Q. I hurt my back in a car accident two years ago and have been in pain ever since.  I have been to chiropractors and medical doctors, they all say there is nothing physically wrong with me.  I’m beginning to feel like I’m crazy.  Is there anything I can do? L.J.

A. Dear L.J.

You may be suffering from chronic pain syndrome.  Chronic pain — pain which extends beyond normal healing time — can be devastating.  It affects every aspect of a person’s life.  Acute pain is the body’s way of warning you that continued activity may lead to injury.  Chronic pain, however, exists long after the acute pain has ceased.  Persons who continue to have pain despite medical treatment or surgery and whose lives have become focused on their pain may have chronic pain syndrome.

People who suffer from chronic pain usually suffer from lowered self esteem and may often feel, as you indicated, as if they are “going crazy.” Because pain cannot be seen and no physical cause for the continuation of pain has been identified, chronic pain sufferers are often treated like malingerers or like they are exaggerating their pain.  A recent study reported that Americans lose 550 million work days a year because of pain, accounting for an estimated $55 billion loss to the economy.  In most cases, chronic pain is so complex it’s hard to say exactly what has caused it.  This leads to the cycle of chronic pain.  There are several factors which can decrease a person’s ability to deal with pain.

Many people who continually suffer from chronic pain are physically deconditioned (out of shape).  They’ve been told “if it hurts, don’t do it.” They are afraid of being reinjured, or that their pain will get worse.  If you do not exercise to stay fit, your body is less able to deal with the pain.  The more out of shape you are the more your pain may affect you.

Being in pain may lead to depression.  If a person is unable to work due to pain, their sense of self-worth decreases.  Eating patterns are often affected by depression — some people will eat and drink more, while others lose their appetite.  Proper nutrition is essential to combat pain.  Nutrients in some foods may actually increase your pain tolerance.

Along with pain comes stress.  Being unable to work causes stress related to financial problems.  Inability to participate in family functions or social activities also causes stress.  When a person in stressed out, their pain increases.  As the pain increases, their stress increases.  Again, part of the chronic pain cycle.

Not all pain can be cured, but programs have been developed to help individuals learn to live with their pain.  Statistics indicate that the average participant in a chronic pain program has been to at least five doctors, a physical therapist, a chiropractor and a psychologist prior to entering the program.  Most of them have been unable to work for nearly two years.

A chronic pain program will teach you how to deal with your pain.  Things to look for in a pain program include:

• a knowledgeable and experienced staff specialized in dealing with chronic pain; including physicians, psychologists, nurses, exercise specialists and dietitians — The kind of experienced and expert staff that can help empower you to turn your own life around.  A staff that has confidence in your own unique strength and ability to rehabilitate yourself. 

• a wholistic approach to treatment.  This means the program addresses all aspects of your life which may affect or be affected by the pain you feel; including physical, psychological, emotional and spiritual.  Your family members should be encouraged to participate with you in the program. 

• a physical reactivation process to help improve your overall physical capacity.  This would include instruction in body dynamics, daily exercise during the program and a prescribed individualized exercise program for you to continue after completion of the program. 

• an education component covering pain management, anatomy and physiology, diet and nutrition, self-defeating behaviors, relaxation, and other health and wellness issues. 

• vocational and psychological counseling.

Your physician should be able to refer you to a chronic pain program for evaluation.  One where the staff understands the difficulty you are facing and the vision you have for a brighter, more productive future.


Dale Moss, Director
Chronic Pain Rehabilitation Program
Sister Kenny Institute

To submit questions on medical or rehabilitative issues for future columns, write: Medical Issues and Disability, Sister Kenny Institute, Dept. 16601, 800 E.  28th St., Minneapolis, MN 55407-3799.