Why do I still have pain?

The car accident in which you were injured may have been months or perhaps a year or more ago. You have seen the doctor and you have gone for appropriate treatment, whether it be chiropractic, physiotherapy, massage or maybe all of these and more. Everybody told you at the beginning that you would recover completely, but it hasn’t happened. You still have pain. You still have not returned completely to all of your activities. Maybe you’ve gained weight. Maybe you are depressed. You don’t have the same energy you used to have.

If this sounds like you, welcome to the world of chronic pain. Most people injured in car accidents get better within a few months. Unfortunately, some people do not get better and go on to develop chronic pain.

What do we know about chronic pain?

These are the facts:

(a) In most cases, there is no physical cause for the pain. The muscles have already healed. The joints and discs are not damaged.

(b) Despite the fact that there is likely no physical cause for the pain, the pain is still very real.

(c) Nobody knows what causes chronic pain where there is no damage to the tissues. There are many theories, ICBC and the doctors who work for ICBC want you to believe that it is all in your head and that you can make it go away if you wanted to. These doctors tell the Judges that you are making up the pain to get money from ICBC and that the pain will go away when you get your money.   Some of these ICBC doctors are outright dishonest. Others have not bothered to keep up with the medical literature.

(d) The leading theory for chronic pain is that something has happened to the way that your brain perceives the pain. Let me explain. Damaged tissue sends pain signals to the brain. This is normal and is part of your body’s protection system. When the tissue heals, the signals should turn off. In chronic pain patients, even after the tissue heals, the pain signals don’t stop.

(e) In most cases, chronic pain patients are wasting their time and money having frequent treatment in the form of passive care such as chiropractic, physiotherapy, massage or acupuncture. These treatments are appropriate in the first six months after the accident when the muscles are still damaged and still knitting together. After about the six month mark, the tissues have healed and frequent passive treatment is not useful.   The best plan after the six month mark is:

– See your doctor for a good chat and satisfy yourself that there is nothing physical that is maintaining your pain. If your doctor thinks that your pain is caused by tissue damage, he or she will do more investigation.

– Once cleared by your doctor, see a kinesiologist or personal trainer to set up a strengthening and stretching programme that you can do every day at home or in the gym. Twenty minutes a day is usually sufficient. Twelve sessions should be enough to ensure that you can do the exercises correctly. Going back for two or three sessions every six months to modify your programme will ensure that you don’t get bored.

– If you have a flare up of pain, that is the time to see your choice of practitioner, whether it be a chiropractor, physiotherapist or other paramedical professional. Once the flare up subsides, stop the treatment and get back to your exercise programme.

– Do your best to get back to your pre-accident activities. You may have increased pain temporarily but try to work through it. Remember that increased pain does not mean that you are damaging your muscles.

– Do your best to keep a positive attitude which is certainly difficult in the circumstances.

Over time, you will improve and get back more and more of your pre-accident life. If there is one consistent message that chronic pain patients should take to heart, it is this : Take control of your pain and your life. Don’t let yourself be a victim.