Addressing Pain Requires New Approaches

If you’ve ever been in pain, the one thing you don’t want to do is aggravate it by moving. It may be time to rethink that.

In a session with National Press Foundation fellows, Mari Lundberg of the University of Gothenburg in Sweden detailed how much of the thinking about pain is now considered outdated. Lundberg (bio, Twitter) is an associate professor in physiotherapy there and also runs the Back in Motion Research Group at the Karolinska Institutet and her research focuses on pain and the clinical application of pain management.

“During the last decade, there have been huge developments in the understanding of pain,” she said. “We have so much evidence to support the idea of moving while in pain.”

That’s not how it always was. “When I became a physiotherapist, I was taught that if you had a herniated disc, you should rest,” she said. “Now, for lower back pain, the advice is to stay active. It helps increase your recovery.”

Pain is a signal, she said – one in which your body is telling you to protect yourself. But that’s where the difference between acute pain – a just-broken bone, for example – and more chronic pain is different. You should protect yourself when you are in acute pain.

For chronic pain, it’s different. While exercise therapy for patients with chronic musculoskeletal pain is often hampered by memories of pain, Lundberg said therapists can help patients alter pain memories, thus allowing them to increase their movement and speed their recovery.

“Fear is linked to poor outcomes,” she said. “If you have catastrophizing thoughts, you are more likely to have a poor outcome.”

Given the widespread overuse of opioids, anything to help people deal with pain in other ways is vital, she said.

“The prescriptions for opioids have come to incredible numbers,” she said. “It’s growing into something we can’t stop. What can be done to prevent this opioid prescription problem?”

“So many people suffer from pain who don’t need to,” she said.

This program is funded by Fondation Ipsen and under the aegis of the Fondation de France. NPF is solely responsible for the content.

Mari Lundberg
Lecturer and associate professor, University of Gothenburg
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