The Pain Revolution

December 19, 2019

The following blog post was written by Rebecca McDonald, B.Sc., M.O.T., who is the co-founder of the British Columbia Pain Collective, a community of health care professionals to advance the understanding of pain neuroscience, rehabilitation and recovery. 

Merriam-Webster definition of a revolution: activity or movement designed to effect fundamental changes in the socioeconomic situation; a fundamental change in the way of thinking about or visualizing something; a change of paradigm

It is no coincidence that Professor Lorimer Moseley and a team of passionate researchers and clinicians in Australia have coined their movement, which is directed toward spreading pain neuroscience education, The Pain Revolution.

Sadly, while we have accumulated mountains of literature and a great depth in understanding on the science of pain (knowledge fraught with enormous complexity, hope and opportunity), many health care providers and clients alike are stuck in old ways of thinking.

Why do we care? We care because the old way continues to perpetuate unnecessary fear, disability, illness, and pain. It’s been 55 years since Ron Melzak (a Canadian!) and Patrick Wall began to revolutionize our understanding of the complexity of pain with the Gate Control Theory. Melzak has since helped us move beyond this theory, in order to better explain the complexity of pain, with the Neuromatrix theory 30 years ago. And yet, I dare say, most, healthcare practitioners are stuck in the Descartian paradigm of hurt equals harm, which dates back about 355 years ago.

So why are we so stuck? The answer is likely complex and involves factors such as limited time to stay on top of the research, educational systems that continue to ignore shifts in best practice, financial disincentives to changing the way we practice, conflicting patient expectations, pride and fear in admitting we were wrong, etc. etc. etc.

And we all seem to be affected; all helping professions continue to struggle with adopting a new way of practicing. To be clear, by a change in practice, we do not mean merely sprinkling some pain education into your client interactions. To quote one of my favourite pain therapists: “We should turn pain science into the air we breathe, not the thing we do”. By this, Sandy Hilton suggests that we should move beyond using pain education as a treatment tool, but rather, an up-to-date understanding of pain neuroscience and rehabilitation should inform every element of our thinking, language, tools, and care environments. Admittedly, it is a very challenging time to be an up-to-date pain therapist; often a feeling of swimming upstream, a lone voice of reason amongst a sea of antiquated sludge.

So why do we persist? Because the evidence compels us. And we are fortunate to have truly inspirational leaders in the field like Lorimer Moseley, David Butler, Beth Darnall, Mick Thacker, Adriaan Louw, Bronnie Thompson, Mark Hutchinson, Johan Vlaeyen, Jon Kabat-Zinn, Michael Sullivan, Frank Keefe, Greg Lehman, Neil Pearson and many many more.

And, of course, we want to be part of the change. When a health care provider takes the time to power up with current literature and best practices in pain care (and accept that your previous care may have been unhelpful, at best), they take the first step forward. They can then practice a new way of speaking and behaving with clients and themselves. They start to rebuild their vocabulary and stories. They begin to see how they can help people in a way that feels authentic, empowering, and sustainable. And suddenly they are part of a revolution.

The tide is turning, and there will be no turning back. The British Columbia Pain Collective will strive to share with you thought provoking new research, consensus on best practices, evidence based resources, personal insights, clinical pearls, humbling failures, and small and large successes from our growing community. Come join the revolution.