Haven’t Got Time for the Pain

Here’s the breaking news in pain relief for baby boomers

A WHILE BACK, MY RIGHT ANKLE started hurting. It hurt when I played tennis and during my weekly volleyball game. The pain wasn’t excruciating. On a scale of one to 10, it was maybe a three. “Nagging” would be an apt term.

I’m 50 years old, so part of me was thinking, “Well, you’re 50 years old; things are going to start hurting.” But I wasn’t about to give up volleyball. So I went to see a foot doctor. “It’s the way your feet are made,” he said. “There’s nothing I can do. Stay off it as much as you can.”

Twenty years ago, I would have listened to the doctor. He knows best, right? That’s how my parents thought. What made “The Greatest Generation” so great was its stiff upper lip. Arthritis, back pain, sore muscles — these were trials to be endured. What didn’t kill them made them stronger. No pain, no gain.

Boomers are the Whiniest Generation. We don’t believe that pain makes you strong; we think that pain makes you cry. Hurting is bad. Stoicism sucks. From Watergate to bottled water, we’ve spent our lives reacting against our parents’ values. To us, the medical establishment is just that: The Establishment. And if doctors can’t help us, then to hell with them. Who needs a doctor when it’s so much cooler to have your chakras rebalanced? Herbal medicine … well, isn’t that like pot? The result of this revolution is that Americans now spend some $50 billion a year on “alternative medicine” — and much of that is out-of-pocket, since insurers tend not to cover Reiki therapy.

And guess what? Once hospitals noticed all that money being siphoned off to herbal remedies and homeopaths, the strangest thing happened. The Establishment that always told us those folks were charlatans couldn’t move fast enough to take them under its wing. Philadelphia, for once, has been ahead of the curve on this trend. Jefferson has its Myrna Brind Center of Integrative Medicine. (“Natural medicines, acupuncture, meditation, massage.”) Riddle Memorial in Media offers chi gong and laughter therapy. All over the region, hospitals and treatment centers are serving up new approaches to what experts have called the current “epidemic” of chronic pain.

They’re going after patients like “Paul,” a 50-year-old Main Line ­father of two who suffers from temporomandibular joint syndrome, or TMJ. Pain flares in his jaw when he’s stressed or unhappy: “It took every ounce of joy from my life. It hurt even to talk to my little boys.” His search for relief began with his dentist and has since led to doctors, painkillers, an orthodontist, biofeedback, a shrink, hypnotism and three chiropractors. Now he’s seeing an acupuncturist.

Eastern medicine practitioner Ian Cyrus, who works at Myrna Brind, admits that if he were in a car accident or had a raging infection, he’d beeline for the emergency room: “That’s where Western medicine excels.” But it’s not so hot at pain management. Some 90 million Americans, like Paul, experience chronic pain, from aching ankles to migraine headaches to lower-back spasms.

And we’re scared of our pain. We’re afraid of the way it takes hold, undermines our will, gets into our heads. “Experts suggest pain is 60 percent physical and 40 percent psychological,” says physiatrist Matthew Schwartz, of the Montgomery Rehab Hospital of Chestnut Hill. Pain has its uses, he points out: “It alerts the captain at the helm — ‘Hey, I’ve been hit by a bomb, my leg is missing.’” It’s protection, too, when it tells you to stay off an injury. But scientists are now unraveling how pain can feed off itself, actually rewiring our brains, building channels that nerve impulses follow long after an injury is gone. What we continue to experience is only the ghost of pain — but it’s no less devastating.

It could be that Eastern medicine, with its emphasis on mind-body integration, is better suited to addressing the puzzle that is pain. Or it could just be that aging boomers, disillusioned with doctors who shunt us in and out in 10-minute intervals, are thrilled to drop a hundred bucks on acupuncture if the therapist strokes us and soothes us and makes us feel we’re the center of the universe. But it’s not all touchy-feely. Research is proving just how individualized our experience of pain is. There’s a genetic component: Some of us are born stoics; some of us are weenies. There’s a family in Pakistan that doesn’t feel pain at all; scientists recently identified the gene mutation behind that. (And in case you’re envious, the family’s babies sometimes bite off their tongues, since nothing warns them not to.) No wonder science seems to be at a disadvantage: Pain is so subjective that sometimes what should hurt doesn’t, and what shouldn’t does.

That doesn’t mean the West is throwing in the towel. While the East focuses on the big picture, Western medicine is trending small, developing an arsenal of weapons that literally micromanage pain, like tiny implanted drug pumps, and invisible energy waves that zap nerve tissue. And it’s Western scanning technology that’s mapping out exactly what goes on in our brains when we experience pain.

Where the East may have something to teach the West is in what Penn shiatsu therapist Wayne Mylin calls “the differentiation between pain and suffering.” “Pain is pain,” says Mylin. “Suffering is a person’s relationship to that pain.” What patients struggle with isn’t so much their pain as their emotional responses to it — fear that they’re getting old, anxiety that the hurt may be permanent, frustration that they can’t enjoy life the way they once did. At the bottom of pain’s Pandora’s box, though, lies hope. A recent study of patients treated with acupuncture for migraine headaches, low back pain and osteoarthritis showed that the more they believed being stuck with needles would help them, the more it did.

What East and West agree on is that our lives are out of whack. Today, Matt Schwartz says, “You have to be 24/7 — connected to the pager, the cell phone, the BlackBerry.” The result? Our sympathetic nervous systems are always near panic stage — “as if our survival is at stake.” We work too hard, and when we get the chance, we play too hard. “A lot of us still try to exercise as intensely as we did when we had 25-year-old bodies, and we’re paying the price,” says Peter Clain, a Delaware County Memorial physical therapist.

The best news on the pain front is that between East and West, we have a whole rainbow of potential cures to choose from. The takeaway: Don’t just give up and live with the pain. Chances are something out there — pump implantation, biofeedback, meditation, aerobics — will work for you.

So, how’s my ankle? Nice of you to ask. A month ago, I decided to take up field hockey again after a three-decade hiatus. I’d no sooner joined an adult indoor league than a pert young thing cracked a ball into my right shin so hard that I grew an entire black-and-blue boot. The swelling still hasn’t gone down completely. Funny thing, though. Something about the way I have to favor the shin seems to have helped the ankle. I’m feeling so good, in fact, that tonight I’m trying racquetball.

People like me are the despair of guys like Peter Clain. But we’re going to keep the pain experts in business for a long, long time.