Your chronic pain may not have a solution

Recently a reader asked for my opinion on a website about a miracle cure for some serious, chronic muscle pain — one of the most common kinds of requests I get. It was one of the most extreme examples of a too-good-to-be-true cure I have seen in a while, and that’s saying something. I've been studying therapies for a wide variety of pain problems for a long time now, and I have seen a lot of well-intentioned but egotistical practitioners claiming to be (a lot) better than the competition, but I have yet to see any evidence that any manual therapist is actually capable of producing dramatically better results than any other.

The “good therapist” is largely a myth, in terms of effectiveness.

The huge majority of people with chronic pain carry right on suffering from pain chronically, no matter who they pay for help. (Nowhere is that story of disappointment told more charmingly than in Paula Kamen’s dazzling book, All In My Head: An epic quest to cure an unrelenting, totally unreasonable, and only slightly enlightening headache.)

I have a low opinion of the ethics of health “professionals” who promise miracle cures to chronic pain patients. Nothing is easier to sell than false hope to people in pain — they are one of the most motivated groups of potential customers there is. Half mad from their symptoms, their minds are pried too far open to bad ideas by agony. They will grasp at any straw, consider anything, and pay for anything, if there is the slimmest possibility of relief.

Nothing is easier to sell than false hope to people in pain — they are one of the most motivated group of potential customers there is.

Exploiting people in that mental state is morally equivalent to the work of faith healers. It’s low. It’s cruel. Good intentions and the occasional placebo effect cannot give it honour.

The ugly truth is that not every health problem has a solution, and this is particularly true of most chronic pain problems. Any honest chronic pain specialist — physician or manual therapist — will tell you that. But a century of genuine scientific miracles, one after another for decades, has given us all a collective case of medical overconfidence, and it seems as though there “must” be a treatment out there, somewhere, for every problem.

But the only miraculous thing about most quack cures for pain is the size of the egos behind them. So much for “humility” in alternative medicine.

Over the years, I have been told by a few manual therapists that it would “put them out of business” if they were honest about their limitations. That’s a strange combination! Admitting in one breath that you have limitations, but carelessly concluding in the next that you daren’t admit it — how tagic and untrue. Patients deeply appreciate candid honesty, even self-deprecation. A therapist’s practice can easily be built-in on overt humility.

Pain is tough to treat, period. In your search for relief, stick to professionals who are candid about that: they are the ones who are actually more likely to find a way to take the edge off a little, and not take your money for bogus treatments. That’s mostly what makes a “good therapist.”