Chronic Pain

Chronic Pain

What is chronic pain and why do we have it? The International Pain Society defines pain as “an unpleasant sensory and emotional experience associated with actual or potential tissue damage, or described in terms of such damage.” Chronic pain is generally defined as having persistent pain longer than 3 months.


How do we treat it? Well, this is a subject of much debate. We have lifestyle advice and modifications, medications, injections, surgical procedures, talk therapy, chiropractic care, physical therapy, acupuncture, massage therapy, exercise, cryotherapy, heat therapy, laser light therapy and so on.   It turns out that a multidisciplinary approach has the best results. Your team should include: pain management specialist, rehab specialist (like a chiropractor or physical therapist) and a talk therapist experienced in  CBT (cognitive behavioral therapy) and working with chronic pain patients. 

Pain Models

In the medical world, we frequently follow the traditional BioMedical model of treatment. This model teaches that if a patient experiences pain, then there must be tissue damage present.  Patients assume if it continues then the damage must be getting worse.  This idea is taught in most medical and graduate schools. Intuitively it makes sense to patients and doctors but doesn’t explain pain very well.  In the late 70s, we started to realize that this definition did not account for many of our patients.

Today,  we now know that the biomedical model doesn’t account for as many as 70% of patients. There are many people who feel no symptoms at all, but if imaging was performed, there would likely be findings of all types: bone spurs, cartilage and muscle tears, disc degeneration and herniations, meniscal and labral tears, rotator cuff tears, etc. Multiple studies have confirmed these findings. Some patients have long term pain, but imaging and blood work find no explanation.  And then we find a group of people in the middle- they have pain and some positive imaging results.  However, that isn’t helpful in understanding why the patient has pain on that day.

Biopsychosocial Model

In our office, we take a different approach to our chronic pain patients than our acute patients (less than 3 months). At Balanced, the treatment model used is called the Biopsychosocial model of treatment. We like this model because it takes into account not only the likely pathology occurring, but it also makes sure to address the psychological (thoughts and beliefs about the condition) and social aspects (patient goals and activity limitations) of chronic pain. In other words, we treat the patient and not the condition. 

At Balanced, we believe there is a place for pain relieving modalities like spinal manipulation, massage, and electrical stimulation, but we don’t want the patient to rely on these to heal. Most of the focus is based on pain science education and active therapeutic exercises to help patients function better in everyday life and to put the patient in control of their own outcome. Balanced will help you learn about your pain, gain control over your condition, and learn active skills you can do on your own at home. Our goal is to empower the patient and enable them to take control of their treatment and condition. We will also be happy to work with your other healthcare providers on your behalf. 

If you’ve been struggling with chronic pain in Charlottesville, give us a call and we will be happy to see if we can help. (434)293-3800. We offer free consultations. You may also email me at [email protected]

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