An Epidemic of Pain

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According to a Veterans Affairs study, up to 60% of people with Type 2 diabetes report having chronic pain. This can be compared to rates of about 20% that have been found in the general population. This is an astonishing difference. Is diabetes really that painful? Or is something else going on? What do we know about chronic pain, and how can we reduce its crippling effects?

If there is a way to address chronic pain, we should do it. In a study published in Diabetes Care, people said pain had disrupted their daily life for an average of 18 out of the last 28 days. Self-care suffered with chronic pain. Participants with chronic pain had more trouble exercising and following their recommended meal plans.

Chronic pain in diabetes takes several forms. Neuropathy in the legs and pain in the back are the two most frequent complaints, but many other sites of pain are common. In the Diabetes Care study cited above, people with diabetes who had chronic pain tended to be younger, heavier, female, and insulin users.

Chronic vs. Acute Pain
Chronic pain is very hard to deal with, and one reason is that people confuse it with acute pain. Acute pain is what you get from an injury—a burn or catching your fingers in a car door, say. It’s your body’s natural reaction to injury. It tells you “Stop what you’re doing! Rest the part that hurts!”

Acute pain is a lifesaver. There are a few children who are born without pain sensations. They need to be watched all the time to keep from injuring or killing themselves accidentally.

Chronic pain is different. It may have started with an injury, but it doesn’t reflect any injury going on at the moment. It is felt on completely different nerve pathways and in different parts of the brain. In an article about chronic pain published in February 2008, author Christine Sullivan explains, “chronic pain is almost never merely a physical thing. We can see from brain mapping that chronic pain uses very different nerve paths from acute pain. In fact the brain maps of chronic pain look just like the brain maps of anger, or sadness, or fear.”

This doesn’t mean that chronic pain is “all in your head.” But it’s not all in your feet or all in your back, either. Chronic pain is a whole body/mind experience. It always has a physical component, and it always has an emotional component, and there may be other factors as well.

What this means is that you can’t treat chronic pain well with narcotics. Because different parts of the brain are involved, you’d have to pretty much knock yourself out before you got much pain relief from narcotics. You really need a whole body/mind approach.

Why Do People With Diabetes Have So Much Pain?
In my book Diabetes: Sugar-coated Crisis, I make the case that Type 2 diabetes, depression, and pain often come from similar causes. Simply put, that cause is not having enough power over your life. Obviously, power is not the whole cause, but it is a significant piece.

Think about it. Chronic pain is felt on the same nerve pathways that feel anger, grief, and sadness. It’s really another form of depression, which is strongly linked to Type 2 diabetes. By the way, people with Type 1 diabetes do not seem to have higher than usual levels of chronic pain.

How to Relieve Chronic Pain
I’ve been researching chronic pain and interviewing pain specialists for my work on the New Health Partnerships Web site. I’m planning a couple more blog entries about treating and managing chronic pain.

Help me out here. What have been your experiences with chronic pain? Are you dealing with it now? What have you tried, and how has it worked? Please let us know by commenting here.

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