Professional Documents
Culture Documents
OVERVIEW
I never knew such pain existed. Several years ago, my neck suddenly
went bonkers—a long-lurking arthritic problem probably exacerbated
by too many hours spent hunching over a new laptop. On a subjective
scale of 0 to 10 (there is no simple objective test for pain), even the
slightest wrong move—turning my head too fast or picking up a pen
from the floor—would send my pain zooming from a 0 to a gasping 10.
Sitting in a restaurant was agony if the table was too high, which
forced my arms and shoulders up. So was sitting in the movies, look-
ing up to see the screen. Shifting from sitting or kneeling on the bed to
lying down was excruciating—there is simply no way to do it with a bad
neck. Even silly little things like bending forward to try and paint my
toenails became impossible.
During these episodes, which happened many times a day for
months, I couldn’t talk through the pain, though mere words couldn’t
have captured the pain’s intensity anyway. So new, shocking, and incom-
prehensible was all this that I felt utterly alone, convinced that no one
had ever felt like this before. But, of course, I was not alone. America,
as I soon discovered, was then—and is still—in the midst of a chronic
pain epidemic.
At first, I tried to cope by myself, with handfuls of ibuprofen, lots of
stretching, and extra computer breaks. I kept on working as a nation-
ally syndicated health columnist based at the Boston Globe and I kept
hosting my weekly radio talk show. I also kept going to the gym and
swimming three times a week. I kept singing and performing with
my classical music group, too. And, of course, I kept hanging out with
friends and family. Best of all, I continued to enjoy a new romance.
But as the months ticked by, the pain only got worse, so I sought
help from the medical system, a system I thought I knew well, having
covered it for decades. In fact, as the Globe’s “Health Sense” columnist,
I probably had the best address book in town, filled with the names of
hundreds of eminent doctors. A funny thing happens, though, when
you become a powerless patient, not an on-top-of-things journalist.
The medical system I encountered as a person with pain was shockingly
different from the one I thought I knew. And it was almost completely
unprepared to help.
My first doctor, a young, female physiatrist (rehabilitation specialist)
who came highly recommended, was initially nice. But over the course
of our visits and escalating medications and injections, she seemed to
grow angry when I didn’t get better. At one point, she told me, rather
coldly, that we had 10 minutes, during which we could either talk or
I could get “trigger point” injections. Then, during what would end
up being our last visit, she seemed to imply that my pain was caused
by some emotional problem. I wanted to scream, “You bet I’m emo-
tional—I’m in agony!”
Eventually, a magnetic resonance imaging scan (MRI) would show
several almost-herniated disks in my cervical spine, as well as verte-
brae sliding over each other (a condition called spondylolisthesis) and
bone spurs stabbing my nerves. My facet joints (small joints that help
stabilize the spine) showed arthritic damage. (I was actually lucky. Many
people with back and neck pain have normal MRIs, while other people
with no pain have disastrous-looking scans, a puzzle doctors can’t figure
out. At least mine showed something.)
More technically, what appeared to be happening was that my
inflamed, irritated cervical nerves were firing almost nonstop, caus-
ing the trapezius muscle in my left shoulder and neck to spasm. The
spasming in turn caused my head to twist bizarrely toward my shoulder
(a condition called cervical dystonia), where it would stay “frozen” for
long periods, forcing me to use both hands to turn my head back to a
more or less normal position. The resulting pain was twofold: a searing,
burning nerve pain that ran in a straight line from my neck to the top
* * *
One hundred million American adults live in chronic pain, according to
a 2011 report from the prestigious Institute of Medicine, an arm of the
National Academy of Sciences.1 In 2010, that was more than 40 percent
of the US adult population, 235 million.2 That is a staggering figure, to be
sure, and it’s based on one massive study.3 But it fits with other estimates.
A 2012 Gallup telephone survey of more than 353,000 American
adults found that 47 percent were suffering from some type of chronic
pain, a figure that translates to 111 million people.4 Other estimates put
the prevalence at about one-third of adults.5, 6 A 2008 telephone survey
of nearly 4,000 randomly selected Americans found that on any given
day, 27 to 29 percent said they had been in pain during three randomly
selected 15-minute periods that day.7 A 2006 telephone survey of 46,394
Europeans in 15 countries showed that 19 percent had suffered pain for
six months or longer, with pain in the moderate to severe range.8
To be sure, not everyone suffers chronic pain as badly as I did. But
many have it much longer, and much worse. In fact, some people in
chronic pain—a tenth to a third, depending on the estimate—hurt so
badly they can’t function.9, 10, 11, 12
Usually defined as pain lasting three to six months or more, chronic
pain is vastly different from short-term, acute pain. It can transform life.