Long-term pain should not be called “noncancer pain” because it suggest that there are only 2 types of pain; cancer and noncancer pain.

NO! That is an incomplete concept. Over the years, I’ve deconstructed the word pain with the help of old references and now this situation can be presented in a different concept.

All pain has a pathological cause and All pain has a cure, treatment or therapy which depends on the exact category of pain. There are 3 types; structural, injury or nonstructural.

Structural-pain requires removal, repair or medications for the “defective or infected structures” like an aneurysm or cancer or hot appendix.

Injury-pain requires minimal attention from us. Basically nature and time in cases of sprains, dislocations, sprains and fractures.

The 3rd type of pain has “no-structure” and is embedded in the flesh, connective tissues and muscles, so called Myofasical pain and dysfunction. MF pain is the main cause of long-term or chronic pain. This is the most neglected, confused and misunderstood pain. Because this pain has no-structure it can not be analyzed in the blood, with any detectors or radiology. But this pain is real and it requires effective therapy.

The patient is the sole purveyor this pain and must be trusted to guide the treatment so that it can be customized to their unique problem. The treatments options are on a spectrum from simple to complex. Beginning with hands-on options; massage, stretching, PT, tissue manipulation and myofasical release. Then onto the most “invasive” but still holistic, safe and nontoxic is myofascial release with various needles.

I have just recently returned from an intensive meditation retreat in Myanmar (Burma), where I sat for 10 hours without moving - this involved going through agonizing pain but in doing so, the realization was that the pain which really is so difficult to bear is the mental pain and once this is seen through, really very very intense bodily pain is easy to bear or transcend (if concentration levels are high) . It is not easy to get to this place (as the Burmese will tell you that westerners cannot tolerate pain) , but by watching the mental reactions to the pain rather than the pain itself, one comes to see that the pain is not so solid - it arises and passes away and with continuing in this one, one comes to see the end of pain. I decided not to believe the thoughts in my mind re pain eg I can't stand this etc and came to a place where I could easily sit 10 hours in meditation without moving - with only the first hour being in intense pain and now am able to be with levels of intense pain without mental pain, which before I would never had been able to tolerate - it is very liberating - as they told me 'The rewards are so great, but there is a price to pay' ..... I would happily help anyone who wanted to go down this route (the centre in Burma wont take westerners for their intensive retreat as they are short on resources..)

Pain can be a way of learning to be a better person. With the hundreds of pain treatments- you can spend a small fortune marching through the world of goods and services- i would look to see what the pain is telling you and try to be a better person. And yeah i had pain for 4 years.

There are many brilliant natural topical products out there. Dynamint is recommended by the Reflex Sympathetic Dystrophy Society here in Canada and it is wonderful.

Maria,
I am truly happy to hear that you have managed to get completely off the medications. I hope that as time passes you are able to maintain this level of control and to continue to use what you learned to good effect.

My wife (who suffers from Regional Sympathetic Dystrophy Syndrome) was an attendee at the original Pain Management Course at the Royal National Hospital For Rheumatic Diseases in 1998 when she was 24. Unfortunately, unlike yourself, she was unable to completely remove the requirement for medication, though she was able (at least for a few years) to reduce the amount she needed. I feel that I must warn you that at least in her experience, once you have attended the course - with the exception of some telephone advice, and presumably electronic communication - you are now on your own.

Over time, my wife's reliance on the various forms of medication increased, and new "specialists" have resorted to the failed methods employed by her previous "specialists" - epinephrine pain blocks, increasing amounts of opiates, sleeping tablets, and medications such as lansoprazole to deal with the fall out from the epinephrime, opiates, and sleeping tablets.

I write this not as a complaint at your article, more as a warning and a suggestion:

Right now, you feel better coping with the pain without the medication, I hope that you remain that way for life. Just in case you don't you need to get some form of plan in place with whoever your specialists are now, so that if/when this wears off you can go through the correct treatment - understandably the cost of the courses tends to cause the NHS to only send you to it once, however I believe that as time passes you will need refresher courses.
If you cannot take steps to ensure such courses will be available from the NHS perhaps you can contact the other people who were on the course with you, and try and arrange regular support groups and refreshers amongst yourselves?

