps you limber. The worst thing patients can do is not exercise, says Noble.
• Be your own pain advocate. "You can't just sit back and let the doctors do it," says Kelly Corry, a chronic pain sufferer In Hillsdale, Ont. What you can do: search out pain specialists on the Internet, join a support group to share findings, know your treatment options and be vocal about your concerns to doctors, employers, friends and family.
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