The Mathematics of Pain
By Hal S. Blatman, MD

In our lives, certain activities contribute to increasing our pain. In turn, certain treatments add up to decrease pain. These concepts and relationships can be described in terms of a mathematical equation.

First, accept that in a chronic pain condition, there is always some degree of pain, "P." In conditions of myofascial pain, fibromyalgia and chronic fatigue syndrome, this pain can be made worse by physical activity, "A;" changes in weather, "W;" posture, "P0;" and stress, "S." So far, pain can be described as worsening with therelationship of A+W+PO+S.

On the other side of the equation, there are ways to reduce pain in people with these conditions. These include body work, "BW" (massage, chiropractic, physical therapy, myotherapy, trigger point injections); medication, "M;" nutrition, "N;" aerobic exercise, "AE;" and home exercise and stretching, "ST."

Body work reduces pain by decreasing soft tissue pain input to the brain. Medication works by numbing the brain or healing the soft tissue. Nutrition is important because you get out of your body what you put into it. Aerobics and conditioning help by increasing the margin of safety between physical activity and how much of this activity you must do without causing an increase in your pain. Home exercising and stretching reduce pain by decreasing the pain input to the brain from the soft tissue.

This relationship can be described as: P=A+W+PO+S-BW-M-N-AE-ST.

The more you expose your body to the factors that add up to increase pain, the more you must expose your body to the factors that decrease your level of pain, or the net result will be an increase in your level of pain. 
As you examine your life, try to determine which activities are most important to you, and which of these factors relate to these activities. Also, try to learn more about what you can do to take care of yourself in an effort to decrease your pain.

For example, say that your pain is increased with the physical activity of sitting at your child's football game. This involves posture, stress, activity, and changes in weather. If you give your body better food, exercise to increase your level of conditioning, and stretch out your body before the game, you will be able to sit at the foot-ball game longer before your pain worsens.

Additionally, stretching and body work after the activity will reduce the pain that the activity has caused or increased. If you do not want your level of pain to increase, whenever your activities involve "+" parts of the equation, you will need to balance this out by increasing what you can do with the "-" parts of the equation. Perhaps you can stretch more, condition your body, eat better, or do some body work. Medication can be helpful, but when it is your only answer, your condition is not likely to improve, and it may indeed deteriorate.

About the Author:
Hal S. Blatman, MD is the founder and medical director of The Blatman Pain Clinic, and a globally recognized specialist in myofascial pain. He is board certified in both Pain Management and Occupational and Environmental medicine. More information is available at www.blatmanpainclinic.com or by calling 513-956-3200

© Blatman Pain Clinic, 2008