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While there have been scientific advances in the understanding of the neurophysiology of pain, we need to recognise that this has largely been based on a biomedical concept that struggles with the subjective and psychosocial nature of chronic pain.
The scientific forces that have driven our understanding of pain since the early 19th Century have largely viewed pain as an expression of an identifiable disease process resulting from tissue injury, nerve injury or a sensitised nervous system.
The biomedical model of pain has given rise to a massive global pain management drug market which includes non-steroidal anti-inflammatories, corticosteroids, acetaminophen and opioids. The global opioids market size alone was valued at $4.4 billion in 2020 and, with a current surge in demand, is projected to reach $6.1 billion by 2030.
A recent US study from May 2021 found that the prevalence of chronic pain is increasing for all demographics of adults, but especially for people from lower socioeconomic backgrounds. The research also found associations between people’s mental and physical health and a higher prevalence of chronic pain.
This finding supports the biopsychosocial model of pain which recognises physical symptoms as the outcome of a dynamic relationship, not only between mind and body, but among mind, body, and society.
Most research supports the effectiveness of a biopsychosocial approach and frequently finds that multi-disciplinary, multi-modal treatments give good outcomes in the treatment of chronic pain. And, while its effectiveness is becoming more widely accepted, its incorporation into clinical practice is still limited.
To provide us with a better understanding we asked Ananda Mahony to join us on the podcast.
Ananda is a naturopath with post-graduate qualifications in Nutrition and a Masters in Pain Management. She is experienced in all areas of general naturopathic practice however, over the last 6 years Ananda has been working extensively with clients experiencing persistent pain. Her interest in pain management stemmed from the observation that patients were not getting good results using standard naturopathic and medical approaches, as well as an innate curiosity about what underpinned their pain and how to work more effectively with it. Ananda incorporates aspects of pain education, nutrition, naturopathy, lifestyle and self-care, working in with patients’ existing persistent pain health care team.
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Find the podcast transcript in the Materials section.
- Ashar YK, Gordon A, Schubiner H, et al. Effect of Pain Reprocessing Therapy vs Placebo and Usual Care for Patients With Chronic Back Pain: A Randomized Clinical Trial. JAMA Psychiatry. 2022;79(1):13–23. doi:10.1001/jamapsychiatry.2021.2669
- The Lancet. Rethinking chronic pain. Lancet. 2021;397(10289):2023. doi:10.1016/S0140-6736(21)01194-6