PainScience.com Sensible advice for aches, pains & injuries
 
 

An Introduction to Health Literacy

Why everyone needs to know more about biology, medicine, and health

updated (first published 2004)
by Paul Ingraham, Vancouver, Canadabio
I am a science writer and a former Registered Massage Therapist with a decade of experience treating tough pain cases. I was the Assistant Editor of ScienceBasedMedicine.org for several years. I’ve written hundreds of articles and several books, and I’m known for readable but heavily referenced analysis, with a touch of sass. I am a runner and ultimate player. • more about memore about PainScience.com

It’s easy to cut corners on your health. You can get away with almost anything when you’re younger, and in the short term: smoking, for example, or a really terrible working posture. When you get hurt, if it’s not too serious, you can usually get better without help, or so it seems. Imagine if your car worked like that: “well, it’s not too bad, it’ll probably get better on its own.” You could go years without seeing a mechanic!

This is generally true of all medicine, but particularly true of body pain and injury. Most doctors aren’t well prepared to help patients with these problems,1 so even if you take your body to the “mechanic,” the chances of getting good advice are slim.

The trouble with healing is that it it’s not as “miraculous” as it seems

The allegedly miraculous healing powers of the human body are, from another perspective, not all they are cracked up to be, and in some ways it’s downright glitchy.2 Healing from injury is often awkward and incomplete, with many non-obvious long-term consequences. We don’t so much get better as we learn to “work around” the pain. If it hurts to turn your head to the left after a whiplash injury, for instance, you will may just stop turning your head to the left — permanently.

Such a patient once demonstrated his range of motion to me. When he turned his head to the right, all was normal. When he turned it left, his entire torso rotated! And yet he was unaware that he was “cheating” to turn his head that direction.

The human body is a marvel of adaptability, but not particularly good at actually healing. Later in life, the quality of our lives is usually eroded by the consequences of these accumulated adaptations and compromises.

The economics of health

But no one wants to pay a dime more than they have to for anything, including health care. It’s not that most people can’t afford health care — if you can afford to maintain and repair a car, you can afford to maintain and repair your body — it’s that they won’t do it if they can possibly get away it.

Forced to choose between your pocketbook and a pain that you can put up with but probably shouldn’t put up with, you are going to choose to save money every time. I know I do. Because of this simple equation, we need universal public health insurance (American readers please bear in mind that I’m writing from Canada, where we actually have universal public health insurance, in theory). Unfortunately, there isn’t a government in the world right now that is footing the bill for preventative health care, and many other services are not adequately provided either.3

I was a Registered Massage Therapist for a decade — an expensive musculoskeletal health care coach and consultant. I helped people with the most common of human health problems: the aches and pains that are the early warning signs, the causes, and the consequences of the most common disabling injuries of life (i.e. back pain, headaches, neck cricks, and repetitive strain injuries). My clients were courageous visionaries in a way: people who believed that their health was a high enough priority to pay a premium for help maintaining it. They spent hundreds or thousands of dollars on my services each year.

Unfortunately, there are so many others — the great majority — who do not make their health a high enough priority to pay for it, or cannot afford to even if they did. I sympathize with them all. Even my most affluent clients spend no more than necessary!

Public health education to the rescue!

Over the years, I found myself in the awkward position of wanting to compensate, in whatever small ways I could, for the lack of universal public health insurance. I minimized the cost of my services however I can. My career became an exercise in educating my clients as quickly and effectively as possible, so that I could keep them out of my office! And save them money. I spent years condensing my knowledge into the most digestible nuggets of wisdom, the most relevant and explanatory imagery, the most interesting, practical, and affordable ideas about how to take care of yourself.

Eventually that process took over, and became this website. And now this is all I do: basically I decided that teaching was the best way that I could help, more cost effective than therapizing people.

Most people would greatly benefit from an hour of massage therapy once per week for the rest of their lives to help them compensate for the constant barrage of stressors in their lives, even just to stay “tuned in” to the valuable messages constantly being broadcast by their tissues, if only anyone were listening. But only the most wealthy and/or determined clients ever saw me this regularly. Massage is great, but it ain’t cheap.

