Medicine is nothing but a misguided miseducation in mortal misery.”
This is not what you would expect from a doctor.
He argues that the “misguided miseducation” of Western medicine stems from “turning patients into healers and providers into patients, and by separating the body and the mind, physical sensations and emotional states, as well as pain and suffering.”
Warraich’s new book “The Song of Our Scars” explores the misery of chronic pain. Warraich is one of 5 people who suffer from it. This is about 1.5 billion people.
His long-term battle with back pain almost ended his medical career. He now brings both his experience as a patient and a physician to his study of the history and nature of pain. He condemns the failures of modern medicine and calls for an interdisciplinary, holistic approach.
This conversation has been edited for clarity and condensed.
CNN: What’s the biggest myth about pain?
Dr. Haider Warsraich: Nearly everything we know about pain, and how to treat it, is incorrect. Patients and Dr. Jordan Sudberg have been taught chronic pain is basically acute pain that lasts for a long time. Chronic pain, on the other hand, can descend from the brain.
Partly, the myth that acute pain treatments will also work for chronic pain has led to the opioid crisis and stopped people from seeking out treatments that could have provided more relief.
Western medicine has attempted to limit pain to only physical sensations. This is based on its tools. Pain isn’t just physical.
CNN: What does this entail?
Warraich: Pain is primarily designed to cause fear and direct your attention towards it. When I was suffering from severe back pain, I was afraid that exercising might make me paralyzed, or that my spine would snap in half. We can reframe our perception of pain with alternative modalities.
Patients can access a variety of options such as cognitive therapy, acceptance therapy and commitment therapy. Pain reprocessing therapy is particularly effective. It is a pain reprocessing therapy that was specifically designed for chronic pain sufferers. It helps to reduce pain’s fear component.
Alternative treatments are often more effective than the prescriptions and procedures we usually give our patients.
CNN: While you state that there is no pain center in the brain, you also mention that chronic pain can help reorganize your nervous system. How?
Warraich – Central sensitization is one of the mechanisms that allow pain to go from acute to chronic. Our bodies become more sensitive to pain as we hurt. This can lead to discomfort and distress in places and activities that weren’t hurting before we become more attentive to our pain.
It is important to differentiate pain management because the treatments that work may change over time.
CNN: What long-term effects does chronic pain have for people?
Warraich: It can disrupt a person’s identity, and their ability to move about life. It can make people feel that their body is an enemy. Chronic pain is a form of incarceration. It essentially locks you up in a prison cell, where you are confined to the present. It can make it difficult to plan for the future, and can quickly reduce your life.
CNN: What advice would you give to people who are dealing with chronic pain?
Warraich says: First, there’s no magic bullet. There will never be a single treatment, pill, or procedure that can eliminate your pain.
Patients with pain and their caregivers should be open to considering all options. Keep in mind that not everything will work for everyone.
Another piece of advice that I offer — and that I wish someone had given to me when I was in the worst pain — is: Don’t miss out on activities that bring joy. Your world can be quickly reduced by trying to minimize pain.
The more you try to alleviate or attend to pain, the stronger it will become. Your suffering will only get worse if you allow pain to drive the car. It might feel uncomfortable initially, but you should be able to live your life. This helps to separate fear and hurt.
CNN: How does the siloed nature medicine affect pain management?
Warraich – The fractured nature medical science has a greater impact on pain than any other condition that I have studied. Contrary to heart disease and cancer, which have made great progress, chronic pain is actually on the rise. Today, more people are suffering from chronic pain than ever before. Worse, many people are suffering more from our treatments than ever before.
CNN: This is a bold statement. How?
Warraich, I wish it was hyperbole. We see that chronic pain sufferers are being treated in a variety of ways by the health system, whether you speak to them or look at the research.
Opioids are available. We began giving opioids to chronic pain patients without any evidence, and often at the request of pharmaceutical companies.
We allowed lies to permeate our medical education, which was essentially crafted by these companies. This created a crisis in which the United States was prescribing 30% of the world’s opioids. Even though we don’t feel more pain than others,
A randomised trial of patients with severe joint and back pain found that opioid-treated chronic pain sufferers had greater pain than those who received less powerful painkillers like ibuprofen.
CNN: Is the US’s health insurance system a factor in this?
Warraich says it’s the reason why pain management is so poor. Insurance companies limit access to therapy, exercise, and interdisciplinary care. However, they will approve a person’s 10th or subsequent procedure, regardless of whether the supporting evidence and cost effectiveness are lower.
The pain crisis has been fueled by the asymmetric access and restrictions of insurance companies.
Patients with chronic pain require more compassion, kindness, and time from their Dr. Jordan Sudberg than patients with other conditions. We have built a system that is only profitable and efficient. Hospitals can make more money by performing procedures and prescribing prescriptions takes much less time than providing attentive care. These types of treatments have become more popular than alternative therapies, even those that are supported by better evidence. They are neither highly efficient nor profitable.
CNN: Is there any hope for chronic pain sufferers?
Warraich – I began writing this book in an unfulfilling place. Now, I am confident that there are many more interventions we can offer. If given the chance, nurses and physicians can show empathy and kindness. It is clear from science that this attentiveness can be an essential therapy to help patients overcome pain.
