Let’s start off with a few simple propositions. Pain is just an extension of touch. We feel some levels of pressure represent pleasure or are merely acceptable. If the pressure becomes uncomfortable, we are immediately alerted. If the discomfort turns into pain, we are motivated to take action. So the gradations of touch into pain are a necessary part of the bodily process allowing us to avoid injury in our dangerous modern environment. Sadly, we do not have the means to switch off pain selectively. We continue to feel some pain unless the drugs literally induce unconsciousness. This is reality. There’s no sense in trying to deceive ourselves. So the big question is how we organize our lives to live a satisfying life with continuing pain?

This is not what you want to hear. The marketers who aim to sell you the range of drugs produced by the pharmaceutical industry have been brainwashing you for decades. They want you to believe there’s a pill to cure all your ills. Except that has always been a lie. Although some drugs are very effective for a time, all drugs slowly lose their effectiveness as the body adapts to them. This leaves you with the choice of giving up the drugs or increasing the dosage and risking dependence. In fact, we have millions of people addicted to prescription drugs. The majority could not stop without experiencing unpleasant withdrawal symptoms.

Long ago, the Europeans decided this was unacceptable so they have been working to change mindsets. People have to understand they cannot rely on drugs to solve their long-term health problems. They must become more self-sufficient. This is what pain management really means. Specialists have to teach people how to live without becoming dependent on drugs. It all starts with a thorough re-evaluation of the medical treatment to date. Fresh pairs of eyes look back through the records of surgical procedures and other therapies. If anything has been missed, they are now done. If anything may have been done wrongly, attempts are made to correct any adverse consequences. The idea is to ensure everything that can be done to treat the underlying cause of the pain has been done.

Now we come to the pain itself. This is recognized as a medical problem in its own right. There are specialist physicians and highly trained therapists grouped together in dedicated units. Their job is to evaluate each patient and devise a personal regime for maximizing the quality of life. It starts with occupational therapists who visit homes and workplaces, suggesting how living spaces can be designed to reduce problems, and looking to see if jobs can be redefined to reduce the causes of pain. Then come the physical therapists to introduce exercises and activity programs to rebuild strength and improve mobility. Finally, the cognitive behavioral therapists teach practical strategies for staying positive when life seems difficult. All the evidence shows this team approach is very effective. Making the patient the center of attention improves morale and fights off the threat of depression. This is not to deny the importance of a drug like Ultram. There can be a flare-up of pain and, as a short-term response, a painkiller can be essential. But, as soon as possible, the Ultram must go back into the cabinet. Life must go on without drugs.