Spectrums; a sociopolitical perspective on pain

When some of you hear this blog title, you may cringe, or turn off in angst. What kind of dickhead blogs about politics and pain!? Well, I do – I blog about politics and pain because I think they have a lot to do with each other. Let me explain.

Spectrums are everywhere we look. And the zeitgeist of the time pushes the ‘popular opinion’ pendulum between each ends in none moreso than allied health practice and musculoskeletal pain treatment. Here are just some of the spectrums you might recognise.

Now a few points:

  • The arrow is a pendulum, NOT MY PENDULUM.

Because, before you ask, I would consider myself a radical centrist in most of these spectrums (just like my political bias itself..).

  • The pendulum will always swing to and from one end of the spectrum, and I’ve placed it fairly arbitrarily to an end that captures what I believe the current Zeitgeist translates to.

  • No, I’m not saying these things are a spectrum at all. In fact I think these things people should be able to hold multiple conflicting ideas and ideologies in their head at once, making these spectrums redundant – more like a circle – and in fact, some people obviously can. So if you are one of these people, stand up loud and proud and I mean no offense.  

In the political realm, the left-right spectrum is relatively new – French Revolution of 17th century is where the ‘wings’ were originally coined. And just like in my imaginary spectrums above, it is very arbitrary – because multiple issues will be taken in an individual context and it’s obviously very common for someone to take a ‘left’ stance on one issue and a ‘right’ stance on another. It’s really imperfect, but it is what we’ve got currently.

What happens to Pendulums?

They stop swinging and generally settle somewhere in the middle. So I think the salient questions are is this a good thing for treating people in pain? My opinion is that in some instances it is not. And secondly, is this actually going to happen in our realm? Will we have a settling effect? My initial thoughts are that the evolution of clinical practice has been drastically sped up by the uptake of evidence based practice and my spectrums above don’t really do this fact justice, so maybe we will have a constant march towards improvement. Then again, some say this is the case in the political sphere as well.

A sociopolitical spectrum of pain?

Now, try to get rid of any of your political bias for a second and tell me where you lie on this spectrum?

Once again, put aside your political bias and hazard a guess at which one is better for the society.

I’m not calling you a socialist, but are we all ‘pain’ socialists?

We all got into this game to treat pain. And it is fairly clear, that presently, what has been happening for the past 40 years has not actually been treating pain. There is some evidence to show it is actually increased by our presence (Ref, Ref, Ref). Now, I think we need more evidence before we go bandying around the notion that we – as health professionals – may have actually been contributing to a global burden, rather than helping it, for the past 30 – 40 years, but I have blogged about this before and I do think we have a lot to answer for.  Our system for managing this global burden has not been working, we have not been solving a problem, we have – if anything – been simply ‘farting in the wind’ as the structures around us ramp up a pain epidemic around us. Asleep at the wheel.

Things are different now, though. At least from where I stand. People are waking up to the power of their words, the power of the way they manage people who have high likelihood of becoming a chronic pain patient. There are a lot of good people out there who are now trying to turn the tide and get the message out. That we need to do better, that we need to change the way we are doing things to ensure we no longer sit idly by and watch the steamroller of persistent pain envelope our society. If you are reading this, then you already know who these people are – people like @thesportsphysio, @drjaraodhallpt, @bencormack, @thephysionetwork, @thefreshmanphysio, @hannahmoves, @thekettlebellphysio – I could go on and on! These people are working hard to promote better clinical practice, higher value care and to change the way we use lower value interventions that create dependence and disability.

Whether you like the term socialist or not, you are probably reading this because you think we can do a lot better – individually and collectively – to help the collective (no, I won’t call them the proletariat ! ) in pain. And what I mean here is that, you are part of a community that is bandying together to change minds, change practice and alter the course of the ‘old way’. Maybe we should call ourselves radicals, not socialists. But we are definitely doing it for the good of the whole of society, so give yourself a big pat on the back.

So what camp do you belong to? Can you get other people into our camp? This is, unfortunately, going to sound very Marxist, but here goes.. Viva la Revolucion! We need a new world order, and are you going to stand around on the right or are you going to fight with us on the left to change the pain burden experienced by society?

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