My Story: Changing the Chronic Pain Polarity

My Story: Changing the Chronic Pain Polarity

Editor’s Note: Dr Kent Smalley is a physician with history of personal pain illness issues and a voice for integrative healthcare philosophy, public health as well as an advocate for chronic pain & chronic illness sufferers. Read more about him on his website.


Chronic Pain care is not an either or proposition. And yet, it seems to be.

Polarization seems to be the unavoidable thorn in our society, but when it comes to major public health issues we need to change the discourse to a framework of healing principles. We have 2 growing crisis in the United States that need to be addressed; the inadequate treatment of chronic pain and the growing addiction problem.

Opiate misuse is certainly a major problem. The overdoses, accidental deaths and addiction numbers are astounding and have increased dramatically over the last decade. But at the same time we must recognize that there are people that need chronic long-acting opioid therapy and must have access to them for function and quality-of-life; these include patients with cancer, neuropathic pain syndromes and severe arthritis to name a few. It’s not the medications that are the problem; it is the people misusing them.

There are more and more strategies, caucuses and agendas regarding these issues but there is a great divide with polarizing discourse. It’s seems like two great armies both making dogmatic, reductionist, all or nothing, punitive statements that do not bring us closer to solutions or forward moving policy. I say we need to come together under the banner of healing, framing the discourse in recovery principles: education, rehabilitation, research and wellness. We must focus on education of patients, caregivers and healthcare providers on proper use of medications and all the opportunities for restoration of wellness. Also we need to focus education on opportunities to turn down the volume of pain like the complementary methods; herbal supplements, exercise, imagery, mindfulness meditation and hands-on therapy. Additionally, we need more funding for research, so we can discover the best validated conventional and complementary methods for treatment.

How to help now

  • Change your discourse to a healing one
  • Do your homework –get educated
  • Work with your healthcare providers
  • Politic, let’s get more research and education funding.

We need to come together for recovery for the sufferers of these diseases and make therapeutic opportunities available in a safe effective way.

It’s about time don’t you think?

Dr. Kent


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Authored by: Dr. Kent Smalley

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Steve M

I don’t think that generalizations about “young people” are productive or accurate. If we’re going to generalize, middle aged, middle class pill poppers got us into this mess. Most people under 30 that I know avoid opioids like the plague because of propaganda and yoga can make pain worse, although most people try it regardless of age (well, maybe less in the boomer generation) and every pain patient I’ve ever met uses relaxation, either intentionally or as a natural response.

This idea that anyone jumps straight to opioids is nonsense. Those of us who use them use them because nothing else works.

Instead of yoga, which can be dangerous, physical therapy is a much better recommendation.

Before COT (chronic opioid therapy), I did the following (I’ve done more since and this list is incomplete and off the top of my head):
* SEVEN MONTHS of aquatic and “land” physical therapy (3 days a week, plus daily homework)
* NSAIDs (which caused bleeding ulcers)
* acetaminophen/paracetamol/Tylenol
* relaxation
* muscle relaxers
* antidepressants (Cymbalta, Prozac, tramadol, Savella, etcetera)
* massage
* thermacare hot packs
* ice packs

Becky Roberts

Dr. Kent, you are so right, the major issue with Chronic pain is research.. There are so many diseases that are not even known about that cause chronic pain, and until research is taken seriously There will be no steps taken to help all of us that suffer daily. Thank You for being on the side of chronic pain..


Chronic pain patients also need to read and know exactly what federal and state laws say regarding the prescribing and filling of pain meds. That way thet know what the laws actually say and can discuss them.

Nancy Ribok

I agree with some of your statements about chronic pain and opioid addiction. I dont believe its the chronic pain patients that are miss-using pain medication. The problem for chronic pain is the difficulty in access and their treatment as if they are “drug seeking” . They are having to have urine tests and are tested to see if they may in the future sometime become addicted. Many patients have given up trying to obtain much needed pain relief, some committ suicide, some become totally disabled due to their pain. Medical professionals need to be aware of new treatments and become experts in pain management. They need to teach their patients about how to take these meds and what side effects they may encounter, they need to monitor then for effectiveness and proper use.
As to addiction, these people have a true mental and physical problem. They need effective treatment and therapy. Also, often they use drugs they have bought on the street, or heroin and other powerful and not legal and very dangerous drugs. They sometimes die because they didnt realize the strength or they too end their own lives due to the way the must live in order maintain this addiction. Often times the death will occur right after they are released from treatment.
This is what i have researched while trying to find the best treatments for my own severe chronic pain from fibromyalgia, which currently has no cure. These two issues are related, but should not be treated the same at all. Thank you.


I see so many of the younger people who avoid trying relaxation, yoga herbals etc and thinking they just need taking drugs upon drug for their pain. Some do but I think a lot don’t try to work it out. I did and lived and worked with chronic pain for half my life without doing drugs. But my 60’s came and on top of my already chronic pain came new pains and surgeries. And now I do take pain pills every 4 hours to dull the pain and to be able to still do a few things around home. Without them I would not be here. I have been offered all sorts of other meds and patches to help out too but after trying them all, they are not for me because I want to live what life I have left clear headed , not walking around like a zombie or stay in bed every day. I am fortunate to still be able to get around some with a walker. Trust me, if I could I would still be doing healthy gentle exercises. You are only young once. You won’t get another chance to live those years again. I am still proud that I was able to hold on as long as I could so I could live.