Resolution, not management, of chronic sciatica. Claire’s experience and views.

Sciatica nerve pain

Evie speaks with Claire, a person with a 29-year history of back pain and sciatica. Claire found strategies which helped her to actually resolve, rather than manage her pain.

Claire’s story is unusual in the sense that she was able to resolve her chronic pain after many years, and she takes the view that “acceptance and management” of pain is not always the best option, even for those who have a long history of pain.

In this discussion Claire talks about the despair she felt when she was unable to get a diagnosis or satisfactory explanation for her pain in the last 90’s. She discusses importance for her personally of discovering postural-type training approaches such as including the alexander technique, pilates and yoga. She explains that learning how to improve her body awareness such that she could control her posture better was a very important first step to improving her pain.

She explains that at first she believed that posture itself was important, but that the has since changed and evolved her views on how and why postural-based exercise approaches were successful in reducing her pain.

Often in cases of long-term or chronic pain, the focus is on acceptance and “management” of the pain. Patients with long-term pain conditions are often referred to pain clinics for “pain management programmes (PMP’s), usually after a long period where other treatments like physio, surgery and interventions have failed.

Claire takes a different view from many other patients and clinicians. She feels that emphasis should NOT be placed merely on “management”, but that a resolution or improvement of pain should be pursued. She also suggests that “acceptance” of chronic pain is not always a good solution, and that a better alternative may be to “acknowledge” the pain without necessarily accepting that it will always be there.

Claire’s opinions are very thought-provoking and and well worth listening to and reflecting on. For me as a clinician, her story highlights the dilemma of how to best approach a person with chronic pain – should we clinicians encourage the person to “accept” and “manage” their pain while improving their quality of life but improving their ability to participate in meaningful activities, or should we encourage the person to keep seeking helpful strategies which may reduce or resolve their pain? We must be honest and open with our patients in the knowledge that some people with chronic pain do not find a resolution for their pain despite everyone’s best efforts, and yet we must also ensure that we never take away a patient’s hope or close the door on a possibility that they may find a solution that helps them, personally.

It was fascinating to listen to Claire’s thoughts and experiences, and I can’t wait to further explore some of the topics we touched on in this conversation including

  • Perfectionism and how this may relate to chronic pain
  • The attitude of “pain is not going to beat me” and “pushing through”, continuing to work despite this being highly provocative for pain and how she reflects on this now
  • The extent to which one can or cannot “choose” or control their health or illness
  • Why might improving one’s control of posture help reduce pain?
  • Should healthcare professionals place more emphasis on management or resolution og pain?
  • Claire’s reluctance to “accept” her pain, but willingness to “acknowledge” it

Claire’s hope is to inspire others with chronic pain and to give them hope and optimism that with effort and persistence they may yet find a way to become pain-free.

Nobody has the same chronic pain experience or journey as anyone else.

It seems likely that different approaches to the struggle of chronic pain will be helpful to different people. So while Claire’s views and experiences may differ from your own, I hope you enjoy listening to her perspective all the same. Evie, GetBetterOnline