Absolutely spot on in everything you have stated here. Courses are one-offs from our experience, and it is really important to have links with fellow sufferers as support when you are discharged from the NHS and find yourself very alone. We set up a website to offer as much help and support as possible and are offering coffee mornings to share experiences etc.

I read this article with much interest but let's not get carried away by the thought that this one lady can manage off drugs, so everybody can! For a start, how on earth did she manage to get on a month's residential pain management course for starters. I have a family member who is currently taking a cocktail of drugs and had the notion she no longer wanted to be on them. That was where the fun started..... there wasn't anybody out there, in any of the medical professions, who could help her to come off them. She tried and failed of course because she couldn't tolerate the increased pain and side effects of withdrawal. She was offered sessions at a pain rehabilitation centre, which she attended and gained a lot from, however once it had ended after three weeks, she was dropped out of the system like a stone. Sorry for the rant but I don't like this article at all and I don't think many of the other sufferers will either.

I don't suppose the author wrote it for you to like it, but to share her experience. What treatment you get will depend where you live and what specialists are around who understand your condition.

I don't think everyone is imagining they can cope without the painkillers they take, but this is a possible alternative for some people. Don't dismiss it because it doesn't appeal to you.

I haven't dismissed it because it didn't appeal to me. I have five years of caring for someone who has chronic pain. Do you have it?

I take my hat off to this lady - she is amazing; but my point is it isn't easy to get to that place where you can ditch the only thing that takes away the relentlessness of pain. I liaise with people all over the world who live with this chronic condition and believe me I know what I am talking about. I am just concerned this article will in some way suggest it is easy to just get off the drugs because it is most definitely isn't I can assure you.

No one said it was easy....and I don't have chronic pain, but a chronic incurable auto immune disease which means I have a choice between surgery, steroids and other drugs with horrendous side effects for the rest of my life, or no treatment and suck it and see. I have been sucking it and seeing for 19 years with steroids three times to push my platelets up.

My God daughter has chronic pain, and has had since she was a teenager....she is now in her 30s and is a social worker, so some do manage to balance things and make it work.

The article made it very clear that it isn't easy to get off the drugs. If you read it carefully she says doing so took her to the edge of reason, but for her, it was worth the try. Do credit the readership of this paper with some intelligence please.

From one scary teacher to another!!!

I would hope the readership of the paper do have some intelligence but sniping at me for a comment I made doesn't show much on your behalf, I'm afraid. I am entitled to my opinion on this article and I will again reiterate, as you don't seem to have taken it on board, I am pleased for Maria and for those who do manage to balance their life. My family member has also managed to do it too, working and taking care of two very small children, albeit on drugs and no support whatsoever!

I know Maria will have had a hard time coming off the drugs and I'm not decrying that; the doctors must just love her.

Admitting in your initial comment, or rant as you describe it, that you don't like the article and raising questions about how she got on the month long pain course smacks of bile to me. You even do it here....you say you don't decry Maria, and yet you do with your closing six words, undermining what she is attempting to do.

I grew up with a parent who used a trick like that. I can spot it a mile off, and it makes me angry when I see it used. I hope you don't do it with your students.

Mo Roberts is the most caring person ever, and was a wonderful teacher. She is frustrated by the system {pain treatment and such like). I believe she felt the article made it sound easy to get the correct care and treatment, when in reality that isn't the case. The medical profession would also agree to large extent. Its very easy to push pain meds but there is very little help if at all in coming off them especially when dependant.

If you read the article it doesn't make it sound easy at all, and unless you are a doctor, you can't speak for the medical profession. I'm sure Ms Roberts can stand up for herself without ex students weighing in, which is a tad suspect.

Incidentally, Jesus or Mother Theresa probably qualify more for most caring person ever.

You're hysterical, I love it. I'm not an ex student either.
Doctors have told me they feel that the system is lacking help, and wish for more funding.

How would you know that Ms Roberts was a wonderful teacher unless you have experience of her teaching?

Doctors have told me things as well, but I don't extrapolate that to mean that I know what the entire medical body thinks about a subject ' to a large extent'. Somewhat hubristic surely.

