If you have ever had a headache, try imagining a headache that goes on for days, weeks, months or years. As a migraine sufferer, Pj was interested in speaking with Toronto-are pain specialist Dr. Michael Zitney about the myths and treatments surrounding chronic pain. Dr. Zitney is the director of the Headache and Pain Relief Centre and has devoted the last 15+ years to the treatment and management of chronic pain.

One of the most interesting things about this particular podcast is the de-bunking of the top 5 myths surrounding chronic pain. Dr. Zitney sees things this way:

MYTHS:

5. Chronic headaches are caused by the weather. Yes, we know barometric pressure changes can trigger headaches, but for daily or almost daily headaches, there are always more important triggers (that you CAN do something about). Check the neck, jaw joints and muscles, sleep patterns, diet, caffeine use, etc.

4. Back Pain needs surgery. Only cases that have primarily one-sided leg pain and weakness that haven’t responded to a good course of physical therapy are even considered for surgery. Most back pain by far represents an uncoordinated, inefficient pattern of back muscle firing and responds to a good physical therapy and exercise program.

3. If you can get it over the counter, it must be safe (even in large amounts!). Over the counter pain killers are fine for occasional headache and pain. If you find yourself taking pain killers more often than 10 days each month, you run the risk of triggering even more headaches (called “rebound headaches”), pushing you into a vicious cycle of increasing headache and painkiller use. Also, follow directions. Taking too many pain killers can be dangerous, even if they are non-prescription.

2. MRI shows our pain. MRI, CT scans, and X-rays are just pictures at a moment in time. They may or may not show damage but that is not the same as pain. As many as 60% of us walk around with positive findings on imaging studies but have no pain! Conversely, when someone has back pain for example, much (maybe even most) of the pain is coming from surrounding soft tissue irritation that doesn’t even show up on the test. Doctors should treat patients, not lab results.

1. Opioid (narcotic) pain killers are the best treatment for chronic pain. When pain happens most or all of the time i.e. is chronic, there is always something wrong with our pain processing system and more importantly, our natural pain relief (endorphin) system. The best treatment for chronic pain is to improve our brain’s ability to fight the causes of pain on its own. Only when this proves impossible should we resort to treating ongoing pain with a daily dose of painkillers.

Dr. Zitney can be found on Twitter @mztorontopainmd.

Visit the website for the Headache and Pain Relief Centre: www.headachepainreliefcentre.ca.

If it’s massage or physio or osteopathic or acupuncture or naturopathic treatment or general assessment for pain, patients can just come and get what they need in one place. If you have ever wondered about chronic pain, why it happens and what people can do about it, this podcast is for you.