The Science of Functioning and Its Impact On Pain

Functionality is critical in treating chronic non-cancer pain (CNCP) because, when correctly  treated first, statistically significant increases in functionality occur, followed by significant decreases in pain, but not the other way around.

The validity of this relationship – on which evidence-based medicine rests – is the characteristics of pain and functionality’s “response to treatment.” When we carefully control the treatment conditions to which we subject CNCP patients, they exhibit 3 different types of “response to treatment,” depending on who provides it and how:

– Patients treated by primary care physicians (trained in general, family or internal medicine) using only medications, in 3 months posted 25 percent worse pain, less ability to function, and significantly increased use of medical services;

– Patients treated by board certified pain management anesthesiologists, using the right pain medications, in 3 months posted 32 percent less pain, unclear changes in functioning, and significant increases in their use of medical services; and,

– Patients who were treated by specialists in restoring functionality and the right pain medications, in 3 months posted 78 percent less pain, significantly increased functioning (including, the  return to work, which did not occur in the other two treatment method), and significant decreases in their use of medical services.

What Are The Implications for Treatment?

The pain field has known since the 1950s that pain, as it transforms from an occasional to a daily phenomenon, lasts about three months as a brief, localized phenomenon that only disrupts trivial amounts of our ability to work, study, make effective decisions, coordinate complex motor activities, maintain stable emotions, and fulfill basic social roles. However, as it becomes a daily phenomenon, pain systematically disrupts progressively more integrated, complex functions. When we, then, treat functionality directly, pain drops predictably. And when we treat pain directly, the ability to function normally does not automatically return. This provides abundant evidence that the integrative mechanism that ties biobehavioral systems together has failed. Therefore, what research increasingly shows is that when treatment focuses on the restoration of functionality through the right combination of treatments rather than attempting to focus on drugs alone, patients begin to function again more effectively and more quickly than their counterparts who just try to relieve pain by only taking drugs.

The Availability of the Right Treatment

Just before the end of 2008, when the financial crisis occurred because American legislators permitted American banks to go unregulated, and thereby practically destroyed the world economy, there were only half a dozen integrated, multidisciplinary pain program left in the country, and those only existed in the largest US cities. The services of what research calls one of the best pain programs is the one at the James A. Haley Veteran’s Hospital in Tampa, Florida, which only available to veterans.  Every one else with serious pain will have to either:

– subject themselves to powerful drugs prescribed by physicians unqualified to treat CNCP; or,

– accept the fact that they will never get the right type of pain management and will just have to learn to live with profound disability, unemployment, divorce, indigence, living like a full-time patient, becoming vulnerable to a wide variety of chronic diseases, and likely dying earlier than your counterparts who received the right pain care.

This Site

This site offers the same qualified functionality restoration treatment that we offered the study sample of CNCP patients who posted 78 percent less pain, significant increases in functionality and significant decreases in the use of medical services. Here we have added to that the benefit, convenience of being able to access that treatment online and at an extremely inexpensive rate relative to the overwhelmingly unqualified pain management efforts being offered in the community.

To implement this treatment, you will have to find a prescribing physician in your own home town willing to help you restore your functionality through this program. Without powerful pain drugs correctly prescribed and managed, the broad-based functionality that is disrupted by your CNCP  will be virtually impossible to restore. If your prescribing physician has qualified people implementing a functionality restoration pain program locally, then you should follow that program. But we know that will be extremely unlikely.

However, as all the research indicates, restoration of what is deemed “normal” functionality to each patient is the only way to turn moderate to severe CNCP into the “eminently manageable disorder” that you can make it.