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An exasperating contradiction in modern chronic pain management

Paul Ingraham ARCHIVEDMicroblog posts are archived and rarely updated. In contrast, most long-form articles on are updated regularly over the years (see updates page).

There’s an exasperating contradiction in modern chronic pain management. The entire point of cognitive-behavioural therapy for pain is that pain can be managed — or why bother? — and yet much of the modern literature focusses on the notion of reducing “suffering” rather than pain, based on the premise that pain is unavoidable. Dr. Lorimer Moseley:

I found this situation quite confusing — ‘pain can be modified by our beliefs and behaviours’ seems inconsistent with ‘pain cannot be relieved by modifying beliefs and behaviours’. I also think that this approach of ‘conceding that we can do nothing for pain’ seems inconsistent with what we now know about the underlying biological mechanisms of pain — that pain is fundamentally dependent on meaning.

And the meaning of pain can often be changed. Not that it’s easy! But it is possible, and that is the point of trying to help people understand that their pain doesn’t necessarily mean they are in any danger.

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