Why am I doing this?

This is not a whining post, just that I thought it was time I mentioned why I write this blog.

I looked on the internet for ages to find a resource that gave me good information about nonmedical approaches to managing chronic pain and other chronic disorders.

If you use a search engine to look for ‘chronic pain’ or ‘back pain’ you’ll find endless listings for organisations (I used Google just now and found 8,320,000 in 0.34 seconds!)  and many of them are designed for patients, but not a lot for the nonmedical treatment providers who work with them! And we need to remember that the majority of health care providers working with people with chronic pain are nonmedical. We don’t prescribe!

You’ll see I also wrote ‘good information’.  The problem isn’t so much the amount of information available, as the quality of it. When I searched using Google, the advertisements on the right hand column of the search field included: ACC’s page, Ehlers-Danlos, Quantum Touch, biomag, natural health, craniosacral therapy, herniated disc relief, electrotherapy… a bit of a mix.

I also found the same lack of good quality information for nonmedical health providers when I searched using Yahoo.

I enjoy working in the field of pain management, but I’m worried that with so many nonmedical health providers and so little nonmedical health information that is based on science (and what is there is relatively inaccessible) that the field is wide open for well-meaning but misguided people to tout treatments that simply don’t work. OK I’m being charitable, the field is wide open for quacks, ‘alternative’ therapists, and lazy health providers who don’t have time or skills to delve into the scientific literature.

In my own field of occupational therapy (all right, I’m heavily warped by psychology), I find therapists gladly prescribing adaptive equipment including vehicle modifications and ‘ergonomic solutions’ for office settings for people with chronic pain with not a scrap of evidence that this is effective in the long term.  Therapists suggesting ‘pacing’ is all about working within your pain limits (therefore progressively reducing activity tolerance).  Therapists being unwilling or afraid to ask people with pain to develop skills to tolerate pain while they carry out activity, and as a result unwittingly supporting pain-related anxiety and avoidance.  Teaching people that there is one ‘correct’ way to lift items or they may risk ‘injury’. (more…)