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Pain as a symptom of complex trauma

 •  • by Paul Ingraham
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Weekly nuggets of pain science news and insight, usually 100-300 words, with the occasional longer post. The blog is the “director’s commentary” on the core content of PainScience.com: a library of major articles and books about common painful problems and popular treatments. See the blog archives or updates for the whole site.

Overwhelming chronic pain, when it’s burning in the eye of a hurricane of related conditions like IBS and chronic anxiety — important context — is consistently a symptom of “toxic stress and trauma,” says Dr. Jonathon Tomlinson.

Dr. Tomlinson is a UK physician who works regularly with complex pain patients. He elaborates on his treatment methods in this article: “Hope and salutogenesis.”

A few months ago, I faced a woman whose daughter had recently died by suicide. The woman I faced, a patient I knew well, had suffered her own terrible traumatic past and suffered with chronic pain related to connective tissue disease, trauma and grief. She wanted me to prescribe more painkillers. “What kind of pain are we treating?” I asked her, “Is it physical, emotional or grief?” She stared back at me, confrontational, “What. Is. The. Difference?” She demanded. “How can you even tell?”

I can remember the confrontation vividly. She was right. All pain affects, and is affected by physical, biological, emotional, biographical and social systems. You cannot neglect any of these areas if you want to manage pain.

Sharing this without analysis or comment. Just food for thought for now.

P.S. Salutogenesis is (Merriam-Webster) “an approach to human health that examines the factors contributing to the promotion and maintenance of physical and mental well-being rather than disease with particular emphasis on the coping mechanisms of individuals which help preserve health despite stressful conditions.”

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