I'm not hysterical at all, just somewhat cynical that you have popped up in defence of Ms Roberts shortly after my reply to her and have registered just to post here.

I'm not Mo in another guise!I No need to be suspicious.

I think its wonderful you're so passionate about the author of this article and people suffering with this terrible plight. Maybe you could use this passion to help others with CP.

I have always thought an NHS channel on TV would inform people more reliably about such matters and pain management advice an apt topic given that new approaches are constantly been studied and updated. Perhaps it is best to be wary of all foreign substances entering the body since all the organs and the brain are affected by them and have to process them and while relieving one part they could be undermining another?

Did you ever try cannabis (in either "raw" form or extracted cannabinoids)? The UK is miles behind in therapeutic use of this group of compounds. Look to Israel where there is considerable experience and success in chronic pain management using cannabis in various forms, and now developing a simple cannabis inhaler device which has shown much promise.

Yes and it works damned well on nerve pain!
My understanding of the "refined" type of cannabis though is that its not very affective although at present no one seems to know why, apparently its something to do with the various compounds interacting together in a particular way.
If you remove some components of raw cannabis it ceases to work.
Whatever the reason the one thing I know is it works on nerve pain better than anything else I have ever used!

Exactly which is why this Israeli startup is developing a small self use inhaler (already developed and well reviewed clinic use inhaler) for self administering "raw" cannabis by inhilation.

After going through similar things for the last three years, I can only sympathize with you and say, there will always be good days make the most of them. I have attend pain classes and after five operations rely on a combination of implants and drugs to be enable me to be mobile and continue to work. I am lucky in working for a very understanding company.
The one thing that stands out for me from the last few years is an episode at a group session that I attended. One person sat slouched, emitting little groans and grimacing throughout. There only input was when told that the treatment being offered could clear all the pain and remove the need for drugs; "If It does that, will I lose my benefits?". I am sure the majority of us in these conditions would 'give our right arm' to be free of pain and drugs, sadly her type makes some class us as malingerers as our pain is invisible.

Malingerers? How very cynical of you! Of course the dramatic rise in cases of chronic disability related to "whiplash" since the implementation of "no win no fee" litigation is purely coincidental. Like wise the observation that persistent disability parallels unsettled litigation, resolution parallels settlement.

Many are suffering due to some accident and I agree, the no win, no fee firms are happy to drag cases on as long as possible. There are also many, like myself, who suffer without being able, or wanting, to sue someone.
I don't know the solution but have witnessed the strains it puts on the NHS.

Unavoidably, the suffering of the genuine is being negated by the abusers.

Very sad. It is true that pin does not go away it only hides. I hope that you get better. But I say this I prefer pain when it is hiding than suffering in pain. How shameful we can fly to the moon, kill our enemies in wars and yet are unable to cure pain or even a common cold. I know many suffering with back pains and nothing really helps them. It is always taking this or that pill or go thru operations that do not help.

It sounds very much to me like you have a condition called Reflex Sympathetic Dystrophy, a condition that affect the sympathetic nerves and causes chronic pain.
It can be brought on by surgery, trauma, and on occasion it can just occur and once someone has contracted RSD its very difficult to get rid of.
The best Chance of freeing yourself is to tackle it hard and fast when it first appears but thats dependant on being diagnosed and if you arent within 18 months forget it, its too late!
The preferred method of combating RSD is opiate based painkillers which are a 2 edged weapon, you get addicted AND over time you need more and more to achieve the same result. I was recently told by a pain management consultant that to increase morphine doses to over 100mg daily is counter productive and can actually increase nerve pain because your system sees the level of opiates and assumes, as you have taken the dose you have that you need it, so your system then actually increases the pain to a level commensurate with your opiate level!
How true this is I dont know but I DO know it worked for me.
Good luck.

chronic pain is totally debilitating, but the hard part is the gradual realisation that it may never go and the fear that if its this difficult now, what how will I cope when I'm old ?
Another problem is that it isn't visible, so you get little sympathy...and sometimes you wonder how many of the strangers walking down the street also have chronic pain.
Sometimes the conditions go or lessen...you just never know...