Most people can get much more bang-for-buck from information.

The power of health literacy

Health literacy is just as important as other basic academic skills, and maybe more, if you think that your chronic pain is coming from your tibula or perhaps your quadriglutator. I often hear both patients and, alas, even professionals talking about the anatomy of injuries with great ignorance and confidence — a nasty combination, and sadly common.4 They believe pain is coming from a part of them that literally doesn’t exist, or not in that neck of their woods. This is problematic.

The need is great. None of us learns the slightest useful thing about our own bodies in grade school. When I started my own training in health care, I barely knew a bruise from a blister. People generally don’t know even what they are made of or the basic conditions that need to exist for healing. The average person knows much less about their own body and healing than they do about, say, internal combustion engines. Consider the consequences of this …

Someone comes to me with a problem like plantar fasciitis (inflammation of the bottom of the foot), a problem that has been keeping him off his feet for three years — resulting in significant weight gain, depression, and an increased risk of heart disease — and he tells me that he has “tried everything” when in fact he has tried hardly anything at all yet.

When I started my career, my advice was only available to my paying customers, the minority who were willing and able to pay for preventative care. To the extent that I was able to educate them as we worked, I helped to fill in the gap left by a lack of public health insurance. The vast majority of the population, however, will never really know what to do when they pull a muscle or get flattened by back pain.

Years later, the articles on PainScience.com now constitute a user friendly text book for a class you should have had in grade school. Everyone should know this stuff.

The goal of PainScience.com is to help you understand how you work, so that the skills and tools described here can make sense and can be easily remembered, adapted and applied in different situations, and even passed on to others. Furthermore, it will also help you learn, remember and make use of other information about your body, from any other source, for the rest of your life. That’s the promise of health literacy.

I wish I had started learning this stuff in grade two. It is the prerequisite for self-knowledge and personal growth, for the use of all health care services, for the prevention of injury and illness, and, of course, the part of health care closest to my heart: troubleshooting the aches and pains that are the highest health care priority for most people, most of the time.


About Paul Ingraham

Headshot of Paul Ingraham, short hair, neat beard, suit jacket.

I am a science writer, former massage therapist, and I was the assistant editor at ScienceBasedMedicine.org for several years. I have had my share of injuries and pain challenges as a runner and ultimate player. My wife and I live in downtown Vancouver, Canada. See my full bio and qualifications, or my blog, Writerly. You might run into me on Facebook or Twitter.

Related Reading

This article is part of the Biological Literacy series — fun explorations of how the human body works, what I think of as “owner’s manual stuff.” Here are ten of the most popular articles on this theme:

Notes

  1. Doctors are unqualified to care properly for most common pain and injury problems, especially the stubborn ones, and this has been proven by other doctors: Stockard et al found that 82% of graduates lacked “basic competency” in this area. For more information, see The Medical Blind Spot for Aches, Pains & Injuries: Most physicians are unqualified to care for many common pain and injury problems, especially the more stubborn and tricky ones. BACK TO TEXT
  2. PS Ingraham. Why Does Pain Hurt? How an evolutionary wrong turn led to a biological glitch that condemned the animal kingdom — you included — to much louder, longer pain. PainScience.com. 5139 words. Research has shown that immune cells (neutrophils) unnecessarily “swarm” sterile injury sites, causing damage and pain with no known or likely benefit as a tradeoff. It’s just a clear error: they appear to have mistaken mitochondria for a foreign organism, a legacy of ancient evolutionary history, and a biological glitch with profound implications about why some painful problems are so severe and stubborn. BACK TO TEXT
  3. For instance, it’s a source of constant puzzlement to Canadians that most of our health care needs are paid for…but not eye and dental care. Huh? BACK TO TEXT
  4. Dunning-Kruger Effect. Wikipedia.com.

    “The Dunning–Kruger effect is a cognitive bias wherein relatively unskilled individuals suffer from illusory superiority, mistakenly assessing their ability to be much higher than is accurate.” In other words, ignoramuses are ignorant of their own ignorance.

    BACK TO TEXT