Conquering Pain
Treatments for body and mind break a cycle of agony
A Wisconsin rarity, bright April sunshine, beams through the windows of a large room at Milwaukee's Columbia Hospital. The rays catch milk crates filled with weights, sets of dumbbells, a treadmill, gym mats spread on low tables, and other trappings of a makeshift gym. On one of the mats, Bill Mains, 49, is learning how to get into bed.
"Not that way," says Steve Olson, a physical therapist, as Mains swings his legs up and then flops down on his back. "You're going to twist yourself up." Mains, trim in a maroon sweat suit and a neat gray beard, looks puzzled; he has been getting into bed this way for decades. "You want to move your hips, torso, and shoulders as one unit," Olson says. "Sit on the side of the mat, then lower down sideways until your shoulder touches and then swing your legs up. That way you won't twist your spine."
The last instruction resonates. Mains slipped on the ice while walking three years ago and landed on his back. "At first I tried to ignore the pain, kind of bull my way through," he says. "But it feels like someone is drilling into my spine. And they're using a large drill." Despite painkillers, he started snapping at his wife and eight children. The pain spread to his legs and grew worse. "At times the nerves in my legs feel like they're on fire, with flames running up and down. All the things I liked to do--canoeing, bowling, even gardening--I couldn't do anymore." He couldn't even climb the steps of the Lutheran church where he serves as the minister. His pain would come in the night, stealing sleep. Flaring. Firing. Minute by unending minute. It is hard to imagine this type of agony.
No hope? Unless, that is, you're one of 50 million Americans who live with chronic pain: body-wrenching jolts from arthritis, back injuries, headaches, cancer, and nerve problems that no one can pin down and which never go away. In April, a Gallup survey reported that Americans with severe or moderate pain typically have lived with it for a year and a half. Many of these people see no hope for relief.
They're wrong. At Columbia, and many other clinics, therapists are now attacking these stubborn cases with a variety of weapons: not just painkillers but relaxation techniques, physical therapy, psychotherapy, and drugs originally developed to treat epilepsy and depression. Doctors tend to treat chronic pain by dousing it with drugs, mainly painkillers such as Vicodin, Demerol, and morphine, or the new generation of anti-inflammatory medicines such as Celebrex. Sometimes surgeons block the pain-carrying nerves. Often this works, especially for short-term pain. But often the pain comes back.
The reason: New research shows that chronic pain is a vicious band looped between mind and body, where agony creates stress and stress magnifies pain, over and over and over again. "The pain becomes part of a cycle. Our job is to break into that cycle wherever we can, and so we use a lot of things, not just a needle with Demerol," says psychologist John Galbraith, who directs Columbia's pain clinic and is treating Mains. (Three years ago, Galbraith also treated this reporter when he was suffering from shooting leg pains.)
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