Understanding Chronic Pain

Failure to Recover

[From Chapter 1 of Understanding Chronic Pain]

The body is able, at least over the short-term, to protect itself from pain. Most of us are aware that an acute injury can be quite painless. This effect is sometimes dramatic, particularly when the wound is severe. A youngster was involved in an automobile accident. An unrestrained passenger, he was thrown forward, his head into the windshield and his knee into the dash. He was concussed, lacerated, and fractured—his femur broken into two pieces. When we talked about the accident during his convalescence, he told me, "Dad, when I woke up on that pavement, I didn't hurt at all. I felt good. It was wonderful. I never had a feeling like that before."

The strange sense of well-being which may accompany major injury is mediated, as most of us know, by the release within the brain of chemicals known as endorphins. Metabolic energy is directed to the stabilization of injured tissue rather than being dissipated in pain, anxiety, and apprehension. It happens quickly and automatically. We cannot will it. It is nature's gift to us.

The analgesic and euphoric effect of the endorphins is duplicated by morphine. The drug deceives the body to its benefit by replicating nature's agency for the relief of pain. An attribute of the opioid effect, whether indigenous (endorphin) or exogenous (morphine) is that it is short-lived. It has to be. A state of analgesia and euphoria, so valuable in the face of overwhelming injury, cannot be sustained. Vigilance, attention, and awareness are lost, and that is detrimental. The being can no longer react appropriately to its environment.

You can read the rest in Dr. Cochran's book, Understanding Chronic Pain

Last Updated: Nov 19, 07:58 AM

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The Story of Bruce from the Introduction What is Chronic Pain?