Hello Doctors. I am a 32 year old woman suffering from chronic back pain. I have been to several doctors as well as many specialists and there seems to be NOTHING wrong with me. This has been confirmed by numerous tests – cbc blood test, scans etc .  My question is: Please inform me as to what are my options. What can I do to get rid of this chronic pain I am suffering from? Thank you ahead of time. God bless you.

Hello. In response to your question I think it is important to underline some facts.

At times pain is not caused by anything physically. And it isn’t imagined either. It is real.

Pain can be purely psychological. It is often caused by psychogenic factors meaning pain that’s psychological in origin. It also is possible it starts from fearful thoughts…negative perceptions of ourselves.

There are 100 million Americans who suffer from chronic pain, with back pain, neck pain, fibromyalgia symptoms, or other forms of pain that have no diagnosed physical cause…none whatsoever.

It’s not that their pain is “in their heads.” The truth is much more nuanced: All pain can have both physical and psychological components. But the psychological component is often dismissed or never acknowledged.

Big pharma’s aggressive marketing of pills and the minimal training doctors get in pain medicine mean that for too long, the go-to treatment for many forms of chronic pain has been opioids. Yet opioids have proven to be not only largely ineffective for treating most chronic pain but also highly addictive and risky.

Other forms of therapy do exist for relief of chronic pain

Cognitive behavioral therapy

Cognitive behavioral therapy shows meaningful benefits on chronic pain — both for psychogenic pain, and for pain with a physical cause — according to systematic reviews of the research. There’s also promising research around mindfulness-based stress reduction and therapies inspired by it.

Yet pain psychologists are hard to find and hard to pay for, and most patients don’t even know they exist. “At the moment, they tend to be seen as a route of no hope for the hopeless, for people who have gone through everything else,” says Amanda Williams, a psychological researcher who conducted one of the reviews of studies on the effectiveness of psychological therapy for pain.

Doctors have long known that pain can exist in the absence of any physical harm.

Likewise, doctors have known that pain can be suppressed without any real medical intervention.

“Pain can be ‘real’ pain — and it can be caused by brain circuits,” says Tor Wager, a neuroscientist who studies pain at the University of Colorado Boulder. “We have to get over this concept that either the pain is real or it’s all in my head and I’m making it up.” It’s both. Pain, explained

Chronic pain may start off as an acute injury and then never go away. It could also be the result of nerve problems, or degenerative diseases like arthritis. Some people might be more susceptible to acute pain turning into chronic pain due in part to genetics. And there’s some evidence that differences in brain structure can predict who goes on to develop chronic pain and who does not.

Our thoughts, personalities, and learned behaviors can also influence whether our pain alarms get tripped. So do our emotions.

Overall, the takeaway is that “pain isn’t just something that happens to us,” says Beth Darnall, a professor of anesthesiology at Stanford University. “We are participating with pain by how much attention we give to it, by the contents of our thoughts, and our appraisal. How awful and negative is it? How helpless and hopeless do you feel about it? Do you feel as a victim; do you feel at the mercy of your pain?”

The power of the mind to self-heal.

You might be thinking: Isn’t this all a placebo response? Well, maybe. But don’t dismiss placebos’ healing power. Even powerful painkillers like morphine are much less effective when people don’t know they’ve taken them.

It could be that psychological therapy is kind of like a strong placebo, or that placebo is a weak form of therapy –

the power of healers to cure disease may in fact stem form the psychological effects healers exert on people’s own inner mental placebo effect.

The best evidence base for this is for cognitive behavioral therapy

Considering how dangerous and damaging the past decades of treating chronic pain with addicting opioids has been, and how risky and expensive surgery can be, they’re a worthy option, one that’s never sold to doctors by pharmaceutical representatives or advertised directly to consumers on TV.

The most common psychological treatment for pain, and the most well-studied, is cognitive behavioral therapy, or CBT. Overall, it’s one of the most rigorously tested and effective tools psychology has to offer. More typically, it’s used to treat anxiety, phobias, and mood disorders like depression. But it can also help some people manage their pain.

CBT “helps people change ways of processing their beliefs and their experiences when they are overly negative,” she says.

Alternative treatment therapies have also shown to help with chronic pain… one of which Reiki healing being presently used in hundreds of American hospitals as well as thousands of hospitals throughout the world.

In the brain, emotional pain and physical pain interact. Just as people sometimes turn to opioids to mask their emotional problems, psychological therapy and other healing techniques can help physical pain. “It’s time to recognize that there is so much overlap that we almost can’t treat one without addressing the other,” Darnall, the Stanford professor of anesthesiology, says.

Psychological therapies can get better — and so can access to them

On the bright side, psychological therapies for pain are low-risk. The same cannot be said of medical treatments for chronic pain. Back surgery for lower back pain often backfires. Doctors literally call this “failed back surgery syndrome” — around 20 percent of back surgery patients will still have chronic pain despite successful procedures, which can cost $50,000 or more.

So the best advice to chronic pain sufferers is to explore ALL avenues even those that seem out of the ordinary.

Answer by: Dr. D Zluf, Consultant Physician