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Pain & TreatmentDr. Lamb’s Uncommon Sense For Common PainsDr. G. Blair Lamb MD C.C.F.P. My area of special interest is actually a relatively new area of medicine called myofascial pain, which simply means muscle and tendon pain. However, you will learn it is much more than simple muscle problems. To really understand pain, I must first take you back into what I call the Principles of Pain. Some of these principles are theories of mine and some are clearly proven, yet not well known. They have tremendous importance in the understanding and treatment of pain and actual disease. On this website, I will be offering my opinion, which should not be considered direct medical advice. Always seek the opinion of your own knowledgeable professional before embarking upon any of the concepts I discuss here. I am a Logician and a Darwinian!A logician is simply a person or animal who uses logic, or what we sometimes call common sense, to solve a problem. My dog uses logic to figure out how to open up my cupboards in the kitchen, and steal a snack. Animals use logic, and so do we all. I am simply reminding myself that I should because logic, used in steps, helps a person solve complicated problems as a series of small problems. Seems logical doesn’t. The statement I often make that I am a Darwinian simply refers to Charles Darwin’s theories of natural selection, evolution and adaptation. It helps to explain why we develop many of the pain problems we do. We need to recognize that a certain adaptation is generally good, but can sometimes be bad. For example, white fur on a fox in the winter helps the fox hide from larger predators. If that fox remained white in the lush and warm summers, the white foxes would all become snacks for some larger animals. Eventually, foxes would mutate and adapt to have white fur coats in the winter, and darker, gray-brown fur coats in the summer. So the fox adapted by natural selection, over time. Now the time can be quick or gradual depending on the importance of the adaptation. Pain could be considered a very important adaptation. Many of my patients would probably argue this point, but, nevertheless, pain can save your life, and in a world of natural selection, this is good. A good example is diabetes. Diabetic patients often lose the ability to feel any pain on the bottom of their feet and legs. This lack of feeling occurs because some of the nerves in the feet and calf die from the high sugar in their blood. All diabetics need to check their feet regularly, because they may not feel a cut or injury in their foot, and they can develop a serious leg infection and lose their leg or even die. So pain can save your life. Now many of you are wondering why diabetes still exists if problems like that can occur. The tendency to diabetes exists in about half our population. It exists because in a world where starvation can exist, insulin resistance, which is a precursor to diabetes, allows you to survive better. This does not mean diabetes is good but that it’s precursor is helpful in a world of starvation. These rules do not really apply today in North America, so we may see a change. Now pain that goes awry is not adaptively a good thing either. Most of the pain problems and principles that I will explain in these pages apply to an aging population in a technically advanced society. So many of these pain principles may have been helpful in a more primitive, simple society. So What is Pain? Click the link in the left margin to continue through these concepts.
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