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A group heads up the Mountain View Trail at Wind Wolves Preserve.

As a physical therapist, one might think that I see athletes or treat shoulders and knee pains all day. In fact, this was my vision of physical therapy about four years ago before I began practicing.

Sure, my trade is orthopedic- and musculoskeletal-centered, but over the last couple of years, I have been able to testify to the overwhelming amount of people in Bakersfield who suffer from persistent or chronic pain. This type of pain is generally described as pain that persists past normal healing time.

According to a recent study done by John Hopkins University published in the Journal of Pain, health care economists report the annual cost of chronic pain in the United States to be $635 billion, which is more than we spend per year on cancer, diabetes and heart disease.

Unfortunately, pain is part of the human experience, where each one of us will confront occasional aches and pains. Acute pain is an important reaction of the nervous system that is built in to protect us from potential and even further injury. When an injury occurs, pain signals travel from the injured area up your spinal cord and to your brain. Think of a bare hand over the hot stovetop analogy. But what happens when you experience chronic or persistent pain?

Assuming that normal tissue healing has completed through stages of inflammation, remodeling and maturation, why do the pain signals continue to relay?

Simply explained, we tend to understand that the human body has a brain, but we forget that the human brain in fact has a body. The nervous system undergoes a drastic rewiring process after losing signals, such as a missing body part, that can result in pain or even a dysfunction in sensory output where the patient may experience sensation on the missing limb by touching the opposite leg or arm.

Modern pain science demonstrates a similar process occurring with the nervous system when the body part or segment is neglected by nonuse, say in a case where a patient suffers from chronic low back pain.

Chronic pain is often unrelated to tissue damage. In fact, studies have shown that chronic pain conditions have been related to several other factors like mood, sleep, thoughts and emotions. Chronic pain has also been linked to other health problems such as obesity, depression, anxiety and stress. We know that pain is not exclusively housed or controlled by the nervous system, rather, pain emerges from the nervous system’s interaction with other systems in the human body like the endocrine system and immune system. This makes the human pain experience incredibly complex and, therefore, a central control “switch” to rid someone of pain forever does not exist. In order to actively manage and control our individual pain experience, we must change the behavior of the system as a whole.

So, if you are experiencing pain lasting longer than three months, ask yourself if you are stressed. Ask yourself if you exercise your body. Ask yourself if you eat a balanced and healthy diet. Ask yourself if you are getting adequate sleep. Analyze your interpersonal relationships – are they healthy?

Pain is complex. We cannot fix a complex problem with a simple solution.

Opioids and surgeries have shown to yield poor outcomes in long-term follow-up pain studies, not to mention the inherent risk of death that may occur. The health care system can often be disarming to patients at times.

You need to be active in the management of your own health – it is your responsibility. If you sit eight hours a day at work, try yoga to reverse your posture and improve your spinal and hip mobility. If you eat garbage, stop. Quit smoking. Quit drinking. Get adequate cardiovascular exercise. Make your exercise meaningful and set goals for yourself. Become ritualistic about movement and understand what you put into your body. Finally, educate yourself.

The best exercises and diets are not typically what Hollywood is telling you. They are SMART – simple, measurable, attainable, realistic and timely. 

Paul is native to Bakersfield, graduating from BHS in 2001 and later from CSU Bakersfield in 2010. Following a five-year enlistment as a U.S. Naval Search and Rescue operator, he earned his doctorate in physical therapy from Rocky Mountain University of Health Professions in 2013. Paul specializes in orthopedic rehabilitation, sports injuries, vertigo management and helping patients who suffer from chronic pain conditions.

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