Monday, July 25, 2011

Pain, Responsibility and Perspective

Earlier this month a few news stories appeared about chronic pain.  The Institute of Medicine reported to the NIH that over 116 million Americans suffer from chronic pain costing the nation around $635 billion each year.  When I see data like this, I naturally think about behavior – what we are choosing, doing, believing that is healthy and positive, and what might be detrimental.  How much of the $635 billion is wasted by poor choices?  I don’t mean to minimize anyone’s real pain, but with almost one in two adults reporting chronic pain, I do see the possibility of failures in responsibility and perspective.

The study presents a “blueprint” with a host of interventions to address the problem and to educate “patients” on how to manage their pain.  But others professionals point out that people too often look to a quick prescription for relief.  This puts their problem in the hands of someone else, classic low-responsibility behavior.  I’m sure we all know someone who does something or eats something that causes them pain, but then just takes a pill instead of heeding the message from his body to change the behavior.  Remember, low-responsibility behavior is an invitation for outside interference in our lives.  Recommendations for pain management actions before resorting to medication already exist.  They include regular exercise, meditation and acceptance. Acceptance of pain is not a kind of martyrdom; it’s changing the focus.  “OK, it hurts, now let’s get on with living.” 

That leads to the perspective question – I wonder where these 116 million came from.  There are about 312 million people in the US, but less than 250 million adults.  The report doesn’t address whether this is a growing problem, but I don’t recall that over 45% of adults in chronic pain was an issue in the past.  What has changed over the last 40 or 50 years?  Are adults indulging in more dangerous or strenuous activities, have they mysteriously started to hurt more, has diagnosis increased, or have they just developed new expectations, expectations that life should be totally pain-free?

Joseph Campbell paraphrased Buddhist teaching calling us to “participate joyfully in the sorrows of life,” to recognize that life contains hardship and to live affirmatively in the face of that unavoidable sorrow and suffering.  Most of us know that this is a more realistic expectation.  Our perspective guides our choices.

I have many questions about this subject and feel we have not been given all the facts, but I have a strong suspicion that a government study of pain in the news is another indication of some lack of perspective and responsibility in our society.  It seems like one more issue that can be resolved by us rather than by a government program.

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